Sclerotherapy is effective when appropriate veins are chosen for injection, always from proximal to distal areas of the lower extremities.
You asked about side effects and most importantly one should remember that any of the sclerosant solutions can cause hyperpigmentation which in rare cases, can last as long as a year or more.
To prevent hyperpigmentation, meticulous technique should be used as well as avoiding excessive pressure during the injection process to avoid extravasation of blood. As well, treating venous reflux disease will also reduce the likelihood of hyperpigmentation.
Another important problem can be clot formation in injected reticular veins which should be evacuated with a micro puncture blade to minimize dermal pigmentation - i.e. hyperpigmentation.
Sclerotherapy should be avoided in patients that have a history of deep vein thrombosis, in patients who are pregnant and patients who have phlebitis. It is also important to make sure that the patient is observed for 30 minutes in the office as some individuals can have hypersensitivity reactions that could be deadly (very rare).
