Site Navigation
Featured Articles
Sclerotherapy Injections
Target Veins
This therapy is generally aimed at medium sized reticular veins and spider veins (telangectasias). These veins range from 1-5 millimeters in diameter. This treatment has been used for larger veins, however large varicose vein response to this therapy is mixed and the recovery can be more difficult and complications such as pain and skin bronzing are more common.
How it Works
A chemical agent usually Polidocanol, Sodium Tetradecyl, or some other sclerotherapy agent is injected into the vein. The chemical causes the live cells that line the vein wall and the blood cells to shrivel up and die. The damage to the vein is extensive. Scarring, clotting, and inflammation then take place and the body essentially tries to remove and/or scar down the damaged vein. This renders it useless and it is no longer visible and can no longer cause symptoms or problems.
Treatment Technique
The area of the vein or veins to be treated is usually cleansed using an alcohol wipe. A 27-30 gauge needle (very small) is then introduced into the vein. This is much like starting an IV only with a much smaller needle. The provider then pulls back on the syringe and if blood appears in the needle, then it is in the vein. The sclerotherapy agent is then injected into the vein.
The agent usually will course throughout the vein and many of the varicose branches. Experience tells the provider how much to inject and when to quit. The needle is then withdrawn and direct pressure is applied to the injection site for several seconds. Often times the solution can be seen moving through the veins and gives a clue as to where to make the next injection. It can take several injections to entirely treat a large area of the leg.
Treatment Tolerance:
Most patients find the sclerotherapy injections to be one of the easiest treatments to endure. There is a slight prick as the needle is introduced followed by a mild burning sensation as the solution is injected. The burning may persist for several hours afterward, but then usually resolves. The chemical agent used greatly influences the amount of pain (See the table describing "Types of Sclerotherapy Agents").
A mild dull ache is usually present for 4-6 weeks as the veins slowly resolve. Patients describe this as a 'bruised' sensation.
Post Treatment Care:
A compression type dressing is applied to the veins treated. This can consist of simply cotton balls taped in place with a compression sock over that or some similar setup. Most providers recommend 48 hours of this dressing followed by use of the compression socks for 7-14 days. Follow up with the provider is usually 2-4 weeks.
There are few limitations to activity and most patients can return to work the following day. It is good to avoid heavy lifting, straining or standing for several days.
Results:
Usually very good. Most veins treated with this method will resolve. Occasionally with larger veins repeat treatment is needed to complete the task. The main difficulty with this treatment technique is a healing period of several months.