Is this red coloring normal after Sclerotherapy? (Photo)

Question

I had sclerotherapy injected for spider veins. It has been a week and there is still some dark red blotches like the one shown in the picture. Is this normal, i ask because some people say all bruising should have subsided in a week? thank you

Jason Emer, MD · Answer

I suggest speaking to your physician.  bruising, clots and color change can occur for weeks to months after treatment.  Best, Dr. Emer.

John Landi, MD · Answer

Bruising after sclerotherapy is very common and may take several weeks to resolve depending on how extensive the treatment was. Your picture is very acceptable for one week post treatment.  Allow more time form healing.  By the 3 week point, if you still have bruising, see your treating physician for possible evacuation (drainage) of any clotted areas.

Leonik A. Ahumada, MD · Answer

Thank you for your question. Sclerotherapy for spider veins does not immediately erase your veins. The sclerosing agent irritates the spider vein lumen causing it to slow or stop flow and the color is often bright red. The blood is initially trapped in the vein structure unable to flow. The spider vein is non functional at that point and is broken down by your body.  Similarly the blood stagnant in the spider vein is also broken down and removed by the cells in your body. The color is a mixture of the various breakdown products of iron with hemosiderin being rust brown in coloration. The time for complete resolution of the color varies by patient and you probably have an idea of how long it takes you to normally clear a dark bruise; this time frame will be similar for resolution of the pigmentation following sclerotherapy. In a small amount of patients the brown pigment remains even though the spider vein was successfully treated. This is similar to the venous dermatitis seen in patients with long standing vein problems and is related to the byproducts of the blood that was in the spider vein. Fortunately most patients see a visual elimination of the spider vein and the brown, red and rustic hues resolve with time which may take weeks to some months.  Be patient and talk to your physician.

Hratch Karamanoukian, MD, FACS · Answer

Early bruising is common following sclerotherapy and pigmentation arises from hermosiderin deposition in the skin once the vein is chemically irritated and 'leaky'. Topical creams such as Scleroquin will help (see link below) or you can elect to have the discoloration cleared sooner with a Q switched laser. Dr Karamanoukian

Is this red coloring normal after Sclerotherapy? (Photo)

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