Questions About Sclerotherapy
1. What is Sclerotherapy?
2. Am I a candidate for sclerotherapy?
3. What are the contraindications for sclerotherapy?
4. What types of veins can be treated with sclerotherapy?
5. What does the treatment involve?
6. What should I do to prepare for sclerotherapy?
7. How many treatments will I need?
8. What happens after a sclerotherapy treatment?
9. Will my health insurance cover the cost of sclerotherapy?
10. Are there any risks associated with sclerotherapy?
11. What are the chances sclerotherapy won't work?
12. How long will the results last?
What is Sclerotherapy?
Sclerotherapy has been successfully performed to treat spider and varicose veins since the 1920s. It involves the injection of a sclerosing solution into each vein using a very small needle. This solution actually causes a mild irritation in the walls of the vein causing the vein to shrink and eventually disappear.
Am I a candidate for sclerotherapy?
At Young Medical Spa, you will receive a complimentary consultation to determine if you are a suitable candidate for sclerotherapy, or if you need to undergo further diagnostic testing, or referral to a vascular surgeon. Sometimes a treatment plan may involve laser modalities depending on the condition and type of vascular conditions you may have.
What are the contraindications for sclerotherapy?
Sclerotherapy is not recommended for people who are/have:
Spider veins, reticular veins and some varicose veins.
Spider veins (also called telangiectasias) can be found anywhere on the body including the face. They are very small blood vessels, thread-like in appearance, that appear on the skin’s surface layer. They can take many shapes such as lines, dots, clusters, and branches and can be any color from red to purple. They are caused by many factors such as heredity, sun exposure, pregnancy, hormonal changes, medications, etc.
Reticular veins are the “feeder” veins a little deeper in the skin. When pressure inside these veins is increased (by weight gain, pregnancy, pressure from long periods of standing, etc.) they can enlarge. Because reticular veins are not the main veins returning blood to the heart, they can more easily treated with sclerotherapy.
Varicose veins are caused by weakening of the walls and valves inside veins causing them to engorge with blood instead of circulating it back to the heart. These veins are bulging in appearance and can be painful to the touch. Varicose veins need to be evaluated before sclerotherapy is considered due to the health risks associated with the treatment. Often, surgical intervention is necessary.
What does the treatment involve?
The length of the entire treatment can take anywhere from 15 to 60 minutes depending on the size and number of vessels to be treated. Before and after photos may be taken of the veins to evaluate the progress. The physician will then begin the injections of the sclerosing agent. During this time you may feel some mild discomfort or a burning sensation.
After the treatment is complete, you may experience some itching or bruising and the area injected could feel achy for a few days. If your legs are being injected, you may be required to wear support stockings or wraps for a short time following the injections to help compress the vessels as they shrink.
What should I do to prepare for sclerotherapy?
The physician will go over all of the medications you are currently taking during your initial history. You may be advised to avoid taking certain medications or supplements prior to the procedure. This may include any over-the-counter medications you are taking, vitamins, herbs, etc.). You should avoid taking any aspirin, ibuprofen, or any other anti-inflammatory medication for 48 hours prior to and after your treatment. No lotion, powders, sunscreen or creams should be applied to the treatment area prior to your procedure. If you are having your legs treated you may want to wear shorts.
Other medications such as Coumadin or any other blood thinner, prednisone, certain antibiotics and high doses of Vitamin E should not betaken for 4 days prior to your procedure. However, it is strongly advised you contact your primary care physician for permission to stop these medications before proceeding with a sclerotherapy treatment.
How many treatments will I need?
The number of treatments you will need will range from 1 to 5 (average is 2 to 4) depending on the body area you are having treated and the type, amount and size of the vessels treated. Smaller vessels can close after the first treatment, but feeder vessels, or vessels with multiple branches, could take more sessions performed one month apart. You will begin to see the larger vessels disappearing gradually over the series of sessions. Sessions are repeated no sooner than 4 weeks apart.
In most cases, 50% to 70% of the treated vessels will be gone for good with 60% to 80% of patients seeing an improvement. However, new vessels that appear over time will need to be treated. Approximately 10% of patients treated have results ranging from poor to fair, or with no vein disappearance after several treatments.
What happens after a sclerotherapy treatment?
You may resume your regular daily activities which should include walking (if you had your legs done to prevent clots from forming), but should refrain from vigorous exercise until advised by your physician. You should avoid prolonged sitting or standing, or heavy lifting if the areas treated were your legs. You should continue to wear your compression garment for the time period specified by your physician and elevate your legs as much as possible if the veins treated were larger. The veins may appear to look worse before they start fading.
