Treatment

Sclerotherapy

Overview

Sclerotherapy treats varicose and spider veins. It is the treatment of choice for small varicose veins.
The doctor injects a solution directly into the vein which causes the vein to scar. The blood flow gets rerouted through healthier veins. The scarred vein is reabsorbed into local tissue and fades. After sclerotherapy, treated varicose or spider veins fade within a few weeks.

Why it’s done

Sclerotherapy is often done to improve the appearance of varicose and spider veins. The procedure also improves related symptoms such as:
  • Aching
  • Swelling
  • Burning
  • Night cramps
If you’re pregnant or breastfeeding, doctors recommend waiting to have sclerotherapy done.

Risks

Some side effects that may occur at the site of the injection include:
  • Bruising
  • Raised red areas
  • Small skin sores
  • Darkened skin in the form of lines or spots
  • Multiple tiny red blood vessels
These side effects usually go away within a few days to several weeks.

How you prepare

Before the procedure, your doctor takes your medical history and performs a physical exam.

Medical history

Your doctor will want to know your medical history about:
  • Existing medical conditions, such as a heart condition or a history of blood clots
  • Medications or supplements you take, especially Aspirin, Ibuprofen, Naproxen, Blood thinners, Iron supplements, or Herbal supplements
  • Allergies
  • Previous treatment for varicose veins and the results of the treatment
If you take Aspirin, Ibuprofen, Naproxen, or blood thinners, your doctor may instruct you on how to stop taking the medication for a certain amount of time before the procedure, to reduce the chances of bleeding.

Physical examination

Your doctor will:
  • Evaluate the involved veins
  • Check for any underlying blood vessel disease

Ultrasound

Your doctor may request an ultrasound imaging on the veins in your legs, depending on which veins are involved, Ultrasound is a painless procedure that uses sound waves to produce images of structures inside the body.

The day before

Before the procedure, avoid shaving or applying any lotion to your legs. Wear loose, comfortable clothing (consider wearing a pair of shorts so that your legs are exposed) to your appointment.

What you can expect

Sclerotherapy is typically done in your doctor’s office and doesn’t require anesthesia. It generally takes an hour to complete.

During the procedure

  • For the procedure, you’ll lie on your back with your legs slightly elevated.
  • After cleansing the area with alcohol, your doctor will use a fine needle to slowly insert a solution into the selected vein.
  • The solution (usually liquid) irritates the lining of the vein, causing it to swell, shut, and block the flow of blood through it. The solution may contain a local anesthetic called lidocaine. The vein will become scar tissue and disappear.
  • Sometimes a foam version of the solution may be used, when a larger vein is involved. The foam tends to cover more surface area than liquid.
  • You may experience minor stinging or cramps when the needle is inserted into the vein. If you have a lot of pain, tell your doctor. The pain usually occurs if the solution leaks from the vein into the surrounding tissue.
  • Once the needle is withdrawn, your doctor applies compression and massages the area to keep blood out of the injected vessel and disperse the solution. A compression pad may be taped onto the injection site to keep the area compressed while your doctor moves on to the next vein.
  • The number of injections depends on the number and size of veins being treated.

After the procedure

  • You’ll be able to get up and walk around soon after the procedure. Walking and moving your legs is important to prevent the formation of blood clots.
  • You’ll be asked to wear compression stockings or bandages — usually for about two (02) weeks — to maintain compression on the treated veins.
  • Most people return to their normal activities on the same day, but it may be wise to have someone drive you home after the procedure. Your doctor will probably advise you to avoid strenuous exercise for two (02) weeks after the procedure.
  • You’ll also want to avoid sun exposure to the treated areas during that time. The inflammation caused by the injections combined with sun exposure can lead to dark spots on your skin, especially if you already have a dark skin tone.
  • Don’t shave or use lotion on the skin after the procedure until the injection site is healed.

Results

If you were treated for small varicose veins or spider veins, you can usually expect to see definitive results in three (03) to six (06) weeks. Larger veins may require three (03) to four (04) months.
Your doctor will likely schedule a follow-up visit about a month after the procedure to determine how well the procedure worked and if you need more sessions. Generally, you need to wait about six weeks before undergoing another sclerotherapy session.



The picture is shown for illustration purposes only. Actual results may vary depending on disease severity and response to the procedure.




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