Sclerotherapy uses injections to eliminate spider veins. During treatment, your doctor uses a very small needle to inject a special solution into the spider vein. The type and strength of the solution will depend on the type and size of the spider veins.
You will need to wear prescription compression hose after treatment. The compression will cause the vein walls to seal together. Your body will then break down and absorb the vein over the course of several weeks. This is very similar to the way the body heals after a bruise. Because spider veins do not have a useful fuction, eliminating them will not affect your circulation.
How many sclerotherapy treatments will I need?
The number of treatments needed to eliminate spider veins can vary, depending on the type, size and number of veins being treated.
After an initial screening exam, your doctor will be able to estimate the number of treatments you may need. The number will be based on your doctor’s assessment, as well as your history and expectations. It is important to discuss your expected outcomes with your doctor.
With sclerotherapy, the best results require patience. Your body will continue to heal for weeks or months after treatment. To get the best possible results, it's also important to follow your doctor's post-treatment instructions.
What can I expect?
After treatment, your legs will probably look worse before they look better. Most people notice a dramatic improvement approximately four weeks after the first treatment. It may take several months and a series of treatments to reach the best results.
While there is no guarantee sclerotherapy will be effective in every case, recurrence to the same veins treated is rare.
New spider veins may form and require treatment. It's encouraged that you follow up with your doctor so any new veins that develop can be injected before they become too large or too numerous.
What are the side effects of sclerotherapy?
Common side effects include:
- Itching - You may experience itching around the area injected. If this occurs, it is usually mild and lasts a day or two.
- Hyperpigmentation - A light brown discoloration of the skin may develop along the vein in the area injected. Approximately 20 to 30% of patients note this discoloration. The hyperpigmentation usually fades in a couple of weeks, but may take several months to a year to totally resolve. There is a 1% incidence of hyperpimentation continuing after one year
A small amount of blood may become trapped and hardened in the vein during treatment. This may feel like a knot or cord and it may look dark blue or bruised. This is a common occurrence and desired effect in order to stop the flow in some veins. If this occurs, you may need to have this area drained to remove the trapped blood and reduce hyperpigmentation.
- Teleangiectatic matting - The formation of new, fine spider veins in the area injected occurs in less than 1% of patients. The exact reason is unknown. If untreated, the matting usually resolves in three to 12 months. In very rare cases, it can be permanent.
- Pain - It is common to have some tenderness or stinging at the injection site.
- Bruising - You may have bruising at the injection site. It may be minimized by avoiding aspirin and ibuprofen products for ten days before and after each treatment.
Rare side effects include:
- Ulceration at the injection site - Very rarely a small ulcer can occur at the site where the vein is injected. An ulcer can take four to six weeks to completely heal, and a small scar may result. This usually fades over time.
- Allergic reaction - There is a very rare incidence of an allergic reaction to the solution injected. Please inform us of any allergies you have.
- Pulmonary embolus/deep vein thrombosis - This is a blood clot to the lungs or a blood clot in the deep vein. It is a rare occurrence.
Care at home after sclerotherapy treatment
Prescribed compression stockings should be worn for 48 hours, day and night. They can be removed to shower. After 48 hours, you should continue to wear your hose while you are awake (12 to 16 hours) for five additional days.
- Bathing - You may shower at anytime. Avoid hot baths, hot tubs and saunas for two weeks after sclerotherapy.
- Exposure to sun - Apply sun block to any areas of hyperpigmentation. Continue to use sun block until the hyperpigmentation has resolved.
- Driving - You may drive immediately after treatment. If your drive home is longer than an hour, we recommend you stop hourly to stretch your legs.
- Activity - In most cases, you may return to work and resume normal activity after treatment. We encourage you to walk. Any other activity or exercise can be done as long as your stockings are worn appropriately.
- Medications - To reduce bruising, do not use aspirin or ibuprofen products for 10 days after each treatment. Acetaminophen (Tylenol) can be used if you experience any discomfort.
Will insurance cover sclerotherapy?
Insurance companies consider sclerotherapy a cosmetic treatment and generally do not cover treatment.