Sclerotherapy has been used to eradicate superficial veins for over 150 years. Prominence of lower extremity veins can occur from pregnancy, prolonged standing, prolonged walking, or genetics.
If you're unhappy with the appearance of spider veins, please call Desert Hills Plastic Surgery Center at (702) 260-7707 to learn more about sclerotherapy treatment in Las Vegas.
What Is Sclerotherapy?
Sclerotherapy involves injecting a solution (sclerosant) into each cluster of spider veins on the thighs and legs. It works best for spider veins above the ankle. Spider veins are very superficial and tiny with a pink hue, and they sometimes look like a bruise. Injecting unwanted spider veins with a sclerosing solution causes the target vein to immediately shrink, and then dissolve over a period of weeks as the body naturally absorbs the treated vein.
Multiple treatment sessions are usually required for a gradual fading of spider veins. Studies have shown that as many as 50%-80% of injected veins may be eliminated with each session of sclerotherapy. Less than 10% of the people who have sclerotherapy do not respond to the injections at all.
Contraindications to sclerotherapy include pregnancy, thrombophlebitis, blood clots, pulmonary emboli, hypercoagulable states, and allergy to the sclerosing agents. Sclerotherapy is not a treatment for venous disease or varicose veins, which are larger caliber vessels. Patients with associated symptoms from venous disease such as leg swelling or pain may not be candidates for sclerotherapy and need a thorough work-up with Duplex ultrasonography.
Sclerotherapy is the “gold standard” and works better than lasers for eliminating spider veins or telangiectasias. Unlike a laser, the sclerosing solution additionally closes the “feeder veins” under the skin that are causing the spider veins to form, thereby making a recurrence of the spider veins in the treated area less likely.
There are many different agents that be used for sclerotherapy. Polidocanol (Asclera, Aethoxysclerol) and Sodium tetradecyl sulfate (Sotradecol) are FDA-approved detergents that disrupt the vein’s cellular membrane. Hypertonic saline and saline and dextrose (Sclerodex) are hyperosmotic agents that damage the vessel by shifting the water balance, causing cell dehydration and cell membrane collapse.
There are many other sclerosants available but less commonly used. Each sclerosant has its own advantages and disadvantages. Results are very operator dependent and are variable regardless of the sclerosant used. Factors such as sclerosant concentration, volume, mixing, and procedure technique are more important factors than the choice of the sclerosant itself.
Sclerotherapy Vein Treatment
- Dr. Brown uses hypertonic saline to treat spider veins.
- 3 cc of solution is used per treatment session, which usually covers the majority of the spider vein clusters on the fronts and backs of the legs. Serial injections are used for each spider vein cluster.
- The procedure is well-tolerated with little discomfort and little to no downtime. Cotton balls are applied to each injection site after injection. The procedure takes about 30 minutes.
- The patient is asked to bring any type of compression support panty hose to the office and wears them home.
- Walking is fine right after the procedure. No heavy exercise for one week.
- In 24 hours, it is fine to shower, and wash normally with soap and water. Compression stockings are advised for one week.
- Avoid anti-inflammatory drugs for at least 48 hours. Tylenol may be used if needed.
- Avoid the following for 48 hours after treatment: Hot baths, hot compresses, whirlpools or saunas and direct exposure to sunlight.
Results can be variable from person to person, but the procedure has a high rate of satisfaction. Some patients experience excellent and dramatic improvements, while others notice a gradual fading of a proportion of their treated veins. The goals are a gradual improvement; sometimes several sessions in the office are required spaced one month apart.
In general, spider veins respond in about 3-6 weeks. If the veins respond to the treatment, they will not reappear. However, new veins may appear at the same rate as before. If needed, you may return for injections.
Risks of Sclerotherapy
- Raised red areas at injection site can last 1-2 days.
- Bruising can last several days to weeks.
- Skin discoloration such as pigmentation can be temporary and rarely permanent.
- Lumps or thrombophlebitis in larger veins that require several months to resolve.
- The development of new, tiny blood vessels. These tiny veins can appear days or weeks after the procedure, but should fade within three to twelve months without further treatment.
- Formation of small ulcers at the injection site.
- Localized skin necrosis or scars.
- Early recurrence of new veins.
- Unsatisfactory results.
For more information about sclerotherapy, please contact Desert Hills Plastic Surgery Center online or call (702) 260-7707 to schedule a consultation at our office near Las Vegas.