What caused blisters after sclerotherapy?

Question

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?

Stephen Prendiville, MD · Answer

Extravasation issues aside, the blisters seen in the picture look like a "tape reaction" or contact dermatitis. The blisters or bullae are epidermal. This should have no effect on the results of your sclerotherapy.

Otto Joseph Placik, MD · Answer

It is difficult if not impossible to predict what caused the blisters in this situation. It could be due to the shear or stress of the dressing or to inadvertent extravasation of the sclerosant in to the skin. With gentle wound care these should heal uneventfully. It is not unusual to require several sessions to achieve successful therapy of varicose or spider veins.

Hratch Karamanoukian, MD, FACS · Answer

The blisters that you show in this picture is most likely an allergic reaction to tape used over gauze that was used to cover the area of sclerotherapy or from the ace bandage that was used to achieve compression following sclerotherapy.

John Landi, MD · Answer

The most common cause of what you are describing is irritation from the tape or bandage.  I have seen this occur if an ace bandage slides/rubs over an area and also from tape irritating the skin.  It would be very unlikely that the sclerosing solution caused this problem.  A topical cream or ointment such as silvadene or bactracin would help.  If the veins were injected, then they should resolve over time.

Margaret Mann, MD · Answer

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

What caused blisters after sclerotherapy?

Answers (10)