You may shower, but avoid a hot shower and make the water as cool as you can tolerate. The injection sites may be washed gently with mild soap and lukewarm water. Do not use a hot water bottle, use a heating pad, or take baths, sit in a jacuzzi or in a sauna for at least 1 week after your treatment. Alcohol and spicy foods should also be avoided. Bruising or discoloration should begin to disappear within 2 weeks after your procedure.
Will my health insurance cover the cost of sclerotherapy?
No, many insurances do not cover sclerotherapy as it is categorized as a “cosmetic” procedure.
Are there any risks associated with sclerotherapy?
Common side effects include redness and swelling at the injection sites, bruising, itching, tenderness, aching or cramping. Pigment irregularities called “telangiectasia matting” (brown spots or streaks caused by very small clusters of vessels that form around the treated area), may take months to a year to fade. Although extremely rare, a serious medical complication could occur such as ulcers, blood clots, allergic reactions to the sclerosing agent (which could result in scarring), or severe inflammation. If you experience any of these conditions, contact us or your primary care provider immediately.
What are the chances sclerotherapy won’t work?
Less than 10% of patients treated do not respond to sclerotherapy. Sometimes a different sclerosing agent can be used or the addition of laser therapy can be considered. If the veins continue to appear large and bulging, a referral to a vascular surgeon may be discussed to consider a vein stripping procedure.
How long will the results last?
Results are very patient dependent. Typical results vary from 2 to 5 years, depending on the patient’s age, how large and numerous the veins were to begin with, the lifestyle of the patient (i.e., heavy lifting, prolonged sitting, jogger, etc.). In most cases, treated veins should not appear and you will likely develop new visible veins.
2. Am I a candidate for sclerotherapy?
3. What are the contraindications for sclerotherapy?
4. What types of veins can be treated with sclerotherapy?
5. What does the treatment involve?
6. What should I do to prepare for sclerotherapy?
7. How many treatments will I need?
8. What happens after a sclerotherapy treatment?
9. Will my health insurance cover the cost of sclerotherapy?
10. Are there any risks associated with sclerotherapy?
11. What are the chances sclerotherapy won't work?
12. How long will the results last?
What is Sclerotherapy?
Sclerotherapy has been successfully performed to treat spider and varicose veins since the 1920s. It involves the injection of a sclerosing solution into each vein using a very small needle. This solution actually causes a mild irritation in the walls of the vein causing the vein to shrink and eventually disappear.
Am I a candidate for sclerotherapy?
At Young Medical Spa, you will receive a complimentary consultation to determine if you are a suitable candidate for sclerotherapy, or if you need to undergo further diagnostic testing, or referral to a vascular surgeon. Sometimes a treatment plan may involve laser modalities depending on the condition and type of vascular conditions you may have.
| Sclerotherapy | Laser Treatment |
|
| How It Works |
Chemical irritation |
Heats blood to the boiling point of water |
| Pain | Small pinprick, only painful with hypertonic saline |
Intense heat for fraction of a second |
| Area Treated Per Session |
Large | Small |
| Risk of Epidermal Injury |
Less than 1% |
1-10% |
| Treatment of Tanned Legs |
Hyperpigmentation in 8-25% |
No (except 1064nm) |
| Risk of Pigmentation Changes |
Variable depending on the total time of treatment |
Up to 50% with lower wavelengths |
| Cost | 1-5 | Up to 100% more per treatment than sclerotherapy |
| Number of Treatments |
Less Frequent |
2-10 |
| Need for Repeat Treatment |
Frequent |
What are the contraindications for sclerotherapy?
Sclerotherapy is not recommended for people who are/have:
- veins larger than 6mm in size
- patients with vascular disease or arterial insufficiency (includes thrombophlebitis)
- pregnant or breast feeding
- bedridden
- immune compromised
- diabetics with neuropathy
- massive obesity
- currently taking Coumadin or other blood thinning drugs
- have had a blood clot within the past year
- have had a previous allergic reaction to sclerosing agents
- unwillingness to comply with wearing compression stockings
Spider veins, reticular veins and some varicose veins.
Spider veins (also called telangiectasias) can be found anywhere on the body including the face. They are very small blood vessels, thread-like in appearance, that appear on the skin’s surface layer. They can take many shapes such as lines, dots, clusters, and branches and can be any color from red to purple. They are caused by many factors such as heredity, sun exposure, pregnancy, hormonal changes, medications, etc.
