Omar Abu-Bakr, MD

Hello there,




Thank you for your question.

Sclerotherapy is a cery good method in treating venous problems on the legs (if used in a propper way of course) as by injecting in ine place we may treat a wide area of small spider veins including their rute, but when speaking about face and head generally then things are different as the anatomy is very different and the structures and tissues we have in the head are very different than those in the legs. Using sclerotherapy at the head's level is so risky as we have alot of "noble tissues" like tge eyes, nerves, the brain, etc, that can be easily affected and the result will be catastrophic if one of these is damaged.

So, sclerotherapy is never used to treat veins on the face. If we want to treat a vein there then we may use laser or any other more precise method.

Dr. Omar Abu-Bakr

Consultant Phlebologist at Whiteley Clinics - London

Hello there,

Thank you for your question. When performing sclerotherapy, what we actually do is killing the vein and your body will absorb the vein (eat the vein) after that in time, that time is usually 2-3 months (till the vein disappears) but in some cases it can take even more. Some times multiple treatment sessions are needed. So for the moment, what I see in the pictures is a normal reaction and at the moment there is nothing to worry about.

Dr. Omar Abu-Bakr,

Consultant Phlebologist and Consultant Venous Surgeon (varicose veins treatment)

Whiteley Clinics London

Thank you for your kind question.

When speaking about varicose veins treatment, we may use different pricedures to treat the same patient and some times even to treat the same vein in the leg. However, our studies in the Whiteley Clinics London have shown that treatung the main trunks using ultrasound-guided foam sclerotherapy is not effective (both from medical point of view as recurrence rate and aesthetic point of view having a high risc of producing brown stains on the skin mainly if the vein is close to the skin).

The reason for that is simple, in order to close the vein (kill the vein) using endovenous procedures (EVLA, UGFS, etc) we have to induce "Fibrosis" in the venous wall and not "Thrombosis" in the venois lumen, although in the firs stages they will both look almost the same on the postop. ultrasound scan, but they are absolutely tow different things. Fibrosis in the venous wall, is the sitiation when all the cells of tje venous wall has died and your body will start absorbing the vein once for ever. Thrombosis is when you only produced a clot within the venous lumen, but the venous wall's cells are still a life, and even if the vein looks like closed now, but it will for sure open again within months - 2 years (and of coarse it will be still a varicose vein; a vein with disfunction of its valvs).

Unfortunately , based on our studies, using foam sclerotherapy in the main trunks (Great/small Saphenous Vein, etc) will always produce "thrombosis" within the vein, but very rarely "fibrosis" of its wall.

Ultrasound guided foam sclerotherapy is only reserved for the mall superficial veins as a completing procedure of the main surgery (EVLA, phlebectomies, etc).

Thank you.

Dr. Omar Abu-Bakr

Consultant Phlebologist and Consultant Venous Surgeon.

Whiteley Clinics London

Hello,

Thank you for your kind question.

When speaking about venous problems, there is a whole plan that should be respected to establish the treatment plan. This includes, first of all and the most important, a thorough and detailed Doppler-ultrasound scan performed by a highly specialised and experienced ultrasonographer to chace each vein and establish its root, content (if there are clots or not), diameter, the venous wall size and the veins relation to the skin and the deep venous system. Based on these criterias we may establish yhe best treatment plan and the best combination of methods to treat your case, do it is a plan that is tailored according to each case apart. The treatments could vary, from endovenous lasers used to treat main trunks and perforators, micro-phlebectomies used to treat big bramches, ultrasound-guided foam sclerotherapy used to treat the smaller branches (that foes not deserve to be treated with the phlebectomies), and microsclerotherapy for cosmetic spider veins anly after treating the main roots in the order I mentioned before. So there is no GOLDEN CHOICE that works for all cases, but there is a plan dobe for each case apart.

Once varicose veins are CORRECTLY TREATED, the recurrence rate is no more tgan 3%, but if the treatment is done without the correct and deep understanding of the disease and the deep understanding of each treatment method then the recurrence could be as high as 85%.

Hope I answered your question.

With kind regards:

Dr. Omar Abu-Bakr

Consultant Venous Surgeon and Consultant Phlebologist - Whitele Clinics London