I Believe I Have Hemosiderin Staining After Sclerotherapy. How Can I Tell and What Should I Do?

Hemosiderin following sclerotherapy may last months or years.  It is likely that the amount of hemosiderin that you have will fade away within a few months.  If the hemosiderin persists, I have had good results treating the hemosiderin with low dose q-switched alexandrite lasers using multiple treatments spaced a month apart.

Generally coagulum that is a result of sclerotherapy is removed within a two week period following treatment. However, what you are seeing should resolve over time, about 6months - 1year. If you still see staining after a year treatment with a laser may be helpful. 

We use a regimen of two topical cremes called Sclerovase and Scleroquin plus to help reduce the hyperpigmentation that can result with sclerotherapy. We also use an oral supplement called Scler-X, aka PIH Relief Complex. Sometimes we use a YAG laser if there is residual pigmentation after 6 months. 

Following sclerotherapy, the treated veins can clot or blood can escape from the treated veins and form around these veins. Both of these can lead to the hemosiderin deposits. The majority of these will dissolve spontaneously over time and could take up to one year. Local care to the area with warm compresses will help. Also, you should return to your treating physician who can evacuate the clotted blood under local anesthesia with a small needle. This releases the trapped blood to lighten the area. If all of this should fail, then there are topical lasers which may help. From your picture, your problem should resolve with local care and evacuations.

Hemosiderin deposition after sclerotherapy usually occurs because either the blood from the treated varicose vein leaks out into your tissue, staining them, or blood clotting within the treated vein, and keeping the area inflammed and "hard."

Here's how you take care of it. Apply heating pad several times a day to the area. Rub/massage the area several times a day, or whenever you get a chance. Call bellagiomedspa.com at 480-788-5621, for a free consultation, ad I will formulate a treatment with Yag laser. Yag is the laser of choice for these sclerotherapy complications because we are ultmately dealing with hemoglobin and iron, which absorb 1064nm lasers the best. In addition, Yag laser penetrate deeper allowing complete resolution of the hemosiderin stainings. 

Your images are consistent with hemosiderin deposition after sclerotherapy. The pigment inside the destroyed blood vessels, hemoglobin, becomes hemosiderin and looks brownish red. Most commonly, it will go away on its own, although this may take several months in some patients. If after 6 months it is still present, I advise you to consult your doctor regarding laser treatment to remove the pigment.