Sclerotherapy is a non-surgical outpatient procedure designed to diminish the appearance of spider veins and smaller, superficial varicose veins. Whether on the legs, the face, or virtually anywhere on the body, unsightly veins can be removed with sclerotherapy. Sclerotherapy is minimally invasive, only involving a micro-needle for the injection of a solution, causing unwanted veins to fade or disappear.

Candidacy

Appropriate candidates for sclerotherapy are those individuals who have spider or varicose veins and the desire to change their appearance. The ideal candidates are non-smokers who are physically healthy and psychologically stable. Since it is not known whether the sclerosing solution affects breast milk, pregnant women should avoid sclerotherapy. Individuals with a blood-borne disease or condition affecting the vascular system should not have sclerotherapy. Laser vein removal or vein removal surgery may be more appropriate depending on the severity of your vein condition and other factors affecting your health.

Drug used for sclerotherapy of varicose veins -

1. Tetracycline
2. Ethanolamine
3. Sclerosant

Causes of spider veins

A number of factors contribute to the development of spider veins, including:

• heredity
• pregnancy
• hormonal shifts
• lack of exercise
• obesity
• weight gain
• occupations or activities that require prolonged sitting or standing
• use of certain medications

Spider veins appear in both men and women, but are more frequent in women. The fact is also that female hormones may play a role in their development. That’s why puberty, birth control pills, pregnancy, or hormone replacement therapy may contribute to their forming. They may also appear after an injury or as a result of wearing tight girdles held up with elastic bands. Varicose veins are mainly caused by the genetic susceptibility.

The procedure

Sclerotherapy entails the injection of a solution introduced directly into the targeted veins. In preparation for treatment, the patient stands while the relevant veins are marked. Using a micro-needle, the sclerosing solution is injected into the vein and causes the vein to harden and fade over time. One injection will treat about an inch of surface skin and a single procedure may involve numerous injections, depending on the size of the area being treated. As there is little to no pain experienced by patients, anesthesia is rarely required. Generally, treatment time is 30 minutes to an hour. Two or more sclerotherapy treatments are usually required to achieve optimal results.

Ultrasound guided sclerotherapy

Ultrasound guided sclerotherapy is a special method that uses ultrasound to locate the underlying leaking veins! the leakage could come from small 'perforated veins' that are usually below the knees, behind the knees or in the groin.

Indications for this type of sclerotherapy are:

• very large varicose veins
• leg ulcers
• skin conditions

Laser therapy

Lasers have been used in varicose vein therapy for more than twenty years, but patients are still often suspicious about it. Wavelengths of light are absorbed by the hemoglobin in the blood vessels to destroy them. Many types of lasers are being used such as pulsed dye, long-pulsed, variable-pulsed Nd-YAG, and Alexandrite, as well as the non-laser intense pulsed light technique.

Recovery

Following sclerotherapy treatment, compression bandages are often applied to increase pressure and swelling of the veins. Bandages can generally be removed within a day or two, although support hose may be required for up to two weeks. Swelling and bruising are typical postoperative conditions. Moderate exercise is recommended in order to increase blood circulation. If sclerotherapy was done on the leg, elevation of the leg may also be recommended. Although rare, complications of sclerotherapy include blood clotting, skin inflammation, allergic reactions, and changes in skin pigmentation.

Frequently asked questions?

What do I do after treatments?

Dermatologists may differ in their treatment instructions to patients. Most advise their patients to "clear" the sclerosing solution out of the circulation. Patients are instructed to walk following the procedure. Some physicians bandage the injected areas and instruct patients to "compress" the treated vessels by wearing support hose. This may help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. It also may reduce the number of treatments necessary, and the possibility of recurrence. Others put tape dressings on the areas and do not use compression unless the veins are large or in special locations. Between treatments, many dermatologists recommend the use of compression or support hose. This may be recommended for people who spend a lot of time on their feet, or work in a standing occupation. The treatment of spider and varicose veins can be successful. Treatment methods vary depending on the size and location of the abnormal veins. The injection method is presently the method most commonly used, but great advances have been made recently in other techniques such as lasers.

Results

Sclerotherapy is designed to improve the appearance of unsightly veins. After each sclerotherapy session, the veins will appear lighter. However, because there is typically some minor bruising, results may not be visible for up to two weeks. sclerotherapy does not prevent new veins from forming at the surface of the skin, so it should not be considered a permanent solution for spider and varicose veins. Most patients are satisfied with the results of sclerotherapy and enjoy the improved appearance of their skin.

Benefits

There are many reasons why a person would want to have a spider vein removal.

The most common reasons are:

• enhancing appearance and self-confidence
• improving the appearance of the skin
• wanting the legs to look younger
• removing bothersome symptoms associated with spider veins

Complications

Complications include:

• painful burning if the injection is too close to the anus
• allergic reaction
• possible shedding of mucosa (rectal lining)
• infection in the sphincter area
• uncontrollable bowels or bladder
• prostatitis (infection of the prostate)
• bleeding

Prevention of spider and varicose veins

There are several simple things you can do to help prevent varicose and spider veins and to relieve the discomfort from the ones you have:

1. Protect your skin from the Sun by wearing sunscreen to prevent spider veins on the face.
2. Exercise regularly to improve your leg strength, circulation, and vein strength.
3. Control your weight to avoid placing too much pressure on your legs.
4. Do not cross your legs when sitting.
5. Do not stand for long periods of time.
6. Wear elastic support stockings, but avoid clothing that is too tight or that will constrict too much

Alternatives

Some dermatologists are recommending a classical surgical approach to this problem, although it has been used less and less in the last couple of years! Some physicians bandage the injected areas and instruct patients to compress the treated vessels by wearing support hose. This may help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. Others put tape dressings on the areas and do not use compression unless the veins are large or in special locations.

Frequently asked questions?

How successful is sclerotherapy?

After several treatments, most patients can expect an 80 - 90 percent improvement. Fading will gradually occur over months. Disappearance of treated spider veins is usually achieved, but similar veins may appear in the same general area.

Tips before treatment

1. Do not use moisturizers on your legs 24 hours before the procedure.
2. Bring shorts or a loose fitting skirt to wear during the treatment.
3. Don't wear tight clothing on the day of treatment. A full skirt or loose fitting pants are ideal.
4. Circle your worst veins or the veins that bother you most with a ball point pen.
5. Avoid prolonged sitting or standing, or strenuous exercise for the first 24 hours after a treatment. During this period try to elevate your legs.
6. Speed up recovery after 48 hours by walking or exercising while wearing fitted support hosiery. the best results are often obtained when this hosiery is worn almost continuously for the 48 hours and as much as possible for 3 weeks following treatment.
7. Avoid hot showers or baths 24 hours after a treatment. Luke warm showers and baths are allowed.
8. Avoid Sun exposure or visits to the tanning bet for 2 weeks after a treatment.