Severe matting and spider veins after sclerotherapy treatment of several reticular veins. Will this go away? (Photos)

Question

I have had both GSVs and Lower SVs closed as well as pelvic closures. Now I want my legs back! After sclerotherapy of several reticular veins I have spider veins everywhere branching off of the bruised injected reticular veins. It has been 1.5 weeks. Is this normal and will it go away?

Alix J. Charles, MD · Answer

Thank you for your question.  I can understand your concern as this is a distressing outcome to experience after undergoing a procedure you had hoped would make your legs look better.  At 1.5 weeks it is still too early to judge how much of what you see is true matting or bruising.  It may be a combination of both.  The bruising can resolve in a few weeks whereas the matted telangiectasias can take months to resolve.  In the short term, some laser treatments or injections of different sclerosing agents (like glycerin) could be helpful.  In the majority of these cases that I have seen, the matting eventually resolves on its own. Best of luck to you.

Hratch Karamanoukian, MD, FACS · Answer

Post sclerotherapy follow up is necessary and sometimes drainage of retained coagulum is key.
Recommend topical Sclerovase and Scleroquin plus and drainage of retained coaguum. Also recommend Scler-X ro reduce PIH. 
H Karamanoukian MD FACS
certified vein specialist from ABVLM

John Landi, MD · Answer

For only less than 2 weeks post EVLT and all that you have had done, your legs look fine.  The bruising will improve over 2 to 6 weeks. The new spider vein formation (neovascularization) sometimes occurs after reticular vein treatment.  I usually wait 6 weeks and then I treat that with  another sclerotherapy treatment with glycerine or foam.  This should clear with time and patience.

Vahe Melkonyan, MD · Answer

You should wait at least 4-6 week to judge results of your sclerotherapy, your legs are still very bruised on those images. Severe matting may often happens when sclerotherapy was performed prior addressing underlying truncal vein/s insufficiency. Meanwhile, matting may happen after any sclerotherapy or any other venous procedure, usually it resolves by itself after some time.You can try sclerotherapy of matting area if it does not relsolve after 3 -6 months, assuming that underlying venous disease was addressed appropriately.

Severe matting and spider veins after sclerotherapy treatment of several reticular veins. Will this go away? (Photos)

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