FAQs About Sclerotherapy
Sclerotherapy is one of the modern procedures used to treat spider veins and varicose veins. Before I address some common questions about sclerotherapy, first let’s briefly review why someone might need the procedure.
Vein disease (also known as venous disease) is a condition that can include varicose veins or spider veins, and it is one of the most common health problems in the U.S., affecting approximately 50% of the population. Healthy veins carry blood from all the extremities back to the heart. The blood in the legs travels up against gravity, so when the valves in the veins become damaged, blood flows back into the legs to create a “pooling” effect. When blood cannot be properly returned through the veins, it can lead to a feeling of heaviness and fatigue and cause varicose veins, among other problems.
Sclerotherapy is a minimally invasive treatment for a vein that is not working as it should. The treatment provider uses very small needles to inject a medicine called a sclerosing agent into the vein’s interior wall. This substance causes the vein to become sticky and seal shut, causing the troublesome vein to disappear. Blood then finds a healthy path back to the heart. “Ultrasound guided” or “light assisted” defines how the vein is visualized during these injections.
Ultrasound-guided sclerotherapy uses ultrasound to locate veins that are not readily visible and cannot be seen with a light. This procedure is often used to treat perforator veins, or veins that connect the superficial system (above the muscles in your leg) to the deep system (veins under and between the muscles of the leg). During light-assisted sclerotherapy, a small, hand-held light illuminates the veins and tissue directly below the skin, which allows the sclerotherapist to clearly identify the source of the dysfunction.
Common Questions about Sclerotherapy
How long does the treatment take?
Number and length of treatments vary from patient to patient. Each session can take between fifteen minutes and one hour, depending on the complexity of vein patterns and reflux (inability of the vein to return blood to the heart).
What should someone expect right after sclerotherapy?
Immediately following the procedure, there may be mild itching of your legs. It typically resolves within an hour. For the next few days, there may be some tenderness and bruising. About two weeks following the procedure, you may feel hard bumps in the area of the treated vein, which usually disappear over the course of several months.
How will the leg look or feel a week after sclerotherapy? A month?
Usually, the changes noticed in the first two months are improvement in symptoms. Patients have reported to me that their legs feel lighter, or without pain. The large, lumpy veins slowly disappear, usually two to six months after the procedure, and the smaller veins may disappear over the following six months. It’s good to remember that as the veins resolve, there may be some color changes in the skin; legs sometimes look worse before they look better. But when they look better, they look great!
Are the results of treatment with sclerotherapy permanent?
Yes, once the vein has collapsed, it typically gets reabsorbed into the body and is permanently gone. Because that vein no longer exists, it cannot cause problems in the future. That said, all the veins in the body have the same genetic makeup and have generally been exposed to the same environmental stresses and, in theory, have the same risk of failing. In other words, if a patient has one bad vein, it is very likely that at some point they will have other bad veins. It’s important to note that small, healthier lifestyle changes can make a big difference in managing chronic venous issues and preventing future problems.
Can you go to work after treatment? What about exercise?
Yes, you can go to work after treatment. However, you should avoid heavy lifting and strenuous physical activity while standing for the first five days following sclerotherapy. Walking is great exercise after treatment. In fact, walking 30 minutes a day is a post-op requirement!
What are the most common side effects after treatment?
The most common side effects are bruising and tenderness of the treated veins. The bruising is usually fully resolved within two weeks and the tenderness responds well to heat and elevation. Patients who follow the post-procedure guidelines for care will help promote the most effective healing. After each sclerotherapy session, compression stockings should be worn for seven to fourteen days, depending on the severity of the venous disease.
Will it hurt?
This is the question that patients ask the most! Everyone’s experience is different, but most people describe it as quick little bee stings. It is always possible to stop the procedure or take a break if someone does find it very uncomfortable, but most patients say it is very tolerable. The medicine is pH balanced and vein access is with a 27-32g needle, so it’s really just a very small perceivable pinch.
Seek out a professional
If you decide to pursue sclerotherapy, first receive a proper evaluation to ensure that this is the right treatment for you. Partner with a doctor who specializes in vein care. Vein therapies today are performed by a variety of providers; some may lack adequate training or oversight, and some treat cosmetic concerns without taking the overall health and venous health of the patient into account.
Dr. Cindy Asbjornsen is the founder of the Vein Healthcare Center in South Portland, Maine. Certified by the American Board of Venous and Lymphatic Medicine, she cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers. She is the only vein specialist in Maine to be named a Fellow by the American College of Phlebology. You can contact Dr. Asbjornsen at 207-221-7799 or info@veinhealthcare.com.
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