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Sclerotherapy

Varicose veins and spider veins are a very common disease that affects over half the world's population. The reason for the onset of varicose veins is still unknown but certain factors such as heredity seem to play a decisive role. The condition can be aggravated by pregnancy, menopause, obesity, aging of body tissue, and the use of birth control pills and other hormone therapy.

Varicose veins are veins that have become permanently dilated. They impede blood flow and hinder the return of blood to the heart from the lower parts of the body. When the valves in a vein become damaged, they are unable to function properly and reflux can occur. In other words, blood may flow backwards away from the heart. This can lead to congestion and bulging of the veins, making them visible and unsightly. But with proper treatment, varicose and spider veins can be controlled.

PREVENTION

There is no known method of total prevention for varicose and spider veins, although wearing prescription compression stockings purchased through a medical facility may prevent some unwanted vessels from developing. Maintaining a normal weight and regular exercise is also very helpful.


Procedure

It is suggested that each patient bring a pair of loose fitting shorts to be worn during the procedure for their personal comfort.

A sclerosing agent is chosen according to the size of the vessel to be treated. A very fine needle is used to inject the solution directly into the vein. Cotton balls and tape will be applied over the injection site that can be removed later in the day. Immediate compression is applied with graduated compression stockings that are worn continually during the day and removed at night. The duration of this required compression will be determined at the time of treatment depending on the diameter of the vessel treated. For example, compression following injection of spider veins will generally be 2-3 days while large varicosities may require a week or more with 30-40 mmHg compression.

Compression is a very important part of the procedure to help seal the treated vessels, minimize the accumulation of trapped blood under the skin, minimize hyper-pigmentation, reduce the number of treatments necessary, and reduce the possibility of recurrence.

Daily activities can be continued immediately following treatment. Walking is recommended immediately following treatment so that blood will be pushed through other vessels. Avoid very vigorous activity for 24-48 hrs.

Avoid hot tubs, jacuzzi baths, and saunas for one week following injection.

Discomfort may be treated with over-the-counter, aspirin pain relievers such as Tylenol or Advil.

Compression stockings are available for purchase at our clinic.  These need to be be brought to each visit to be worn immediately following treatment.


Side Effects and potential Complications

Bruising may occur at the site where the needle penetrates the skin. This resolves in a few weeks and is probably related to the fragility of the blood vessels. Be sure to avoid taking aspirin or non-steroidal anti-inflammatory drugs e.g. Advil for 7-10 days prior to the procedure (if not contraindicated).

Brown lines or spots (hyper-pigmentation) at the site of the treated vessel have occurred in some patients. These result from deposits of hemosiderin, a form of iron stored in the blood. These spots usually fade within a few months but a very small percentage may persist for a longer period of time.

The formation of small painful ulcers at the treatment site has also been documented. Sometimes these occur because some of the solution has escaped into the surrounding skin. These can be effectively treated so it is important to inform the office as soon as possible if the treated area becomes painful.

Allergic reactions to the sclerosing solution are rare but can be treated medically. This procedure must always be performed by a physician in a medical facility.

When large veins are treated, painful lumps may be palpated along the treated vessel. These are actually accumulations of trapped blood in the veins. This blood may be extracted in the office a few weeks after the injection to speed up the healing process.

In addition to these minor risks, there have been very rare documentations of infection, inflammation of the deep venous system with formation of a blood clot and intra-arterial injection.