HOW IS SCLEROTHERAPY PERFORMED?
An irritant solution (Aethoxysclerol) is injected directly into the blood vessel with a very fine needle. This procedure has been used for spider veins since the 1930’s. The solution irritates the lining of the vessel causing it to swell and stick together. Over a period of weeks-months the vessel fades from view, eventually becoming barely or not at all visible. Depending on its size, a single blood vessel may have to be injected more than once
*** PLEASE DO NOT MOISTURISE YOUR LEGS ON THE DAY OF YOUR PROCEDURE ***
STOCKINGS?
Stockings must not be taken off for the first 48 hours at all, THAT MEANS NO SHOWER FOR THE FIRST 2 DAYS. After that, you shower with the stockings on just before going to bed. You will be told if you need night stockings as well. The next morning, shower as soon as you get out of bed then put the strong stockings back on. All stocking changeovers are to be done while sitting on the floor or lying on a bed. Leave the tape on for 5 days or until it falls off, do NOT pull off the tape before this. The stockings are to “squash “ the veins so they collapse and shutdown.
*** YOU MUST WEAR THE STOCKINGS DAILY FOR A MINIMUM TEN (10) DAYS
BUT THE LONGER YOU WEAR THEM THE BETTER THE RESULTS ! ! ***
DOES IT HURT?
Each injection stings like a strong ant bite, which lasts approx 1 min.
HOW SUCCESSFUL IS SCLEROTHERAPY?
After several treatments (3-6) most patients can expect a 70-90% improvement in the appearance of their legs. Your legs will initially look worse because of bruising and blood entrapment. The improvement may be very gradual with some vessels taking up to 2 months to show maximum benefit. Treatments are usually done monthly but sometimes sooner.
DOES MEDICARE COVER THE TREATMENT COST?
Here in Australia, Medicare provides a rebate for Sclerotherapy (approx $78) of symptomatic varicose veins (ones causing aching, burning, itching, bleeding or eczema) larger than 2.5mm in diameter, and only 6 treatments per year. Tell your Doctor if you have any symptoms.
WHAT ARE THE COMPLICATIONS AFTER SCLEROTHERAPY?
Even in experienced hands, some complications can occur, but the serious ones are rare.
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Bruises at injection sites (approx 80%) - these will disappear in 1-2 weeks
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Aching in the leg (10%) can last for a few days
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Staining of the skin (approx 30%) - is the appearance of brown marks on the skin caused by iron pigment leakage from blood cells. They fade slowly, but can persist for 2-6 months or even some permanent mild marks. To minimise this side effect, do not take iron supplements (including most multivitamins) before, during or for 3 months after the course of treatment. You should also avoid taking Aspirin, Vitamin E or anti-inflammatories such as “Voltaren” or “Naprosyn”. These medications increase your risk of bruising. *Mild Swelling around the treated areas is common for 2 days after treatment
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Matting (5%) - The development of networks of new fine red blood vessels near the sites of injection, especially on the thighs. Most resolve spontaneously, some resolve with injection treatment or laser and a few persist
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A Sore (or Ulcer) / Scabs (1%) - Very occasionally a small, painful ulcer can develop at treatment sites within 2 weeks of injection. These occur because the solution has escaped into the skin or if there is an abnormal connection between small veins and arteries. They are more common in-patients who smoke cigarettes. They heal slowly and may leave a small pale scar
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Phlebitis (1%) - or inflammation of the veins can be painful for a week or so but is very uncommon in treatment of spider veins
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DVT (Deep vein thrombosis) approx. 1/100,000 - this is a clot in a deep vein, but is rare (requires hospital treatment) and can have very serious health complications if the clot moves into the lungs (pulmonary embolism). It is important to stop the oral contraceptive pill if larger veins are treated. You must inform your doctor if you or your family have a history of blood clots. A DVT may require admission to hospital for an intravenous “drip” and tablets for 3 months
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Intra-arterial injection (<0.01%) - this is an extremely uncommon complication of larger vein treatment, which may result in muscle and skin damage and scarring.
Because of bruising and brown marks and the veins becoming darker often initially, your legs will look worse for the first 1-2 months before they get better in most but not all cases.
Allergic Reactions to some solutions may occur involving itchiness, rashes, hives, low blood pressure, dizziness, breathing difficulty and extremely rarely shock requiring hospitalisation and treatments.
NO exercise apart from WALKING OR SWIMMING for 2 weeks after injections. Immediately after treatment you need to walk around for at least 15 mins to reduce the incidence of side effects.
NB: WALKING IS GOOD FOR YOUR LEGS AFTER TREATMENT.
WILL TREATED VEINS RE-OCCUR?
Treated veins can sometimes recur. Top-up treatments will minimize this. The more treatments you have the better the results will be.
WHAT ARE OTHER TREATMENTS APART FROM SCLEROTHERAPY?
- Lasers: Lasers are not yet at a stage where they are helpful in the treatment of larger leg veins. Lasers are best used for treating abnormal blood vessels on the face and perhaps new matting or very fine red surface veins
- Surgery: Surgically tying veins off or “stripping” are other procedures for treating larger leg veins.
