Matting after schlerotherapy, 1 year post op, what can I do? (photos)

While the pictures show some scattered telangiectasias, I don't see heavily dense clusters of telangiectasias which is more characteristic of matting.  Sometimes small spider veins can appear after treatment of larger veins, or simply as a result of trauma and inflammation to the area.  I think in your case, treatment with sclerotherapy may be the best option.  From your pictures there are underlying reticular veins (bluish veins) that if properly treated along  with the small spider veins is likely to yield better results.  You would likely need several treatments to get improvement but with a little perseverance, you should see improvement.  Make sure you see an experienced veins specialist in your area.  Hope this helps, good luck!

Sometimes the skin can become colored after vein treatment. This happens for a variety of reasons (blood trapping, skin type, sun exposure). In most people, this is gone after 12 months but there area a few where it is persistent. This can be treated with laser to lighten the color if the veins are indeed gone. I would go to someone local with extensive laser experience in skin (likely a dermatologist, not a vein doctor) to see if you are a candidate for what is, essentially, skin discoloration or a type of scarring.

Your pictures look like staining rather than matting.  Staining is treated by time as most will improve spontaneously.  For staining a q-switch laser will also lessen the discoloration.  Matting is usually very fine vein which form around an area that has been treated with sclerotherapy.  I usually treat matting by using another type of sclerosing solution called glycerine with good results.

I would recommend a venous ultrasound to determine large vein relfux. Matting after sclerotherapy is an indicator of larger vein insufficiency. I would recommend seeing a vein specialist to get evaluated. 

From your picture, it is unclear whether you have matting or staining from some retained blood in the veins. Matting typically appears as many small spider thread veins in an area that was treated. When it occurs, additional treatment of sclerotherapy or laser may be effective in eliminating the veins.

This is an unfortunate complication of injection sclerotherapy. It happens mainly after use of high concentrated solution and especially the brutal 23.4% NaCl (basically table salt) many dermatologist still use. But any other scelerosing agent in high concentration could induce them. I have tried laser, just made it worse.Not much can be done for it as any attempts to further try to close these veins will possibly generate additional ones. This is , of course my humble opinion, other colleagues may disagree.

Thanks for your question.  From what I can tell in the photos, you may have some small telangiectasias that could have developed after sclerotherapy.  This is an annoying but not uncommon side effect.  Sometimes it can be improved with further sclerotherapy treatments, or even some laser treatments.  I have also seen it resolve spontaneously even one year after sclerotherapy.  Best of luck to you.

For the best results in spider vein eliminations, the areas should be assessed with ultrasound and transillumination to find any "feeder" vein (reticulars) below the surface.  If these are not treated, they can cause matting and recurrence of veins.  Typically it can take 3-5 treatments for an area of vein.  We recommend at least two about 4 weeks apart the reevaluate in 6+ weeks.  We typically only use laser to "clean" up an area of fine veins after the complete treatments.  Perhaps seek an opinion from an experienced medical office who specializes in this type of treatment.  Matting can occur in any patients, often for unknown reasons.  If there are no veins below the surface, IPL may help reduce the redness. 

I would treat with VeinGogh using a tiny bristle needle at 5% power. This device is ideal for what you have. If you have recurrent spider or thread veins after a procedure this is probably due to what is called angiogenesis which is a stimulus the body sees from inflammation to regenerate more veins.  I did the first stem cell treatment in the world using a perivascular device to inject stem cells along closed vessels in the heart with nice result. The same thing happens in inflammation in which the body tries to regenerate new tissue with stem cells, and other factors. I would look for the feeder vein supplying blood to that area of your leg where the thread veins are and remove that vein so angiogenesis does not recur.