General Information

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What is sclerotherapy?
Sclerotherapy is a procedure developed to treat spider veins and smaller varicose veins. Veins are treated by injecting a sterile, specially formulated sclering agent into them, which inflames the lining of the veins, causing them to become irritated, harden, and eventually collapse. Blood is then re-routed into healthy veins deeper within the tissues, eliminating the unsightly appearance and potential pain associated with dysfunctional veins.

What are spider veins?
Spider veins, also called telangiectasias, are small vessels that always appear dilated, and are a result of a weakening of the blood vessel's wall due to poor blood flow. Although they are harmless to a patient's health, many individuals dislike their unsightly appearance. Spider veins can appear like a spider, with a larger dark spot surrounded by smaller veins projecting out from the center, or in other patterns and variations in many areas of the body. Found most commonly in the legs, spider veins can appear in dark or lighter shades of blue, purple, or red.

Where is the procedure done?
Sclerotherapy is performed in a physician's office or another outpatient facility. This is because the procedure is minimally invasive and does not require anesthesia. Complications are rare, and any discomfort can be easily managed with a numbing cream or over-the-counter pain medication.

How is the procedure performed?
The skin covering the treatment area will be cleansed, and the physician will proceed by injecting the sclerosing agent into first the larger veins, then smaller ones, stretching the skin over the veins for even dispersal. One injection is commonly required for every inch of vein, or less if a foaming agent is used. Due to the small diameter of the injection needle, patients are typically comfortable throughout the procedure and no anesthetic is needed. The injection process ordinarily takes from 15 to 30 minutes to perform. A slight stinging or burning sensation is normal during and immediately after the procedure, and will dissipate quickly. Once the injection process is complete, the treatment area will be bandaged and compression stockings applied for support.

What chemicals are used for sclerotherapy?
The most common substances used as sclerosants in sclerotherapy are polidocanol (aethoxysklerol), sodium tetradecyl sulfate, and saline solution at 11.7% concentration. Other chemicals may be used depending on your particular case and on the recommendation of your specialist.
Can sclerotherapy be used to treat large varicose veins?
Sclerotherapy is generally used for the small superficial veins next to the skin. Sclerotherapy is not effective for large veins and because of the volume of sclerosant required for effective treatment. However, sclerotherapy can treat many small to medium sized veins effectively, and for larger veins, other treatments can prove equally effective.

How many sclerotherapy treatments are required?
The amount of treatments necessary varies based on the depth, number, and size of the veins being treated. Some individuals require only one treatment to achieve their desired results. Multiple treatment sessions may be needed for other patients, and should be administered a minimum of four weeks apart so that the progress of the previous treatment has reached full effect before more injections are made. A specialist can evaluate a patient's particular needs and provide an estimate of how many sessions will be required for the best result.

Do I have to limit any activity after the treatment?
Walking is highly recommended soon after the procedure, and normal daily activity is possible right away. However, high-impact sports or other strenuous exercise should be avoided for the first 2-3 days following the procedure.

Does sclerotherapy hurt?
There is a little sting associated with each injection. The burning sensation lasts for only a few seconds. Most individuals tolerate the procedure and do not require any type of anesthesia. The majority of patients claim that the procedure is much less than painful than what they anticipated.

Can sclerotherapy be done on the arms or face?
Yes, recent technology has made sclerotherapy safe to perform in some cases on the hands, arms, and face. It is important to discuss the treatment of these sensitive areas with your specialist, as there are other treatments that may be recommended as well.

Can anyone undergo sclerotherapy?
Almost anyone with unwanted spider veins can be treated, except women who are pregnant or nursing. Other relative contraindications include those with skin infections, uncontrolled diabetes, fever, history of deep vein thrombosis, anticoagulant therapy those patients taking corticosteroids.

Is there any preparation required before sclerotherapy?
No preparation is required before the procedure, though it is recommended that patients stop smoking and refrain from taking aspirin a few days before the procedure. Any patient on a blood thinner is not a candidate for sclerotherapy.

What happens after sclerotherapy treatment?
There is some mild pain which can easily be overcome with Tylenol or other over the counter pain medications. The injected site will appear bruised and swollen for a few days. Continual wearing of compression bandages or stockings will relieve the swelling and pain. Side effects are rare, mild, and usually short-lived.

How long is each sclerotherapy session?
The injection process ordinarily takes from 15 to 30 minutes to perform, depending on the size and extent of the treatment area. Once the injection process is complete, the treatment area will be bandaged and compression stockings applied if the legs were treated, to support the resolution of treated veins and enhance blood circulation through healthy veins.

What are side effects of sclerotherapy?
Because the procedure is minimally-invasive, very few side effects are associated with it. Some minor itching and burning immediately after the treatment is normal and quickly fades. In rare cases, allergic reactions, infection at the injection site, or complications associated with poor injection technique are possible.

Can spider veins be treated surgically?
No, because they are so small, spider veins are not operated on. Sclerotherapy and other minimally-invasive procedures are recommended. Due to their size, varicose veins can be surgically removed.

Does insurance cover sclerotherapy?
In most cases, sclerotherapy is performed to treat spider veins, which are typically removed for cosmetic reasons. Because of this, insurance will not typically cover sclerotherapy treatments. However, if varicose veins, which can be painful and have other medical side effects, are treated insurance may provide some coverage. Consult your specialist for a cost estimate and contact your insurance provider for more details regarding your specific coverage.

Who should treat my veins?
Phlebologists, dermatologists, vascular surgeons, and plastic surgeons are all qualified to perform sclerotherapy and other vein treatments. Choosing an experienced, reputable professional is a vital part of achieving successful results.

Disclaimer: This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician.

By OnlineSurgery.com Staff
Updated: October 14, 2009