This is an abbreviated version of the complete article.*
Sclerotherapy is a safe and effective method for eliminating problematic surface veins, such as spider veins and small varicose veins.
In this procedure, a solution is injected into the vein to cause a mild inflammatory reaction that causes the walls of the vein to stick together.
Over time, the collapsed vessel scars and permanently seals; blood flow automatically reroutes to healthy veins.
Sclerotherapy is a procedure used to treat diseased or cosmetically undesirable veins. Most commonly sclerotherapy is used for treatment of veins that are a cosmetic problem for the patient and do not carry any significant amount of blood flow. Sclerotherapy is a highly effective method for removing the fine clusters of veins that are often called "spider veins."
Large varicose veins generally are not treated with sclerotherapy because they have less likelihood of improvement than smaller veins.
In sclerotherapy (chemical sclerosis), the physician injects a chemical substance into the affected veins to harden (sclerose) the veins from the inside out. The veins are no longer able to fill with blood and form a hardened cord, which dissolves naturally and is reabsorbed by the body.
The procedure is performed in a physician's office, without a hospital stay.
WHAT TO EXPECT
A very small amount of a chemical solution is injected into the vein at several points through a fine needle. This sclerosing solution causes a mild inflammatory reaction in the vein walls, which then stick together. To keep the vein collapsed after injection, compression therapy is applied by tightly wrapping the area in elastic bandages.
The compression limits the amount of blood that forms clots inside the collapsed vessel and, over subsequent weeks, the vein turns into scar tissue, effectively making the vein disappear.
To improve effectiveness, sometimes sclerotherapy is combined with vein ligation, a simple procedure in which a vein is surgically tied off at the end of a diseased segment. The number of injections and sessions needed depends on the size and number of veins being treated. Treatment sessions usually take 30 to 45 minutes each.
In the first hour or two following the procedure, walking or leg elevation may be recommended. To increase leg circulation and prevent blood clots, walking is usually recommended in the days following the procedure. With compression therapy, the treated areas are tightly wrapped with elastic bandages, or the patient may wear compression stockings with foam pads or cotton balls inserted over the treated areas to increase pressure at those points. Compression may be continued for up to two weeks following treatment.
Complications that may result from the sclerotherapy solution include:
Staining of the skin from blood trapped in the vein;
Excess scarring, resulting in lumps near the vein; or
Leaking solution, producing an inflammatory reaction in nearby tissue.
Side effects or complications of the procedure may include:
Coagulated blood forming lumps, possibly leading to deep vein thrombosis;
Itching at the injection site;
Blistering and inflammation if tape or pads for compression are too tight;
Bruises near the injection site; or
Light brown discoloration along the skin surface where the vein used to be.
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