What Are the Types of Sclerotherapy Options?

What agents are used for different types of Sclerotherapy? Does everyone use the same strength solution, or does it depend on the severity of the varicose veins being treated?

Doctor Answers 7

Many options work

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There are several options for the sclerotherapy solution, and in my experience, having used them all, they really do all work.  The success lies more in the hands of the person doing the treatment rather than which solution is used.  Sclerotherapy is useful for spider veins, but not the larger rope-like varicose veins.

Burbank Dermatologist

Sclerotherapy options

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There are many options (traditional or foam) and type of solution (saline or other) and visual or ultrasound guided ... talk to the vein specialist who is Board Certified (American Board of Venous and Lymphatic MEdicine) and they will guide you through the process. 

Multiple Types

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There are essentially 3 classifications of sclerotherapy solutions-detergents, osmotic and chemical. The most commonly used sclerotherapy agents are sodium tetradecyl sulfate, polidocanol, saline and glycerine. There are other agents but rarely used anymore. Polidocanol and tetradecyl can be converted into a foam solution and this is called foam sclerotherapy which is currently the most popular method of sclerotherapy. All solutions can be used in different strengths depending on the veins being treated.

John Landi, MD
Naples General Surgeon

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Sclerotherapy and lasers

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There are a few choices when it comes to using a solution for sclerotherapy. I have used them all, and they all do work. Depending on the size of the blood vessel, one can use more concentrated solutions. However, the risk of complications also can increase.

I have found that combining sclerotherapy with the Vbeam laser can really help get better results. Some tiny veins are too small to be injected and the laser gets rid of them in as few as one treatment!

Tanya Kormeili, MD
Los Angeles Dermatologist

Sclerotherapy at Toronto Dermatology Centre

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We use Sclerodex for sclerotherapy at theToronto Dermatology Centre.  The treatment is usually done every 6 weeks, and 3-5 sessions are reqiured.

Anatoli Freiman, MD
Toronto Dermatologist

Different sized varicose spider veins require different solutions and/or concentrations.

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Foam sclerotherapy is what most docs use now and either asclera or sotradecal are the most common ones. Scleremo or glycerin is used for the tiniest of spider veins while hypertonic saline is not used much anymore.  Expect to pay about $450-600 per session and usually 3 sessions are needed with each about 6 weeks apart. Sincerely,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Products for Sclerotherapy

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There are several products available on the market for Sclerotherapy. 

Asclera, Sotradecol, Hypertonic Saline, Glycerin.

Asclera for example comes in two strengths: .5 and 1.0 ml.  If I am treating very small spider veins, I will use the .5ml Asclera.  If I have to treat veins which are larger (know as reticular veins) I prefer to use a stronger concentration of the drug. 

Many physicians will have there preference for a particular product, but in the last year Asclera became very popular and is used by many doctors who treat spider veins.  In my practice I only use Asclera and I find it to be very effective in treatment of spider veins, with very little adverse reactions and no complications thus far.

Victoria Karlinsky, MD
Manhattan General Surgeon
4.7 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.