Sclerotherapy

Definition: “Spider Veins,” known medically as telangiectasias, are small dilated blood vessels just beneath the skin of the legs and thighs. They are, for the most part, hereditary, but mechanical trauma, long periods of sitting and standing, as well as pregnancy and hormones may play a role.

Treatment: Leg vein injections, or sclerotherapy, is performed using a sterile concentrated saline solution. A very tiny needle is used to inject the solution directly into the vessels, causing them to collapse and eventually close completely. This procedure has been used successfully by dermatologists for decades. It is usually convenient for you to wear shorts the day of the procedure. A pressure dressing may be applied after injections, which should be worn until bedtime. Strenuous physical activity is best avoided for 24 hours. Support hose may be recommended for 24-48 hours after treatment. An anti-inflammatory cream may be given to use on treated areas. If severe irritation occurs during treatment, ice packs may be used during the first 24 hours. Vessels that are large enough to feel when you run your finger lightly over your skin are generally too large to treat in this manner.

Expectations: During treatment, a burning sensation is usually felt, lasting several minutes. Immediately afterwards, treated vessels will look swollen and irritated. Tiny spots, usually bluish or brownish, are often seen at the point where the needle entered the skin. About 75-80% of vessels injected during any one session are expected to disappear over a period of two weeks to two months. Treatment of spider veins, especially if large areas are involved, can be a slow process and maximum improvement may require repeat therapy.

Side Effects: Occasionally, a small freckle-like pigmentation can persist at the injection site. These usually fade within several months but rarely can be permanent. Temporary burning or swelling can occur following treatment in some people. Rarely, a pigmented outline of the vessel will remain following treatment and occasionally tiny sores or ulcers will develop, which may heal with a white scar. The most serious side effect is the development of a blood clot that moves to another part of the body. This is, fortunately, very rare, but due to this rare complication, if you have history of phlebitis of the leg, you should not receive leg vein injection therapy. Individual vessels may recur over a period of 1-5 years. Overall, the results are usually quite satisfactory with cosmetic improvement.

Listed below are the answers to some of the more commonly asked questions concerning saline sclerotherapy.

1. How often should I come for treatment and how many sessions are involved?
Treatments may be done as often as every two weeks but may be less frequent at a patient’s discretion. It will always be difficult, if not impossible, to determine how many treatments will be needed. When only a few small vessels are present, perhaps one or two sessions will be sufficient. When more lesions are present, several or perhaps many sessions are required.

2. Does the procedure hurt?
You will feel a sting with each injection. This occasionally causes a cramped feeling in the leg, which is only temporary. There is usually minimal, if any, discomfort after the procedure is completed.

3. Can I resume my normal daily activities after the injections have been done?
Normal standing and walking are fine. Such activities as jogging, aerobic dancing, playing tennis or other strenuous activities are discouraged on the day of treatment but may be resumed the following day with no problems.

4. Is this covered by insurance?
Insurance companies consider this to be a cosmetic procedure. You will be asked to sign a statement that you understand that your insurance will not cover this procedure.

5. Do I pay at the time of service?
Payment is required in full on the day the services are rendered.

6. Are there alternative treatments?
Laser therapy may be an alternative treatment for some kinds of unsightly blood vessels.

7. Any additional instructions?
Do not apply any lotions, moisturizers, sunscreens or other topical agents on your legs on the day of your injections either before or after. If you like, bring a pair of shorts with you to wear during your treatment session.