I had sclerotherapy done 10 months ago. I developed an area of dermal necrosis and ulceration in my anterior leg (1.5cm diameter of true necrosis with 1-2 cm of surrounding skin changes) . This area has slowly healed although the skin still remains very thin in the central area and easily sloughed off. My doctor then recommend fractionated laser to help improve the scar. This was done a month ago and the wound is still occasionally oozing. What kind of doctor and treatment should i get for this?
Dermal Necrosis After Sclerotherapy?
Doctor Answers 5
I would highly recommend that you see a board certified dermatologist specializing in treating wounds.
See a Board Certified Phlebologist (Vein Specialist) and Board Certified Plastic Surgeon
Vein specialists know more about venous wounds than dermatologists (true and hard to believe). Cosmetic dermatologists are good when you need a peel or if you need facial fillers and Botox.
Of course, there are dermatologists that have expertise in venous disease and recognize how to treat this problem.
If the ulcer is without evidence of infection, electical stimulation therapy will help heal it. If it is active and has a lot of drainage, it can be treated with unna boot compression and antibiotics. If it is a healed ulcer with a resultant scar, it can be revised by a Board Certified Plastic Surgeon. Mobilization of tissue in the face of scarring in an individual who has a healed ulcer is prone to tissue necrosis and left best to plastic surgeons who are experts in this area - their expertise in microcirculation, raising tissue flaps, mobilizing tissue is unparalleled among other surgical specialists or dermatologists - that is what they are trained to do ...
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Poor Healing After Sclerotherapy
I actually suggest you see a board-certified dermatologist experienced in treating wounds and in sclerotherapy (therefore familiar with its side effects). Dermatologists are the skin experts and the most adept with how to treat ulcerations in the skin.
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