Sclerotherapy 101

Sclerotherapy is used to treat veins just below the skin's surface that are either invisible or difficult to see with the naked eye. In this procedure, tiny needles provide access to the vein and then a substance called a sclerosing agent is injected into the vein's interior wall. This substance causes the vein to become sticky and seal shut, and the troublesome vein disappears. Blood then finds a healthy path back to the heart. There is little risk of complication, and patients often experience an immediate relief of symptoms. 

There are two ways that providers visualize the veins during this procedure: “ultrasound guided” and “light assisted.” Ultrasound-guided sclerotherapy uses ultrasound to locate veins that are not readily visible and cannot be seen with a light. This procedure is often used to treat perforator veins, or veins that connect the superficial system (above the muscles in your leg) to the deep system (veins under and between the muscles of the leg).  

During light-assisted sclerotherapy, a small, hand-held light illuminates the veins and tissue directly below the skin, which allows the provider to clearly identify the source of the dysfunction.

The number and length of each treatment vary from patient to patient. Each session can take between 15 minutes and one hour, depending on the complexity of vein patterns and venous reflux. Most patients need multiple treatments (3-6 sessions, on average), however, there is usually improvement with each session.

Here is the question that patients ask the most: “Will it hurt?” Everyone’s experience is different, but most people describe the feeling as quick little bee stings. It is always possible to stop the procedure or take a break if someone does find it very uncomfortable, but most patients say it is very tolerable. The medicine is pH balanced and vein access is with a 27-32g needle, so it’s just a very small perceivable pinch.

Immediately following the procedure, there may be mild itching of the legs, which typically resolves within an hour. For the next few days, there may be some tenderness and bruising. About two weeks following the procedure, there may be hard bumps in the area of the treated vein, which usually disappear over the course of several months.

The most common side effects are bruising and tenderness of the treated veins. The bruising is usually fully resolved within two weeks, and the tenderness responds well to heat and elevation. Remember, patients who follow the post-procedure guidelines for care will promote the most effective healing. Compression stockings should be worn for 7-14 days after each sclerotherapy session, depending on the severity of the venous disease.

The changes that patients notice in the first two months are improvement in symptoms. Patients have reported to that their legs feel lighter or pain free! The large, lumpy veins slowly disappear, usually 2-6 months after the procedure, and the smaller veins may disappear over the following six months. It’s good to remember that as the veins resolve, there may be some color changes in the skin; legs sometimes look worse before they look better. But when they look better, they look great!

To learn more about Sclerotherapy or other vein treatments, contact us at the Vein Healthcare Center today to schedule an evaluation. Education is the first step toward healthy legs!