Who should have sclerotherapy?
Spider veins come in a variety of sizes and have many different names.
Telangiectasia: are usually reddish in color and their size is 0.1 to 1mm in diameter.
Venulectasia: are usually bluish, violaceous in color and the size is 1-2mm in diameter.
Reticular: are blue to blue-green in color, and the size is 2-4mm.
Sclerotherapy can treat many different sizes of spider veins, however some veins are too small or too big that other treatments may be ideal instead. If you are pregnant or breastfeeding, it is advisable to postpone sclerotherapy. To find out whether sclerotherapy might help in your case, call us to schedule a consultation with one of our providers.
How is sclerotherapy performed?
While lying on an examination table, the areas to be treated will be cleansed with an antiseptic cleaner. We use the smallest needle possible, the size of an eyelash, to inject a special medicine, a sclerosant, directly into the veins. Sclerotherapy is relatively painless, although the solution can cause some burning, itching or redness for several minutes after it is injected. Very rarely, some experience slight discomfort, such as tenderness and muscle aching/cramping, at treatment sites for the first day or two. Frequent walking, flexing feet while sitting, taking Acetaminophen (per instructions on the label) may help reduce these symptoms.
You will be able to return directly to work following your appointment. Sedation and narcotic medication are not necessary for this treatment.
How does the sclerosant solution work?
At Via Vascular, we use Asclera®, one of the sclerosants approved by the FDA as a safe and effective medication for the treatment of spider veins. This solution damages the endothelium, the cells lining the inside of blood vessels. This causes blood platelets and cellular debris to attach to the lining of the vessels, and eventually clot the blood vessel. Over time, the clotted vein is replaced with tissue.
How do I prepare for sclerotherapy treatment?
To achieve the best results, we ask that you purchase and bring to your appointment medical grade 20-30mmHg thigh-high or pantyhose compression stockings to the appointment.
You will begin wearing them after treatment until the next morning and then during your waking hours for one week. Also, please plan to avoid exercising, exposure to heat such as hot baths, direct sun exposure to legs and airplane trips or long road trips for one week.
Certain medications should be avoided, such as aspirin, ibuprofen, and other anti-inflammatory medications for 48-72 hours before sclerotherapy to minimize bruising. If you are taking tetracycline, an antibiotic, it may increase the risk of skin discoloration if taken seven to 10 days before or after sclerotherapy.
What can I expect after treatment?
Expect treated areas to look worse before they look better. Bruising is normal and is to be expected for healing to occur. Results may be seen at 6 to 8 weeks, with maximum cosmetic benefit seen at 3 to 12 months following the procedure.
Many patients come, wanting to have their legs ready for the summer or for an event. In considering the healing time and the need to wear compression stockings post-treatment, many patients find it best to have treatments during the cooler months. If you have an event or vacation, it is advised to start treatments at least 4 months or greater prior to the date.
What are risks and side effects of sclerotherapy?
As with any medical treatment, there are certain risks and side effects associated with sclerotherapy. Milder side effects, such as itching and raised, red areas at the injection site can last for a day or two. It is possible for a patient to experience an allergic reaction to the sclerosant solution. Allergic reactions are rare and fairly mild when they do occur. Very rarely, blisters, scars, deep vein thrombosis, darkened skin pigmentation, and ulcers can occur after treatment for spider veins. Individuals who smoke or who have an underlying disease may have an increased risk of developing any of these symptoms. Darker skin types are also more likely to have abnormal skin pigmentation after a sclerotherapy treatment.
Does sclerotherapy work with just one treatment?
Typically, for any area of treatment, it requires 4-6 sclerotherapy sessions to achieve the desired results. It is possible to see no effect on the first treatment, as not all veins will respond to the initial treatment. Treatment of spider veins is most effective when done over several appointments spaced at 4 weeks apart. Patients who are predisposed to spider veins may require additional treatments to treat new veins. A yearly follow-up is recommended.
Will insurance cover sclerotherapy treatment?
Insurance companies generally consider the treatment of spider veins to be cosmetic and not a covered benefit.