Sclerotherapy is a medical procedure done in order to remove or minimize the appearance of varicose veins and spider veins. Varicose veins are enlarged blood vessels just beneath the skin. They are twisted and bluish-purple in appearance due to being overfilled with blood. This overfill is caused by an issue with the valves and vein walls, causing constricted blood flow.
Varicose veins typically appear on the lower half of the body—thighs, legs, ankles, and feet—and can be quite painful and uncomfortable. Spider veins originates from similar clots but involve more superficial blood vessels and are therefore smaller in appearance.
There are different types of sclerotherapy that involve using different kinds of tools to facilitate treatment: direct injection sclerotherapy, ultrasound-guided sclerotherapy (UGS), and catheter-guided sclerotherapy (CDS).
Direct Injection therapy is the most straightforward and is usually used for treating spider veins. This involves injecting a liquid or sclerosant directly into the vein with the goal of irrigation which causes the vessel to fade in appearance.
Ultrasound-guided sclerotherapy involves using ultrasound in order to locate veins that are not visible on the skin with the naked eye. The ultrasound helps determine the vein that needs the sclerosant. The amount of solution and number of injections can vary with the affected vein’s length.
Lastly, catheter-guided sclerotherapy is done on larger varicose veins. It’s similar to UGS in that ultrasound is also used in the process, but unlike UGS, the ultrasound is there not to locate the vein, but to help the doctor insert a catheter into the vein through a tiny incision. The sclerosant is then put into the catheter, with the same goal of irrigating the affected vein.
The goal of sclerotherapy is to help address the troublesome symptoms and sensations that can come with varicose veins such as general discomfort, bloating, a burning sensation, etc. The procedure is also done cosmetically for reducing the appearance of these veins.
Average Cost
$608
Price Range
$445 to $771
The varicose or spider veins are injected with the sclerosant which causes the blood vessel lining to be irrigated, which in turn causes the release of inflammatory substances that cause the vein to harden and eventually turn into scar tissue. This scar tissue is then absorbed by the body and the blood flow is then rerouted elsewhere.
This process can cause some bruising and sensitivity to the affected area but does help reduce the appearance significantly as the body absorbs the scar tissue or dead vein.
A new development in sclerotherapy is the substitution of foam for the sclerosant. Foam can make better contact with the blood vessel lining which can require fewer amounts of it being used. It can also show up and be tracked by ultrasound. This is looking to be a better and cheaper alternative down the line.
Before having the procedure, you would need to see a doctor and have them assess your current condition, paying special attention to the condition of your veins and your current blood flow. You would need to undergo physical exams and ultrasound procedures. All the information gathered from these will be vital in determining the best course of action for your treatment.
In these medical tests, a piece of equipment called a Doppler ultrasound will be used. This is a device that uses sound waves in order to show the blood flow or movement in your vessels. This can provide information on your blood flow’s direction and the current condition of your valves.
A Duplex ultrasound, on the other hand, is a combination of the Doppler ultrasound and the traditional ultrasound. This will assess the structure of your deep veins and provide a clearer picture of where they are and their sizes. This scan can also detect circulation issues in both superficial and deep veins.
After the surgery, you would need to have your legs or the affected area bandaged for a couple of weeks. You will also need to refrain from showering for up to two days immediately after the procedure.
The area surrounding the treated vein will be sensitive for some time. You might experience some pain and bruising. This is because, in the process of irrigating them with the sclerosant and converting them to scar tissue or dead veins, the branch veins previously connected are cut off from them, causing some bleeding and inflammation.
It’s advisable to exercise your legs by taking short walks daily and refraining from standing the same way for extended periods of time. Generally, you’ll can return to your normal activities after about two weeks of recovery.
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The procedure is non-invasive and simple, so it’s considered low-risk overall. The most notable side effects are the uncomfortable and sometimes painful sensations that the patient might experience due to the injected area being sensitive and inflamed from treatment. Bruising can also occur for up to a week.
In rare cases, the patient can develop an allergic reaction to the treatment. To minimize discomfort and side effects, it’s extremely important to seek your sclerotherapy treatment from a certified professional.
What are the areas in which sclerotherapy may be used to treat?
Sclerotherapy can address both varicose veins and spider veins. Varicose veins are typically larger and more visible on the surface of the skin, characterized by a swollen and bulging appearance. Spider veins are extremely similar though less intense. Although varicose veins are typically on the lower half of the body, it is also possible for them to develop on the face. This can be treated by sclerotherapy too.
How long does it take for the veins to disappear?
This will depend on the size of the injected vein, its location, and the other veins surrounding it. Some veins, like reticular veins (same color and appearance as varicose but are not bulging to the surface of the skin), can also take several sessions to fully address. A good gauge is usually between two weeks to two months. The consistency of the after-care, as well as the patient’s skin complexion, are also contributing factors.
Is sclerotherapy safe during pregnancy?
Research has not established the safety of the fetus during sclerotherapy so it’s not a procedure advisable for pregnant or breastfeeding women. In a lot of cases, varicose veins and spider veins that develop during pregnancy eventually disappear after birth anyway.
How long are sclerotherapy sessions?
The first session is typically the longest since your doctor would need to gauge how your body responds to the injections, so this can take a couple of hours. There is a limit of 10-20 injections per session so patients typically need to have two to three more subsequent procedures to address multiple instances of varicose veins.