WHAT IS IT?
Sclerotherapy is a medical procedure used to treat varicose veins and "spider veins" usually of the face, lower legs, calves, and ankles. While these veins contain blood, they are not part of the venous valve system and thus they are not essential to healthy circulation. Treatment of these unsightly areas can improve the cosmetic appearance of the face and lower extremities as well as relieve symptoms such as aching, burning, cramping, and swelling.
Sclerotherapy is a time-proven procedure used since the 1930's and it involves the injection of a sclerosing solution (generally sodium chloride or concentrated salt) into the vein; the inner lining of the vein becomes irritated and is destroyed, and the vein disappears from view over a period of several weeks. Because a very fine needle is used for the injection, the procedure is relatively painless, although some patients experience mild stinging or burning which resolves after several minutes. The procedure is done in the physician's office and requires approximately 15 - 45 minutes per session. The number of veins treated per session varies depending upon the size and location of the veins, the patient's overall health, and the patient's tolerance. The number of sessions depends upon the patient's response to treatment; this is positive for most patients. In general, spider veins respond in three-to-six weeks and larger veins respond in three- to-four months. An average of 50 - 70 per cent of vessels can be permanently eliminated. Normally they do not reappear, but if new veins present, the patient may need to return for injections.
WHO WILL BENEFIT?
It is estimated that spider veins and varicose veins affect at least half of the adult female population, most within the age category of 30 - 60 years. More women are affected due to hormonal changes. In some women, the veins become noticeable early in the teen years, and in others, they are not noticeable until they reach their 40's. Spider veins can also occur in men but are often not considered as much a cosmetic problem because they are covered by hair growth on the leg; however, men are excellent candidates for treatment. Other causes can be due to heredity, weight gain, certain medications, trauma, sun exposure, and prolonged sitting or standing.
WHAT WILL THE EVALUATION INVOLVE?
You will schedule a consultation visit with your Facial Surgery Center physician. During that visit your detailed medical history will be reviewed and you will have a thorough examination. It is important that you reveal any information your physician may need to evaluate your medical condition, including records of previous treatment. At that time the risks and benefits of sclerotherapy, anticipated recovery time, and the cost will be discussed with you. If you and your physician decide that sclerotherapy is the best course for you, a Facial Surgery Center staff member will prepare you with pre-procedure teaching, will have you sign a consent, and will assist you in making financial arrangements. Your procedure will then be scheduled.
WHAT WILL TREATMENT INVOLVE?
Prior to sclerotherapy, certain medications should be avoided. TetracyclineŽ or MinocinŽ, both antibiotics, have the potential to stain the skin if taken seven-to-ten days before or after the procedure. Discuss this issue with your physician if you must take an antibiotic during the time period before or after your treatment. Do not take aspirin, ibuprofen (AdvilŽ or MotrinŽ) or any other anti-inflammatory medications for 48 hours before and after sclerotherapy because these medications may interfere with the action of the sclerosing agent. PrednisoneŽ may also decrease the effectiveness of the sclerosing agent. If you taking a steroid, check with your physician who prescribes your steroid to see if you may discontinue it for 48 hours prior to your procedure.
You must arrive for your sclerotherapy without lotion, sunscreen, or oil on your face or legs. You should wear loose-fitting, comfortable clothes or bring such clothing to wear home. If your sclerotherapy is performed on your legs, you may bring shorts to wear during the procedure; otherwise, you will be asked to wear a patient gown and your legs will be draped with a sheet.. Also, you will need compression stockings to wear out of the office and as instructed for home use.
You will be positioned for comfort so the areas to be treated are most visible. The skin of the areas to be injected will be disinfected. A skin-marking pen (which washes off) may be used to outline the areas to be treated. A fine needle will be used to inject the sclerosing agent while the physician stretches the skin surrounding the vein. The nurse or assistant will apply pressure using gauze after the needle is removed. The pain is usually minimal due to the type of solution and needle used. After your procedure is completed, you will be given instructions for home care and an appointment for a return visit. You may dress and drive yourself home.
WHAT DOES POST-PROCEDURE CARE INVOLVE?
Following the procedure you can expect to have some minor swelling and bruising for several weeks. You may want to plan to wear clothing that covers your legs until the bruising resolves. If your sclerotherapy was performed on your legs, it is important to use your compression stockings as instructed by your physician. You may return to your normal activities within twenty-four hours but be sure to avoid prolonged sitting or standing, squatting, heavy weight lifting, and "pounding" exercises such as running or jogging; it is important to walk to promote circulation and to prevent blood clots. Whether your sclerotherapy was performed on your legs or your face, you may take acetaminophen or TylenolŽ for minor discomfort. Do not take hot baths, sit in a whirlpool or sauna, or apply any form of warm compresses to the injected areas for 48 hours. You may take a shower but be certain to make the water cooler than usual. The injection sites may be gently cleansed. Avoid direct sun exposure for seven-to-ten days following your treatment.
You may notice the following short-term side effects:
Serious side effects are rare but be sure to notify your physician immediately if you experience any of the following:
Will my insurance pay for sclerotherapy? Typically, most insurance companies will not cover the cost of this procedure; it is usually considered to be cosmetic.
Can I have recurrence of my spider veins? Although sclerotherapy removes noticeable veins permanently, it is possible to have new veins become visible and these would require treatment. It is important to prevent activities that may cause varicose veins or spider veins, i.e. prolonged sitting or standing, squatting, heavy lifting, straining, etc.
Are there any conditions that could prevent me from having sclerotherapy? Contraindications to having sclerotherapy are pregnancy, breastfeeding, and clients who are bedfast. You must wait for three months after childbirth to have sclerotherapy. If you have a history of blood clots in your legs, your physician will evaluate you for your eligibility on an individual basis. Use of certain medications may prohibit your having this procedure. These medical conditions will be discussed at length during your consult visit.