Sclerotherapy
Sclerotherapy is one way varicose veins are treated. Sclerotherapy has been used on patients around the world since the 1930s and remains the treatment of choice for smaller varicose veins and superficial spider veins. It is also used for larger varicose veins in some situations.
Sclerotherapy involves injecting a solution into the varicose vein using a tiny needle. The solution injures the inside of the varicose vein causing it to scar and then close, or collapse. This keeps blood from flowing through the treated vein and allows it to automatically flow through healthy veins. Different solutions can be used for sclerotherapy. These include Sotradecol (an FDA approved solution), hypertonic saline, Polidocanol, sodium morrhuate, glycerin, and others. At Vein Treatment Specialists, PC we use Sotradecol (sodium tetradecyl sulfate) for sclerotherapy. At each treatment session, 10 ml of Sotradecol can be used. The Sotradecol is injected using a tiny needle on a small syringe.
You may hear different terms used for sclerotherapy. Some of these terms are: cosmetic sclerotherapy, therapeutic sclerotherapy, visual sclerotherapy, shots for spider veins, spider vein treatment, ultrasound guided sclerotherapy, foamed sclerotherapy, compression injection sclerotherapy, and others. No matter which name is used, what kind of solution is used, or the method of injecting the solution, the basic process is the same, and has the same effect on the vein being treated. The veins collapse and gradually disappear.
Sclerotherapy can be used for large varicose veins, middle sized veins, or tiny spider veins. At Vein Treatment Specialists, PC, Dr. Dupper will take the time to carefully evaluate your varicose veins to determine which combination of treatment will be the best for your situation and your goals.
Visual Sclerotherapy
Visual sclerotherapy is an injection of a sclerosant solution into a vein without ultrasound guidance. Visual sclerotherapy is used to treat the smallest spider veins. When doing visual sclerotherapy, the doctor may use a polarized light with a magnifying lens, or a Vein Light. During sclerotherapy you will receive many tiny needle pricks to the areas needing treatment. Just after each injection, you may experience a mild burning sensation lasting about 2 to 3 minutes. The vein will become swollen and mildly sore as it hardens and collapses. The soreness may last for up to ten days. Most commonly, the soreness lasts about five days. You may see some bruising where the injections were made. As the bruising and soreness goes away there may be some discoloration over the vein. These effects will gradually fade away.
Foamed Sclerotherapy
Sotradecol and Polidocanol, two commonly used sclerosants, are mild detergent solutions. Because of this they can be mixed with a small amount of air or another gas such as carbon dioxide or nitrogen, and “foamed.” The foam is then injected into the diseased vein. This mixture has several advantages over liquid sclerotherapy in larger veins. Foamed sclerosant fills up the vein and pushes the blood out of the vein with a smaller volume and a lower concentration of the sclerosant. By displacing the blood more effectively, a larger diameter vein can be treated. Because air is very easily seen with ultrasound it is easier to make sure the injection goes into the vein. All of these advantages make Ultrasound Guided Foamed Sclerotherapy even more effective and safe than Ultrasound Guided Sclerotherapy using a liquid.
Ultrasound Guided Sclerotherapy
Ultrasound is the most important technology for the treatment of varicose veins. Using ultrasound the phlebologist is able to identify middle sized veins needing treatment that are too deep to be seen with the naked eye. Using ultrasound, Dr. Dupper is able to locate the troublesome veins and ensure precise, effective results.
Ultrasound Guided Sclerotherapy is a safe procedure performed by Dr. Dupper at Vein Treatment Specialists, PC. Sclerotherapy takes about one hour. Most of our treatment plans include at least 2 sessions of Ultrasound Guided Sclerotherapy per leg. No anesthesia is needed for this procedure. Most patients experience only minimal pain and a mild burning sensation. The skin is cleaned with an antiseptic solution and the sclerosant is injected into the affected veins with a very fine needle. The number of injections made during each session depends on the number and length of the damaged veins. In our office it is considered a part of the complete treatment plan for "medically necessary" treatment.
Vein Light Assisted Sclerotherapy
A Vein light is a device that uses a very bright light and a fiber optic cord to bring that light directly to the surface of the skin. The light transilluminates the skin and the tissues just below the skin to make the veins clearly stand out. This makes the veins much easier to inject and helps to identify the diseased and healthy veins more easily.
FAQs
- Will sclerotherapy hurt?
- Will you put me to sleep for sclerotherapy?
- I hate needles!
- Can I just get my spider veins treated with a laser? Lasers don’t hurt, do they?
- Is it safe to inject air into my veins?
- What is Sotradecol?
- What can I do and what shouldn’t I do after sclerotherapy?
1. Will sclerotherapy hurt?
There will be a series of injections using one of the smallest needles manufactured. After the injection there may be a slight burning sensation that lasts for a couple minutes. Most people say it goes away with in a minute or two. Usually the anticipation of the needle is worse than the actual needle poke.
2. Will you put me to sleep for sclerotherapy?
There is such little discomfort with sclerotherapy there would be no need to sedate a patient for this procedure.
3. I hate needles!
If you have an unreasonable fear of needles, it is sometimes very hard to overcome this logically. Dr. Dupper will discuss this with you. He will help you decide if you are a candidate for sclerotherapy or not.
4. Can I just get my spider veins treated with a laser? Lasers don’t hurt, do they?
Spider veins on the legs usually do not respond as well to laser treatment as they do to sclerotherapy. Sclerotherapy is accepted to be the most effective treatment of spider veins on the legs by most phlebologists. Believe it or not, most patients say that the skin laser for spider veins hurts worse than the injections.
Facial spider veins do respond better to laser treatment, and Dr. Dupper uses the skin laser to treat facial spider veins most of the time.
5. Is it safe to inject air into my veins?
While there are some theoretical risks to injecting air into a vein, the experience of thousands of foamed sclerotherapy injections every day throughout the world shows that it is an extremely safe procedure. If you get migraine headaches you may have some flashing lights (scotoma) for a short time after the injections.
6. What is Sotradecol?
Sotradecol is a solution that is FDA approved for sclerotherapy injections. The generic name is sodium tetradecyl sulfate. It is a mild detergent solution, and has been in common use for at least 40 years in the treatment of spider and varicose veins.
7. What can I do and what shouldn’t I do after sclerotherapy?
After sclerotherapy you can return to your normal activities immediately. Dr. Dupper will put compression stockings on your legs. He will ask you to wear them 24 hours a day for 3 days and then for another 11 days during waking hours, for a total of two weeks. You are asked to walk for an hour every day, and you may return to work immediately. You are not advised to run, be involved in other high impact activities, or do core muscle exercises for two weeks. Again you are encouraged to walk an hour a day.
