Does Sclerotherapy work and what are the side effects?

Question

I'm 30 years old and plan to get sclerotherapy. Does it work and what are the side effects? How much does it cost?

Raffy Karamanoukian, MD, FACS · Answer

Sclerotherapy is an effective treatment for spider and reticular veins. Treatment efficacy, however, depends on technique and the proper diagnosis of your condition. Sometimes spider veins may be an external sign of a deeper vein problem.

Dennis Gross, MD · Answer

Sclerotherapy is a liquid solution (generally a salt or saline-based product) that is directly injected into the vein. The solution causes the vessel to seal shut and blood flow is redirected to stronger, healthier veins. Results are immediate- some minor bruising is a common side-effect that usually subsides within a few days.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question! Currently sclerotherapy is the treatment of choice when treating enlarged and bulging veins. It uses a sclerosing solution that causes the vein to shrink. Usually it takes only 1 to 2 sessions to achieve fading of the undesirable veins. Side effects may include temporary bruising, discoloration, inflammation, small skin sores and, in rare cases, blood clots.
An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and obtain expert medical advice. Best of luck!

John Landi, MD · Answer

Sclerotherapy is the gold standard for the treatment of spider and blue (reticular) veins and works well.  If you have a  lot of these veins, than it would be prudent to have a pretreatment venous reflux ultrasound to look for malfunctioning valves which could be contributing to the spiders and which may need to be treated before the sclerotherapy.  A vein specialist would be able to best advise you. The cost of sclerotherapy varies from doctor to doctor and may also depend on the amount of veins treated.

Brian E. Dubow, MD · Answer

The cost depends on the doctor and your location.  There are rarely any side effects, but make sure you go to someone who is experienced

Craig Crippen, MD · Answer

This is a great question and i am glad you asked.

	Basically in a nutshell, sclerotherapy is the process by which we inject a "sclerosing" medicine into your diseased veins.  This will cause the veins to close and then be absorbed by the body over a period of time.  It is a very safe and effective method of treating small to medium size veins.

	Cost depends on where you live, here in Canada treatments are partly subsidized by the government.

	Regards

	Dr. Craig Crippen

Usha Rajagopal, MD · Answer

Spider veins and verticular varicose veins can be eliminated permanently through sclerotherapy.
I attached a video of sclerotherapy. This is only a portion of the procedure. You can actually watch the veins disappear as the solution is injected.
A laser is used as a second line of treatment or as a clean-up procedure after sclerotherapy when the remaining veins are too small to inject.

Hratch Karamanoukian, MD, FACS · Answer

Sclerotherapy is effective when appropriate veins are chosen for injection, always from proximal to distal areas of the lower extremities.
You asked about side effects and most importantly one should remember that any of the sclerosant solutions can cause hyperpigmentation which in rare cases, can last as long as a year or more.
To prevent hyperpigmentation, meticulous technique should be used as well as avoiding excessive pressure during the injection process to avoid extravasation of blood. As well, treating venous reflux disease will also reduce the likelihood of hyperpigmentation.
Another important problem can be clot formation in injected reticular veins which should be evacuated with a micro puncture blade to minimize dermal pigmentation - i.e. hyperpigmentation.
Sclerotherapy should be avoided in patients that have a history of deep vein thrombosis, in patients who are pregnant and patients who have phlebitis. It is also important to make sure that the patient is observed for 30 minutes in the office as some individuals can have hypersensitivity reactions that could be deadly (very rare).

Peter Goldman, MD (retired) · Answer

Sclerotherapy for treatment of unwanted vessels on the thighs and legs works very well and most patients are extremely pleased with their results. Side effects of treatment include:

	
		temporary redness,
	
		swelling,
	
		occasional temporary discoloration of the skin (rarely over a few months).
	
		But in general, nothing very serious.


	Cost per procedure is variable in different parts of the country, but based on the amount of areas treated (or the volume of sclerosant used) , the cost can run $250- $500 per session with most patients needing 2-4 treatments for minor vessels and 8 or more session for more major vessels

Arnold R. Oppenheim, MD (retired) · Answer

Yes, sclerotherapy does work. However, you should not expect all those nasty little vessles to be gone in one session. If 75 per cent resolve after each session that is not a bad success rate.

	There are a number of potential complications depending on the solution that is used. For instance, ulcerations are most common with hypertonic saline, and rare with chromated glycerine. Some of the more common complications include bruising, ulcerations, and edema (swelling) of the lower legs,

	It is possible to have an allergic reaction to the solution being injected. This could obviously be a life-threatening event. I had a patient who had an anaphylactic reaction to polidocanol, (not in my office praise the Lord) and nearly died.

	Thrombophlebitis is the most feared event. This is a very rare event. Most physicians will use compression in the form of bandages or stockings to help prevent this.

	Costs, like many of these procedures varies between $100-300 a session.

Does Sclerotherapy work and what are the side effects?

Answers (10)

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