What is sclerotherapy?

Sclerotherapy is a minimally invasive, cosmetic procedure that involves injecting a sclerosant (Asclera® – polidocanol) directly into small varicose veins on the legs using a fine needle. The sclerosant permanently damages the vessel causing it to collapse and be absorbed by the body. The body then naturally redirects the blood flow to healthier veins. Sclerotherapy is the method of choice for the treatment of small-caliber varicose veins known as reticular veins (2-4 mm in size) and spider veins (<2 mm in size). Each session lasts approximately 30-45 minutes. For larger varicose veins your physician may recommend foamed sclerotherapy or refer you to a vascular specialist for endovenous ablation.

How many sessions will I need?

Most patients are pleased with the final results of sclerotherapy which may range from subtle fading to a complete disappearance of part/or all of the tiny blood vessels. The goal of the procedure is at least 75 – 80% improvement and it may take several months to see the maximum improvement. You may discontinue treatment and restart at any time as you desire. It may be impossible to predict how many treatments are required, but usually each network of veins may require anywhere from one to three treatments in order to get improvement. You should not be discouraged that a single treatment does not affect a dramatic change in appearance. Once an improvement has occurred, it can last at least six months to a year and, perhaps permanently. Again, it is impossible to tell which vessels will reopen given enough time. There is also no way to predict where the new vessels will reform and replace the treated veins. It is recommended that repeat sessions be spaced 6-8 weeks apart.

Who should not receive sclerotherapy?

There are several contraindications for receiving sclerotherapy. Please inform your physician if you have any of the following:

  • Known allergy to the sclerosant
  • Hypercoagulable state or history of deep vein thrombosis or pulmonary embolism
  • Peripheral arterial disease
  • Pregnancy or breastfeeding
  • Diabetic complications (i.e. neuropathy)
  • Patent foramen ovale
  • Uncontrolled asthma or severe allergies
  • Severe skin or systemic disease

What are possible adverse effects from sclerotherapy?

  • Common Side Effects
    • Bruising, redness, and/or swelling at injections sites
    • Larger veins may feel lumpy and hard for a few months
    • Skin hyperpigmentation: Temporary darkening along the length of the treated vein lasting for a few weeks. In certain cases the darkening can last for several months to a year.
    • Telangiectatic matting: New tiny blood vessel formation at sites of injection, which typically resolves over a few months. Those that persist can be treated with laser therapy.
  • Rare Side Effects
    • Ulcer and permanent scar formation
    • Local nerve damage
    • Allergic reaction or anaphylaxis
    • Blood clot formation (deep vein thrombosis, pulmonary embolism, stroke)
    • Transient visual disturbances or migraine-like headaches

Pre-Treatment Instructions

  • Purchase knee or thigh high compression stockings (20-30 mmHg) and bring them the day of the procedure.
  • Bring a pair of shorts to wear during your sclerotherapy session along with loose fitted clothing and comfortable shoes to wear afterwards.
  • Stop taking ibuprofen, aspirin, naproxen, or supplements as vitamin E, fish oil, ginko, ginseng, garlic, or St. John’s wort one week prior to the procedure to reduce risk of bleeding.
  • The night before or day of the procedure do not shave your legs or apply lotion on the legs.

Post-Treatment Instructions

  • Injection sites will have taped compression pads that need to remain in place for 24 hours. Wear compression stockings for 24 hours the first day and then during waking hours for at least 1 week and ideally 3 weeks for better results.
  • You can resume activity immediately. It is recommended you walk for 30 minutes after your procedure.
  • Avoid heavy lifting, long standing, swimming, or high-impact activities like running or aerobics for 3 days.
  • Avoid direct sun exposure to the treated areas for 1 week as this may increase your risk for pigmentation.
  • Avoid hot baths and showers, Jacuzzis, saunas, or application of heating pads for 2 weeks.
  • Avoid ibuprofen, aspirin, naproxen, or other anti-inflammatory medications for 48 hours. Only take Tylenol if needed for pain relief.

Please inform your physician immediately if you start experiencing red streaking, leg swelling, ulcer formation, shortness of breath or any other concerning symptoms by calling (303) 796-8200.