What is Sclerotherapy?

Sclerotherapy is a medical procedure used to eliminate spider veins. Sclerotherapy involves an injection of Asclera ampule directly into the vein. The solution irritates the lining of the blood vessel, causing it to collapse and stick together and the blood to clot. Over time, the vessel turns into scar tissue that fades from view. Sclerotherapy is a proven procedure that has been in use since the 1930’s.

Candidates for Sclerotherapy

Prior to sclerotherapy treatment, you will have an initial free consultation to decide if you’re a good candidate for the procedure. You are not eligible if you are pregnant. You can have sclerotherapy if you take birth control pills. If you have had a blood clot in the past, your eligibility will be decided on an individual basis, and will depend on the overall health of the area needing treatment as well as the reason for the clot.

How Sclerotherapy is Done

In most cases of sclerotherapy, Asclera is injected through a very fine needle directly into the vein. At this point, you may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected. The procedure itself takes approximately 15 to 30 minutes. The number of veins injected in one session depends on the size and location of the veins, as well as the general medical condition of the patient.

What to do Before Sclerotherapy:

  • No lotion should be applied to the legs before the procedure.
  • Some doctors recommend avoiding aspirin, ibuprofen (such as Advil)

Spider Veins and Varicose Veins

Spider veins and varicose veins are practically a rite of passage. As we age, many of us find the jagged purple lines or swollen bluish cords spreading across our thighs and calves. These warped blood vessels occur in up to 60% of adults.

What Are Spider Veins?

Spider veins are small, twisted blood vessels that are visible through the skin. They may be red, purple, or blue and most often appear on the legs or face. They take their name from their striking spiderweb pattern.

What Are Varicose Veins?

Varicose veins are larger blood vessels that have become swollen and twisted. They appear dark blue and stick out from the skin like raised tunnels. Varicose veins can develop anywhere in the body, but usually sprout on the legs and ankles.

What Causes Spider/Varicose Veins?

Healthy veins carry blood to the heart through a series of one-way valves. These valves allow blood to flow in the right direction from superficial veins to deeper veins and to the heart. The vessels are surrounded by muscles which contract and help pump blood to the heart. Normally the veins have a one-way valve to prevent backflow. However, problems with the valves, muscles or blood itself can allow blood to pool inside the vein. As blood pools within the vein, pressure builds and the vessel wall weakens. As a result, the vein tends to bulge and twist. Depending on the size of the blood vessel and extent of swelling, the result is a spider vein or varicose vein.

Who Gets Spider/Varicose Veins?

Anyone can get spider veins or varicose veins, but women are twice as susceptible as men. The problem is also more common in people with jobs that keep them on their feet, including nurses and teachers. Other factors that may contribute include aging, obesity, pregnancy, prior trauma, or surgery to the leg and a genetic pre-disposition.

Spider/Varicose Vein Symptoms

For some people, spider veins and varicose veins are more than an eyesore. Varicose veins in particular may cause aching or cramping in the legs. The affected area may throb, burn, tingle, or feel heavy. Severely inflamed veins can be tender to the touch and may reduce circulation, leading to itchy, swollen ankles. They can also produce chronic skin and tissue changes such as discoloration and ulceration of the skin.

Spider/Varicose Vein Complications

Spider veins and varicose veins may be unsightly and annoying, but they rarely pose a serious health threat. Occasionally, they may contribute to ulcers forming– large sores in the skin — especially near the ankles. Varicose veins can also form painful blood clots.

Diagnosing Spider/Varicose Veins

Spider veins and varicose veins are easy to diagnose. Your provider simply looks at the patterns on your legs, feet, or other affected areas. He or she will also check for swelling, tender spots, ulcers, and changes in skin color. Most spider veins and varicose veins don’t need to be treated, unless they result in ulcers, bleeding, and phlebitis, or because you want them removed for cosmetic reasons. If the veins are causing pain, soreness, and muscle fatigue or cramping, there are steps you can take at home to reduce the symptoms.

Treatment: Support Stockings

The simplest treatment for spider veins and varicose veins is to pull on a pair of support stockings. Sometimes called compression stockings, they improve circulation and relieve pain and discomfort in the legs. You can find them in knee-high or pantyhose style at surgical supply stores and some pharmacies.

Treatment: Lifestyle Changes

Losing weight and walking regularly can ease the symptoms of spider veins and varicose veins. If swelling is a problem, try a low-salt diet to reduce water retention. Whenever possible, prop up your legs with a pillow or recliner, so they rest at or above the level of your heart.

Treatment: Sclerotherapy

If home remedies don’t yield enough improvement, there are medical procedures to eliminate spider veins. Sclerotherapy wipes out 80% of treated veins. A nurse injects a solution directly into the abnormal vein. The blood vessel is destroyed, becomes fibrotic, and eventually disappears. A thorough evaluation prior to the treatment is necessary to avoid side effects such as discoloration, or the formation of new, superficial tiny blood vessels.

Treatment: Before and After

After treatments with sclerotherapy, spider veins generally disappear in three to six weeks. Once gone, the veins do not reappear. But you will probably develop new spider veins at the same rate as before.

Preventing Spider/Varicose Veins

Getting plenty of exercise is the best way to ward off spider veins and varicose veins. Exercise helps keep your weight under control and your leg muscles toned, so your blood will flow freely. If your job keeps you on your feet, stretch your leg muscles often to increase circulation. And if you’re pregnant, try to sleep on your left side rather than your back.

Patient Instructions for Sclerotherapy

  • Eat a nutritious breakfast/lunch prior to the procedure. Maintain adequate hydration prior to and after the appointment.
  • You may experience bruising, tenderness, swelling after a treatment. The veins often respond to the sclerosant medication with an inflammatory response. Arnica Gel or Cream may be used during your treatment process to speed the healing of bruises. Arnica does not require a prescription and can be purchased at Whole Foods and some local pharmacies.
  • Please have Motrin/Advil (Ibuprofen 200mg: Take three tablets every eight hours with food) or Aleve (Naproxen 225mg: Take two tablets every 12 hours with food) available at home. You will be encouraged to use one of these medications for up to 2-3 days after a treatment. Please let us know if you are already taking a prescription anti-inflammatory like Celebrex or Mobic.
  • You should expect some discomfort in your leg during the first 24 hours. You may find that your leg feels tender, achy or tight. Muscle cramping is also common as well as bruising. You may also develop a red streak or blotching over treated areas. These are normal reactions to the treatment. Other commonly noted symptoms include itching, throbbing, fullness and swelling. These symptoms will be most notable when you get up and may peak 24 hours following a treatment. An ice pack or bag of frozen vegetables wrapped in a paper towel may be helpful when applied to your leg for 10 minutes three times a day. “Trapped blood” may develop, usually in 2-4 weeks following a treatment session. This occurs when the blood gets caught inside the vein as it heals. This area may feel “bumpy” and tender to the touch. This is an expected side effect with sclerotherapy. If it causes too much discomfort, it can be easily treated in the office at your next follow-up visit.
  • Please limit exercise to walking on the day of a sclerotherapy session. Running, weightlifting and other high impact activities may be resumed the next day.
  • Please do not take a shower for 2 days after your treatment.
  • Please avoid flying for 48-72 hours and long car trips following the procedure.
  • Please bring your compression stockings to the office. We will only require you to wear stockings on the leg we treat. You will be asked to wear the compression stocking during the day for 3-5 days following the procedure.
  • Please avoid use of iron containing supplements during the first 4-6 weeks of your treatment protocol.
  • Please avoid excessive sun exposure and use sunscreen (SPF >30) regularly.