Friday, 18 May 2012 02:39

What You Should Know About Vein Sclerotherapy

sclero legsMany patients come to my office for vein sclerotherapy. Sclerotherapy most often used for spider vein treatment involves injections directly into very small veins. The injected sclerotherapy solution causes them to gradually disappear. The procedure is relatively painless and has few serious side effects. Still, sclerotherapy is not for every vein patient and there are some things that one should know prior to having sclerotherapy.

  • Not all patients are candidates for sclerotherapy.  Sclerotherapy works best on little veins of about 1-3 mm in diameter.  Some patients may want sclerotherapy, when in fact, their vein disease is quite serious and their veins should not be injected without investigating the underlying reason for their condition. Other patients who have veins that are too small for radiofrequency ablation or endovenus ablation may be better candidates for sclerotherapy. Because not all patients have veins suitable for injection, I suggest a consultation prior to treatment. The purpose of this is to allow me to evaluate whether the veins are suitable for sclerotherapy or whether a more thorough investigation is needed prior to treatment.
  • In my office, vein sclerotherapy is only perfomed on the legs. Sclerotherapy can occasionally be performed on other areas such as the face, chest, and back. But in my office, I generally only perform injections on the legs.
  • Compression stockings are very important!  On the day of sclerotherapy, good compression stockings, also known as varicose vein socks, must be brought to the appointment. A prescription for compression stockings is always given at the initial consultation.  Compression is absolutely essential to achieving a good cosmetic result after sclerotherapy. If your spider veins are also in the thighs or on the backs of the knees, thigh high stockings will provide the best results. If they are only on the calves, then knee-high stockings are sufficient. Usually, the stockings should be worn for 24 hours straight after the procedure, then every day (all day) for about 3 weeks. Nighttime use is not necessary.
  • Sclerotherapy often causes bruising for several weeks.  Assessing the success of the spider vein treatment is possible only after the bruising disappears and the veins heal and disappear. For this reason, I recommend sessions be scheduled several weeks apart. Also, it is best to have sclerotherapy done well in advance of important events (such as sunny vacations, weddings, etc.) because treated legs often look worse before they look better. A worse appearance during healing is absolutely normal, and should be expected after treatment.
  • The active agent used by Dr. Aquino for sclerotherapy is called Sotradecol, or sodium tetradecyl.  It is an FDA-approved agent which has been used extensively for this purpose. It generally hurts much less than hypertonic saline injections and has very good results. Read our comparison of sclerotherapy solutions.
  • Sclerotherapy is generally considered a cosmetic procedure and is not covered under most insurance plans.  One exception is when sclerotherapy is done after radiofrequency ablation. In this case, the medical condition of venous insufficiency was proven to be present and so, occasionally, insurance companies will pay for a few sessions of sclerotherapy once the radiofrequency ablation has been performed.

If you have any additional questions regarding sclerotherapy, my office staff can likely address them.  Give us a call anytime 650-991-1122