Reticular veins are the “feeder” veins a little deeper in the skin. When pressure inside these veins is increased (by weight gain, pregnancy, pressure from long periods of standing, etc.) they can enlarge. Because reticular veins are not the main veins returning blood to the heart, they can more easily treated with sclerotherapy.
Varicose veins are caused by weakening of the walls and valves inside veins causing them to engorge with blood instead of circulating it back to the heart. These veins are bulging in appearance and can be painful to the touch. Varicose veins need to be evaluated before sclerotherapy is considered due to the health risks associated with the treatment. Often, surgical intervention is necessary.
What does the treatment involve?
The length of the entire treatment can take anywhere from 15 to 60 minutes depending on the size and number of vessels to be treated. Before and after photos may be taken of the veins to evaluate the progress. The physician will then begin the injections of the sclerosing agent. During this time you may feel some mild discomfort or a burning sensation.
After the treatment is complete, you may experience some itching or bruising and the area injected could feel achy for a few days. If your legs are being injected, you may be required to wear support stockings or wraps for a short time following the injections to help compress the vessels as they shrink.
What should I do to prepare for sclerotherapy?
The physician will go over all of the medications you are currently taking during your initial history. You may be advised to avoid taking certain medications or supplements prior to the procedure. This may include any over-the-counter medications you are taking, vitamins, herbs, etc.). You should avoid taking any aspirin, ibuprofen, or any other anti-inflammatory medication for 48 hours prior to and after your treatment. No lotion, powders, sunscreen or creams should be applied to the treatment area prior to your procedure. If you are having your legs treated you may want to wear shorts.
Other medications such as Coumadin or any other blood thinner, prednisone, certain antibiotics and high doses of Vitamin E should not betaken for 4 days prior to your procedure. However, it is strongly advised you contact your primary care physician for permission to stop these medications before proceeding with a sclerotherapy treatment.
How many treatments will I need?
The number of treatments you will need will range from 1 to 5 (average is 2 to 4) depending on the body area you are having treated and the type, amount and size of the vessels treated. Smaller vessels can close after the first treatment, but feeder vessels, or vessels with multiple branches, could take more sessions performed one month apart. You will begin to see the larger vessels disappearing gradually over the series of sessions. Sessions are repeated no sooner than 4 weeks apart.
In most cases, 50% to 70% of the treated vessels will be gone for good with 60% to 80% of patients seeing an improvement. However, new vessels that appear over time will need to be treated. Approximately 10% of patients treated have results ranging from poor to fair, or with no vein disappearance after several treatments.
What happens after a sclerotherapy treatment?
You may resume your regular daily activities which should include walking (if you had your legs done to prevent clots from forming), but should refrain from vigorous exercise until advised by your physician. You should avoid prolonged sitting or standing, or heavy lifting if the areas treated were your legs. You should continue to wear your compression garment for the time period specified by your physician and elevate your legs as much as possible if the veins treated were larger. The veins may appear to look worse before they start fading.
You may shower, but avoid a hot shower and make the water as cool as you can tolerate. The injection sites may be washed gently with mild soap and lukewarm water. Do not use a hot water bottle, use a heating pad, or take baths, sit in a jacuzzi or in a sauna for at least 1 week after your treatment. Alcohol and spicy foods should also be avoided. Bruising or discoloration should begin to disappear within 2 weeks after your procedure.
Will my health insurance cover the cost of sclerotherapy?
No, many insurances do not cover sclerotherapy as it is categorized as a “cosmetic” procedure.
Are there any risks associated with sclerotherapy?
Common side effects include redness and swelling at the injection sites, bruising, itching, tenderness, aching or cramping. Pigment irregularities called “telangiectasia matting” (brown spots or streaks caused by very small clusters of vessels that form around the treated area), may take months to a year to fade. Although extremely rare, a serious medical complication could occur such as ulcers, blood clots, allergic reactions to the sclerosing agent (which could result in scarring), or severe inflammation. If you experience any of these conditions, contact us or your primary care provider immediately.
What are the chances sclerotherapy won’t work?
Less than 10% of patients treated do not respond to sclerotherapy. Sometimes a different sclerosing agent can be used or the addition of laser therapy can be considered. If the veins continue to appear large and bulging, a referral to a vascular surgeon may be discussed to consider a vein stripping procedure.
How long will the results last?
Results are very patient dependent. Typical results vary from 2 to 5 years, depending on the patient’s age, how large and numerous the veins were to begin with, the lifestyle of the patient (i.e., heavy lifting, prolonged sitting, jogger, etc.). In most cases, treated veins should not appear and you will likely develop new visible veins.