What is causing purple blue patches after foam sclerotherapy of reticular veins done by best vein clinic in the state? (Photos)

Question

After EVLT of large & small SV & ultrasound guided sclerotherapy of other refluxing veins, I got a full session of foam sclerotherapy for mostly reticular & some spider veins. 2.5 weeks later both of my thighs are covered in blue and purple patches as well as new tiny blue spider veins. Those are not bruised areas. Went back to PA and they drained some of the treated veins. This has not helped with the appearance though. Using compression stockings. What is causing the discoloration and what can I do about it?

John Landi, MD · Answer

Some of the discoloration appears to be brusing and some appears to be spider and/or reticular veins.  I would allow more time for the areas to heal post sclerotherapy.  I recommend waiting 6 weeks between treatments.  I agree that evacuation of clotted areas should be done.  Compression and wet heat to the areas may help as well as applying dermaka cream topically.

Rodolfo Farhy, MD · Answer

This is a common complication after sclerotherapy. Would suggest to hold on more treatments for few months. Wear compression stockings for 4-5 weeks.

Ralph Carullo, MD - Account Suspended · Answer

Hello Ursul12,
Telangiectatic Matting can present as “ blush type” area containing large numbers of tiny red blood vessels that are less than 0.2 mm in diameter, directly associated with previously sclerosed or surgically removed veins.
Telangiectatic matting is a recognized complication occurring in approximately 15-20% of patients treated by sclerotherapy. Although the exact mechanism of the phenomena remains unknown, reactive inflammatory and/or angiogenic mechanisms are felt to play a role. Patients are advised that telangiectatic matting is usually not permanent and usually resolves spontaneously in 3-12 months. 
Postsclerosis pigmentation is appearance of persistent, increased pigmentation running the course of an ectatic blood vessel treated by sclerotherapy. The general incidence of hyperpigmentation ranges from 10 to 30%. Although hyperpigmentation may persist for months, its presence rarely deters patients from continuing treatment. Spontaneous resolution occurs in 70% at 6 months with 99% resolution occurring within 1 year.
It will look worse before it gets better cosmetically. It is very very important to wear compression stockings in the injected areas to help prevent pooling of blood which is responsible for the discolored (thrombosed veins).  A study comparing different times of postsclerotherapy compression in treating leg telangiectasia also demonstrated a decrease in TM when compression was maintained for one to three weeks (5%) versus three days (30%) or no compression (40%). Early on in the process, inadequate compression gives this brown green discoloration.

What is causing purple blue patches after foam sclerotherapy of reticular veins done by best vein clinic in the state? (Photos)

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What is causing purple blue patches after foam sclerotherapy of reticular veins done by best vein clinic in the state? (Photos)

Answers (3)

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Everything you need to know about Sclerotherapy

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