What is the best sclerotherapy solution?

There is no such thing as the best sclerotherapy solution. But you need to know about the different types of sclerotherapy solutions.

1. Detergent type - STS, polidochanol, sodium morrhuate and ethnolamine. These cause protein theft denaturation and cause fibrosis of the veins. Only sodium morrhuate and ethanolamine have FDA approval.

2. Hyperosmolar hypertonic type - hypertonic saline and hypertonic saline dextrose (HSD) solution. They obiterate veins via a chemical irritation.

3. Chemical irritants - iodinated iodine and glycerin.

Some of these, like STS and Polidochanol, have been used with foam to obliterate larger veins and currently are being used off label by FDA standards.

For adequate treatment, go to a phlebologist, a vein specialist and he/she will discuss all of your options with risk/benefit discussion and side effect profiles. Ask about individual risk of tissue necrosis, hyperpigmentation, pain profile with injection, allergic reactions, etc. These are very important questions to ask.