Cleveland Dermatologists

Does Sclerotherapy Work on Tiny Facial Capillaries?

Hello, I have very fair skin and lately have noticed that my capillaries are becoming increasingly noticeable. I have tried several types lasers to treat my facial veins (underlying my acne scars, surrounding the nose) to no avail.

In fact, lasers often leave additional scars and capillary matting. The bottom line is that lasers do not work as my capillaries seem to require an intensity that my skin cannot tolerate. Are there other options? Can sclerotherapy target tiny facial capillaries?

In general, facial capillaries are best treated with a laser.  I try to stay away from sclerotherapy on the facial areas due to the risk of complications. While one can theorectically treat veins around the eyes with Sclerotherapy, I would not recommend it. The risk for serious complications including blindness and skin necrosis far outweighs the benefits, especially when there are much better alternatives.

Telangiectases on the face are relatively uniform in size and depth and lasers can effectively eliminate these.  In our office, we have many different laser systems for vein treatment including a Pulsed Dye Laser (595nm), KTP (532 nm, better for smaller vessels), the Diode (940nm, best for larger vessels), Gemini, Nd:Yag, etc.  Just as important as using the right laser is finding the right doctor who knows the correct settings for your skin.  I would recommend seeing an experienced dermatologic surgeon.

Best,

Dr. Mann

Margaret Mann, MD

Cleveland Dermatologic Surgeon

What is in Sclerotherapy Solution?

What are the different agents that make up the solution used for sclerotherapy vein treatment?

There are several solutions that are commonly used in sclerotherapy. However, none are perfect and all have certain drawbacks. Sotradecol and more recently, Asclera (polidocanol), are both FDA approved for sclerotherapy.  I chose to use these agents in my procedures because they are safe, effective, and cause the least amount of side effects. These agents produce better results and do not have the cramping or pain commonly associated with hypertonic saline (salt water).  Some physicians also use glycerin for tiny vessels.

Best,

Dr. Mann

Margaret Mann, MD

Cleveland Dermatologic Surgeon

Blisters After Sclerotherapy

I have some long thin blisters at the injection site as well as large bean shaped blisters. They are painful. The doctor tried to tell me they came from tape, I find this hard to believe. I think he missed the veins and instead injected the solution into my skin. What caused this reaction, and should I expect that the veins will still be there when the bruising and blisters heal?

As a vein specialist who does a lot of sclerotherapy in my office, I have unfortunately seen this type of reaction before.  Fortunately it rarely occurs and tends to happen in my patients who are very active after sclerotherapy treatments.  It results from friction of the skin against the tape and compression wrapping.  Much like wearing a misfitted pair of shoes that causes blisters, friction from the compression rubs against the skin to cause blisters after sclerotherapy, especially if you do a lot of movement on the legs.  It is usually not a true allergy to the tape or adhesive (that usually appears as a rectangular mark exactly the shape of the tape).  And it is unlikely due to the actual injections themselves.  

The good news is that this should resolve without leaving any marks, but be sure to take good care of the blisters (keep it moist with vaseline).  And if the veins were properly treated, they should go away as well!

Best,

Dr. Mann

Margaret Mann, MD

Cleveland Dermatologic Surgeon