Sclerotherapy (Injections)
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- A solution is injected in the vein aiming to seal it. Improvement of symptoms is usually appreciated before cosmetic improvement.
- It is likely that you might develop new veins with time requiring new injections
- Treatment sessions are carried out at 3-4 weeks intervals to allow enough time to evaluate the results
- Sclerotherapy could take up to one year, depending on the number of veins to be injected
- Contraindications include pregnancy, lactation, allergy to the sclerosant, abnormal clotting, non-ambulatory status and long travel within 48 hours of treatment
- Brownish pigmentation occurs in up to 30% of patients. Spontaneous clearing within 6-12 months is typical. Pigmentation occasionally persists longer than a year. Discontinuing oral iron supplements for one week prior to injections may help reduce that complication. In about 1-2% of patients, the pigmentation persists
- Rarely, if the sclerosant leaks outside the vein, skin ulceration may occur
- Allergic reaction to the sclerosant occurs in about 0.3% of patients
- “Matting” or “blushing”: these are tiny red veins that appear following treatment in approximately 15% of patients. The cause is unknown. It is possibly associated with obesity, longer duration of spider veins and exposure to excess estrogens. Although matting may be permanent, it usually resolves spontaneously over several months. Areas of matting may be treated with sclerotherapy or laser
- Superficial thrombophlebitis is painful tender veins affecting mainly large veins. Treatment consists of compression, ambulation and anti-inflammatory drugs. Drainage of a tender clot is rarely required
- Deeper veins would be injected under ultrasound guidance. These are usually larger veins and it is common for the injected veins to feel as firm tender lumps with some bruising/redness for the first few weeks. Relief can be enhanced by walking, cold compresses and compression stockings. The stocking should be worn for 4-14 days, depending on the size of the treated veins
- Avoid heavy lifting, resistance training, vigorous sports, jogging, or extreme heat of saunas and spas for the first 2 weeks
