What is the Outcome of Compression Garments After Sclerotherapy?

Many patients will find that the compression hoses help to improve the outcome of the sclerotherapy treatment.  The hoses help to keep the veins compressed after treatment, allowing for the solution to be more effective. 

     I have my patients wear the compression stockings for a full week after sclerotherapy.

     Wearing compression stockings after having sclerotherapy is actually imperative to getting the best results possible from your treatment. Research studies have shown this to be the case.

     Having the vein walls in close contact with each other (i.e. when being compressed by the stockings) is important because the solution that is injected into the veins ("sclerosant") is better able to act directly on the lining of those walls, and this is what ultimately causes your body to break down and absorb those veins. If you do not wear the stockings, those veins will continue to have excess blood pooling in them, which dilutes the sclerosant, thus preventing it from having as much contact with the vein walls as possible.

    Compression stockings have what is called "graduated" compression. This means that they offer more pressure to the ankle/lower leg than they do to the thigh (the pressure applied by the stockings gradually decreases as you move up from the ankle to the thigh). This essentially helps get blood from the lower legs back up to the heart (working against the force of gravity).

   Even if you haven't had sclerotherapy, it's not a bad idea to wear compression stockings. . . especially if you have a job that requires you to be standing for long periods of time. You want to prevent gravity from causing excess blood to pool in the veins of your lower legs because, over time, this "pooling of blood" will result in stretching of the walls of your veins. As the walls are stretched out with excess blood, the valves within the veins (which prevent the backflow of blood) do not work as well; the blood then has a harder time making it back up to the heart. Thus, the more "help" you get to push the blood upwards (i.e. from pressure applied externally via compression stockings), the less likely you are to get varicose veins. If you already have varicose veins, wearing compression stockings during the day can help prevent them from getting worse.

   Thus, if you are planning on having sclerotherapy (a great treatment, by the way), I strongly encourage you to wear compression stockings. . . especially during the few days immediately following the procedure.  

Compression after sclerotherapy does several things-it keeps the solution in contact with the treated veins, it decreases bruising and swelling and it helps to decrease staining and increased pigmentation.  The controversy with compression revolves around how long to wear compression following the treatment.  Some recommend no compression and some recommend months of compression.  I can only tell you of my experience doing sclerotherapy over 20 years.  I use to recommend 6 weeks of compressions and now I recommend only 48 hours.  Factors that have influenced this include better sclerosing agents and also closing the leaking valves, if present, before beginning the sclerotherapy. I notice no worsening of results with 48 hours of compression compared to 6 weeks.

One thing we know for certain is that sclerotherapy is most effective if you wear compression stockings that cover the area that is injected. You should wear stockings for at least three months after injections AND wear them religiously for the first two weeks after injection - i.e. practically live in them day and night. I tell my patients to shower and put the compression garments on for two weeks after the procedure and leave them on at night as well - then continue for three months when you are out of bed and on your feet. This will give you the best cosmetic outcomes. I don't recommend sclerotherapy in patients who tell me that they will not wear stockings, as sclerotherapy is less effective in those patients and there is more likley to be hyperpigmentation after sclerotherapy in those that don't wear compression stockings.

Depending on the type/size of veins treated, many patients will find an improved result from wearing compression hose after sclerotherapy treatment.  The hose help to keep treated veins compressed, which helps the sclerotherapy agent work effectively.