Treatments

Sclerotherapy may be appropriate for people with varicose veins or spider veins, but it’s not for everyone.

Before the procedure, you’ll meet with a medical practitioner who’ll decide if you qualify for sclerotherapy.

You’re not eligible for sclerotherapy if you:

• Have an active deep vein thrombosis or superficial vein thrombosis (blood clot).
• Are pregnant. You’ll have to wait at least three months after delivery before you can have sclerotherapy.
• Breastfeeding (chestfeeding).
• Unable to get out of bed.

You can still get sclerotherapy if you take birth control pills.

If you’ve had a blood clot in the past, you may be able to have sclerotherapy, depending on what caused the clot and how serious it was.

In most cases, your provider won’t do sclerotherapy on a vein you might need for future surgical bypass procedures, such as the saphenous vein for coronary artery bypass graft surgery (unless that vein is already unusable).

It’s a good idea to talk with your provider about how successful they think sclerotherapy treatment will be for you. Some people with high expectations are disappointed with their results. Knowing what to expect can help you avoid feeling disappointed. You should also know that results aren’t immediate. You won’t walk out of your provider’s office looking like a leg model.

Before your sclerotherapy treatment, you should avoid certain medications. Follow these guidelines:

• Antibiotics such as tetracycline or minocycline (Minocin® or Dynacin®) may make your skin stain if you take them seven to 10 days before or after sclerotherapy. Ask your healthcare provider about other antibiotic medications you may take, or ask for safe guidelines for stopping these medications. Tell your provider if you need to take an antibiotic before invasive procedures.
• Don’t take aspirin, ibuprofen (Advil® and Nuprin®) or other anti-inflammatory medications for 48 hours before and after sclerotherapy. These medicines may get in the way of the action of the sclerosing agent or make you bleed more. It’s ok to take acetaminophen (Tylenol® or Panadol®). Ask your provider for specific instructions before you stop taking any medication.
• Prednisone (Rayos® or Sterapred®) makes the sclerosing agent less effective. Ask the provider who prescribed your prednisone if you can safely stop taking it for 48 hours before your sclerotherapy treatment.

Other guidelines before your procedure:

• Don’t put any lotion on your legs before or after sclerotherapy.
• Bring a pair of shorts to wear for your procedure.

If you have compression hosiery (support stockings) from previous treatments, bring them with you so your provider can make sure they’ll give you enough support after your procedure.

After your treatment, your provider may ask you to keep lying down for 15 minutes or so to make sure you don’t have a bad reaction to the injected material.

You’ll be able to drive yourself home. You may go back to your regular activities, especially walking.

You should wear support hosiery or compression wraps for three to seven days to compress the treated vessels. Support stockings purchased from a department store may not work if your healthcare provider prescribes a heavy compression stocking.

For 48 hours after your procedure, follow these guidelines:

• Avoid aspirin, ibuprofen and other anti-inflammatory medications. You may take acetaminophen if you need it for pain relief.
• Don’t take hot baths or sit in a whirlpool or sauna. You may take showers, but the water should be cooler than usual.
• Wash the injection sites with mild soap and lukewarm water.
• Don’t apply hot compresses or any form of heat to the treated areas.
• Avoid direct exposure to sunlight (including sun tanning and tanning beds).

Call your provider if you have any concerns or questions after your procedure.

Advantages of sclerotherapy include:

• No anesthesia. With enough compression from the bandage on the vein, there is little pain. Compression also may help with bruising and swelling.
• Good results for most people. Sclerotherapy works especially well on smaller varicose veins. A session may get rid of an estimated 50% to 80% of injected veins. In about 10% of cases, sclerotherapy doesn’t work. If this happens, your healthcare provider can try different solutions or a different method, such as laser therapy.
• Fairly quick results for small veins. Spider veins usually respond to treatment in three to six weeks, but it may take three to four months for larger veins.
• With successful treatment, varicose veins or spider veins won’t reappear. However, you may need treatment for new varicose veins that form.

Sclerotherapy takes longer than surgery for varicose veins or spider veins. It can also have side effects.

Side effects of sclerotherapy may include the following:

• Larger injected veins may get lumpy or hard for several months.
• The redness where the needle went in should go away within a few days.
• Brown lines or spots on your skin at the site of the injection usually go away within three to six months. However, about 5% of the time, they can be permanent.
• Bruising where the injection happened can last several days or weeks.
• Tiny blood vessels may develop in the treated area. They may appear days or weeks after your sclerotherapy but should fade within a few months. Usually, they don’t need further treatment.
• Allergic reactions to the injected chemical may happen at the time of the injection and are rarely serious. Symptoms include itching and swelling.

Other side effects rarely develop after sclerotherapy. If you have any of these rare side effects, contact your healthcare provider immediately:

• Inflammation (swelling) within five inches of your groin.
• Sudden swelling in your leg.
• Formation of small ulcers at an injection site.
• Red streaking, especially in your groin area.