Which Sclerotherapy-detergent is the best?

Hi Aisha,Sclerotherapy can be done with several solutions. The old-school way to do it is with hypertonic saline. This was extremely painful for patients. I use a combination of sodium tetradecyl sulfate, polidocanol, and glycerine depending upon the size of the veins. These injections do not hurt (except for the initial pinch of the needle). Sclerotherapy results are VERY physician-dependent. I'm happy to do it for you if you are in the LA area. Hope this helps,Dr. Kiripolsky

I like using Polidocanol solution for sclerotherapy because of a combination of its safety and patient tolerability profile. This is probably the most expensive sclerotherapy agent due its quality over other agents, so may also result in increased cost of the procedure.

The most commonly used agent in the USA now is Polidocanol, but most vein specialists have several agents on hand to deal with different vein issues.  The majority of patients do well with 3-4 sessions of Polidocanol, as long as they do not have underlying venous disease.  During a consultation consisting of your symptoms and exam, we would determine a plan of care with you.  If there is no evidence of venous disease, we typically recommend 3 sessions of Sclerotherapy over a couple mos.  An ultrasound of the veins is helpful to determine if there is an underlying problem, causing the treatment to fail.   If no improvement, we consider other alternatives such as Sodium Tetradecyl or Glycerin or Hypertonic saline.  Also, our skin laser by Candela can be used.  Often, what's really needed is more sessions or healing time.  It takes the veins approximately 3 weeks to 3 months to reabsorb.  It's difficult to be patient during this process, but there is unfortunately no magic eraser. 

Sclerotherapy is a process and it is unusual for one treatment to resolve all veins.  The average treatment sessions for my patients is 3.  I use  foamed sodium tetradecyl sulfate with excellent results.  Rarely do I switch to polidocanol. Occasionally for very small veins I will use glycerine. My feeling is that the results of sclerotherapy are dependent primarily on the person injecting.