Varicose / Spider Veins (Sclerotherapy)

About the Procedure

Sclerotherapy is a non-invasive process used to treat patients with varicose or spider veins located in the legs. While this is commonly done for cosmetic reasons, it is not uncommon for such veins to lead to swelling and pain in the surrounding regions, in which case this procedure is sought out in the hopes of relieving these conditions. Sclerotherapy involves a series of injections of sodium tetradecyl sulfate (STS) into the unwanted veins. The solution causes the vessel to shrink and the blood within it to clot, essentially killing it. Once this has happened, the body can begin absorbing it at which point it disappears from sight.

The STS solution can take a few different forms, differing in dilution and consistency. The most potent solutions in current use take the form of a foam or paste. Aside from a higher saturation of STS, it also gives the solution more surface area, making it more effective for treating the larger, more resilient veins.

While STS is not dangerously harmful if injected outside of a target vein, it can cause some undesired effects such as scarring or, in rare cases involving high STS content solutions, skin necrosis. The damage done by the latter can take months to heal. Due to these associated risks, surgeons sometimes opt to guide the injections by ultrasound if they feel the veins are in an area where they will be difficult to pin point.

Sclerotherapy is typically performed over multiple sessions scheduled several weeks apart depending upon the severity of the condition being treated and the success of each session. One session typically lasts between 15-30 minutes and is performed without anesthesia on an out-patient basis.

What to Know Before the Procedure

A small, but significant number of patients have shown an allergic reaction to the STS solution. In most cases this exhibits as some mild itching or irritation of the injected area, but more serious reactions are possible. If you are prone to allergic reactions, it may be a good idea to discuss this with your doctor so they can test a highly diluted STS solution on you beforehand to gauge the possibility and severity of such a reaction. Should your doctor determine a severe allergic reaction to be likely, other options for treating your spider/varicose veins exist such as laser surgery.

Other factors that may make you ineligible for sclerotherapy include pregnancy and whether or not you have had a history of blood clots. The latter will not always disqualify you as a candidate but further testing and discussion with your doctor will be necessary before proceeding.

Anti-inflammatory drugs such as ibuprofen (the active agent in many over the counter pain relievers) should be avoided for 2 to 3 days prior to the treatment as they can directly interfere with the STS solution, reducing its effectiveness.

What to Know After the Procedure

Patients are able to return to regular daily operation right away after sclerotherapy. Most doctors actually suggest walking regularly afterward. The patient will be advised to wear support hosiery to compress the treated area. Some doctors will have these available at their office, while others will direct you to somewhere you can obtain them. Expect to wear these daily for 2-3 weeks after treatment.

Keep in mind that there are many likely cosmetic anomalies that may present themselves around the affected area. These include the formation of new, tiny veins, lumping or hardening of some targeted veins and the presence of brownish lines or spots. None of these side effects are cause for concern and all of them typically fade away within 3-12 months. However, if you think you are having an abnormal reaction of some kind, consult your doctor.

For the first 48 hours after the treatment, as with before, patients should avoid ibuprofen or any other anti-inflammatory medications. Consult your doctor if there are any regular medications you take if you are unsure if they contain an anti-inflammatory agent. It is also strongly suggested to avoid exposing the treated area to direct sunlight and hot water for several days afterwards, though lukewarm water is fine for showering.

If you Need to Travel Outside of your Local Hospital

The quickness of the treatment combined with the fact that patients are able to resume normal activity immediately means this process travels well and is equally viable for any kind of travel, foreign or domestic. The primary factor to keep in mind is the number of sessions you will require to attain the desired results. Speak to your doctor about the likelihood of multiple sessions being needed. In the event multiple treatments will be required, you will want to work that into your travel decision.