John K. Long, MD

The FDA has approved of only two solutions that I am aware of to use for small vein sclerotherapy.  One is hypertonic saline and this solution has been around and used for a long time.  The other is Sotradecol which has been used also as a sclerosing agent for a long time but in the last decade has been hard to find in pharmacies to use on the patients.

Hypertonic saline is absolutely safe and is used even on pregnant women who had varicosities that are painful.  It is possible to inject improperly into the tissues in the wrong areas and cause pain, redness and even necrosis with skin loss but this is not related to the solution as much as improper injection technique.  In the best of circumstances, hypertonic saline burns when injected and can cause temporary cramping of the calf , leg or foot.

Sotradecol when properly diluted is as safe as hypertonic saline but does not burn or cause cramping.  Complications of pain, redness and necrosis with skin loss is possible with this solution as well if injected into the tissues instead of the vein.

When properly injected into the veins, both agents cause an inflammation of the vein wall and an eventual scarring down of the vein and thus the disappearance of blood flow and the unsightly vein is "gone".  Both agents take the same amount of time for success so the real differences are the discomfort factors of the two agents and the difficult availability and the extra costs of the Sotradecol.

Almost everyone who needs sclerotherapy has a vein problem that is recurring and cannot be entirely "cured".  The goal would be to treat those veins that are offensive and when others return have those treated as well.