Leg Hyperpigmentation After Sclerotherapy

Hyperpigmentation is an accepted complication of sclerotherapy and usually resolves on its own over about one year. Unfortunately, sometimes it may not resolve completely. There are ways to try to improve it such as hydroquinolone and Q-Switch laser but none of these work on all people. Certainly avoiding sun exposure is very important. The best thing to do for now is to allow time for the staining to spontaneously resolve and avoid sun exposure if possible.

Pigmentation changes in the skin (usually darkened of the skin color) is the most common side effect seen after scerotherapy.  It occurs as a result of inflammatory response of the skin to the medication that was injected as well as a result of blood cell pigment released into the tissue during & immediately after treatment. The pigment is typically hemosiderin.  The chances of developing hyperpigmentation varies by individual but also varies based on the sclerotherapy medication that is used.  Polidocanol has a much lower risk compares to sotradecol (STS). One should avoid iron supplements around the time of treatment to reduce the risk. If you develop the side effect, tincture of time is usually the best solution, as most patients will have resolution of the discoloration with time, but it can take many months to even a year. If after a year the pigment is still present, I would recommend getting evaluated for laser treatment (pulsed dye laser or Q-switched Yag laser) to fade the pigment, which is usually quite effective.