• About Sclerotherapy
• Types Of Thread Veins
• Contraindications
• Preoperative details
• Patient Information
• Possible complications

Sclerotherapy/Microsclerotherapy

Takes its name from a Greek word meaning "hardening," is a method of treating enlarged veins by injecting an irritating chemical called a sclerosing agent into the vein.

This process may be used to close small- and medium-sized varicose veins. The doctor injects the veins with a solution that causes a scar to form in the vein, which forces the vein to close and the blood to reroute through healthier veins. The procedure does not require anesthesia and can be done in the doctor's office.

Microsclerotherapy is a new and improved type of sclerotherapy that uses improved solutions and injection techniques that increase the success rate for removal of spider veins.

The chemical causes the vein to become inflamed, which leads to the formation of fibrous tissue and closing of the lumen, or central channel of the vein. The object of compression sclerotherapy is then to compress the vein so that the resulting thrombus is kept to the minimum and the subsequent formation of scar tissue within the vein produces a fibrous cord and permanent obliteration. Non-compressed veins permit the formation of a large thrombus and produce less fibrosis within the vein.

Types of Thread Veins

Sclerotherapy remains the primary treatment for small-vessel varicose disease of the lower extremity.

These small vessels include telangiectasias, venules, and reticular veins.

Telangiectasias are flat, red vessels smaller than 1 mm in diameter.

Venules and reticular veins are blue and smaller than 2 mm, whereas reticular veins are 2-4 mm.

Large varicosities do not respond as well as small varicosities to sclerotherapy.

Treatment of telangiectasias and reticular veins may greatly improve their appearance. Treatment may also improve the associated painful symptoms. These vascular abnormalities are common. Telangiectasias are present in up to 28.9% of men and 40.9% of women.

Thread veins in the legs can be unsightly and embarassing for some people. Now there is a treatment that will improve their appearance.

The major indications for sclerotherapy are to improve the cosmetic appearance and to reduce the associated pain and burning.

Contraindications: to sclerotherapy include

• Pregnancy.
• Pulmonary emboli
• Hypercoagulable states
• Allergy to the sclerosing agents [sodium tetradecyl sulphate] or to any component of the preparation.
• Patients unable to walk due to any cause.
• Patients currently taking oral contraceptives.
• Significant obesity.
• Acute superficial thrombophlebitis.
• Local or systemic infection.
• Varicosities caused by pelvic or abdominal tumours.
• Uncontrolled systemic disease eg diabetes mellitus.
• Surgical valvular incompetence requiring surgical treatment

Preoperative details:

• Detailed history taking and physical examination
• Attention to hormone replacement, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), vitamin E, steroids, and herbal medications.
• Symptoms that may be related to arterial or venous insufficiency must be investigated, and lower-extremity duplex ultrasonography may be necessary.
• Review with number of treatment sessions that are required and the duration of treatment.
• Discuss the limitations in activity that may be necessary after each session.
• Discuss the sclerosants to be used, including potential adverse reactions.
• Pretreatment photographs for documentation and for comparison with the postoperative results. The photographs help to evaluate progress.

Patient Information

• Sclerotherapy involves the use of a tiny needle to flush a small amount of a medication into the thread veins to cause them to dissolve away.
• We will not be able to get rid of every thread vein but we will try to decrease the venous appearance of your legs with gradual lightening of the thread veins with each session.
• You may feel a very slight pricking sensation as the injections are being performed.
• After the first day of treatment, the skin around the vein is a little pink and blotchy. Occasionally people with more sensitive skin see more pinkness or reaction around the vein. Usually a bruise is noted at the treated site. This usually disappears after a few weeks but in some cases may take months to fade.
• A length of tubigrip will be used to cover the treated area after injection. This should be left on for 24 hours. Please remember to bring the tubigrip back for use at your next session. Alternatively, you may prefer to wear your own support tights.
• Do not use any creams, oils, lotions, tanning, or perfumed products on the area on the treatment day or the day after.
• Do not have a very hot bath or shower, or use any additional bath products on the treatment day or the day after.
• You should avoid prolonged sitting, pounding type of exercise, squatting and heavy weight lifting after the treatment. You are encouraged to walk after the treatment.
• You are advised to avoid alcohol and aspirin 24 hours before and after treatment.

Possible complications of sclerotherapy include:

• Pigmentation - a result of staining caused by small amounts of blood just under the skin surface.
• Staining - faint brown marks left by the vein walls as they are dissolving.
• Telangiectatic matting - very fine small blushes of capillaries left as larger thread veins regress.
• Skin necrosis - a shallow ulcer can occur at the site of injection. This is unusual and always heals.
• Allergic reactions - are very unlikely and have not been reported with the solution used at St Mellion Clinic.