Everything You Need to Know about Sclerotherapy

Written By Tony Carabasi III, MD, FACS

Spider and varicose veins can be more than unsightly – for many sufferers, they are physically painful as well. Whether you are embarrassed by your bulging veins or losing sleep due to painful night cramping, you can find relief in minimally-invasive treatments today. While many innovations have come to the field of varicose vein treatments in recent years, there is one decades-old procedure that is still considered the gold standard in treating spider and smaller varicose veins. Sclerotherapy, offered by the staff at Center for Vein Restoration, is one of the most effective ways to say goodbye to those ugly, uncomfortable vessels for good.

The Lowdown on Spider and Varicose Veins
Spider and varicose veins may fall into the same category, but they are actually quite different in terms of how they develop and what they look like. It is important to understand the difference between the two before seeking treatment, because there are different sclerotherapy techniques that may be used for each.

Spider Veins
Spider veins are small veins that are visible on the surface of the skin. Typically red, blue or purple in color, these superficial vessels often appear in a network that resembles a spider’s web. The network can become quite large, leading to significant cosmetic embarrassment for some sufferers.

Causes of spider veins vary and may include:

• Age and heredity
• Sun damage
• Hormonal fluctuations
• Trauma to the skin
• Some types of medication
• Some medical conditions

In some cases, spider veins can be due to the same underlying condition that often leads to larger and more prominent varicose veins. Chronic venous insufficiency or CVI occurs when veins in the lower leg stop working as efficiently, allowing blood to pool inside the vessel. The vessel will swell due to the increased pressure and eventually become varicose. If spider veins are caused by this condition, they may be accompanied by symptoms like leg heaviness, fatigue and swelling.

Varicose Veins
Varicose veins are bulging, flesh-colored vessels that rope up the lower leg. These veins are nearly always due to CVI and can become symptomatic over time if left unchecked. Common symptoms of varicose veins include:

• Leg heaviness or fatigue, especially at the end of the day
• Swelling of the lower leg and foot
• Night cramping or restless leg syndrome
• Irritation or itching of the skin around the vessel
• Discoloration or thickening of the skin
• The appearance of open sores around the ankles, known as venous ulcers

The good news is that when sclerotherapy is recommended to treat spider or varicose veins, the treatment will eliminate the painful symptoms as well as the unsightly vessels.

How Sclerotherapy Works
Sclerotherapy is an injectable treatment that is performed on an outpatient basis right in our office. A very small needle is used to deliver a sclerosing agent directly into the visible vessel. The solution irritates the lining of the vein, causing the vein to seal together and collapse. The treated vessel is eventually reabsorbed by the body, while blood is rerouted through healthy veins nearby.

Types of Sclerotherapy
Sclerotherapy has evolved over the years to offer more versatility in treating a broader range of veins. There are three basic types of sclerotherapy used today:

Liquid Sclerotherapy – The traditional form of sclerotherapy uses a liquid solution, usually a saline agent, which is injected directly into the vein. This type of sclerotherapy is usually recommended for the smallest spider veins close to the skin’s surface.

Foam Sclerotherapy – Instead of a liquid solution, this type of sclerotherapy uses a foam agent. The thicker solution is a better option for treating larger spider and small varicose veins, because it effectively displaced blood inside the vessel so the walls can seal together more efficiently.

Ultrasound-Guided Sclerotherapy – When veins need to be treated beneath the skin’s surface, ultrasound imaging may be used to pinpoint the location of the vein for the injection. This technique is particularly useful with foam sclerotherapy, since the foam solution can also be seen on the ultrasound. Ultrasound allows for treatment of veins that would have been treated with more invasive surgical procedures in the past, giving patients a less traumatic option without incisions, anesthesia or downtime.

Procedure Details Sclerotherapy can be performed without any type of anesthesia, reducing the duration of the procedure and risks associated with treatment. A sclerotherapy session can take anywhere from 15-60 minutes, depending on the number of vessels to be addressed in one treatment session. Patients report feeling a mild stinging or cramping as the sclerosing solution is going into the vessel, but this sensation is generally short-lived.

After Sclerotherapy, patients are encouraged to return to regular activities right away. The only exceptions will be hot baths or strenuous exercise that could impact the results of the procedure. It is also a good idea to avoid direct sun exposure on the treatment area, since skin discoloration can occur. Side effects after sclerotherapy are few and may include mild soreness or swelling at the injection site and small hard lumps along the vein. All of these side effects should subside on their own within a matter of days, although lumps may take a bit longer to resolve.

Getting Results Initial results of sclerotherapy may be seen right away, but those results will continue to improve as the treated vessels are eliminated by the body. Some patients may require more than one sclerotherapy treatment session to achieve full results. Once the treated vessel is gone, it will not come back. However, other spider or varicose veins can appear in the same area of the leg, necessitating additional treatment to maintain positive results.

With summer right around the corner, now is the time to get your legs ready for shorts season. At Center for Vein Restoration, Dr. Carabasi is experienced in a variety of sclerotherapy techniques, allowing him to customize your treatment to your specific needs. To find out if sclerotherapy is the right treatment for you, contact Center for Vein Restoration.

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