5 months after sclerotherapy, is my doctor right? (photos)

Question

I have done expensive 1,3k sclerotherapy treatment and it’s been 5 months, and my legs look worse than ever. Whatever was light view of veins before is now full on bruises. The doctor (best in town) said it’s all ok, did ultrasound, i have few trombosis, but he says the effect is exactly as it should be. Plus i have now lots of new spider veins all over, which I did not have before.

Jason Emer, MD · Answer

Keep in mind, it takes 2-3 treatments of sclerotherapy for improvement otherwise you can try lasers for the smaller vessels. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

John Landi, MD · Answer

The posted pictures show staining post sclerotherapy and, hopefully, most of this will improve over time.  Topical Dermaka cream may help.  I would also recommend repeating the ultrasound looking for reflux since, if present, this could lead to new vein formation and the poor response to sclerotherapy.

Albert Malvehy, MD · Answer

Hyperpigmentation is a discoloration of the skin that can occur in people with certain skin types or if blood was trapped in the vein while it was shutting down. In some cases, it's just bad luck (or a susceptible skin type). If that happens, the brownish color should fade but it may take up to one year. If there are persistent spider veins, there may be an underlying source and you might need an ultrasound. Get a second opinion from a doctor certified by the American Board of Venous & Lymphatic Medicine.

Scott Powell, MD - Account Suspended · Answer

Hello,Sorry for your concerns.  Based on the photos, it looks like you have staining from sclerotherapy.  This is one of the most common side effects from the procedure.  A lot of it will fade with time, but it takes time.  Studies have shown 90% will fade at a year.  It is important to stay out of the sun or use sun screen during that period, or the areas could darken.Potassium oxide creams may help. Lasers have been tried, but most are expensive and do not really speed up the process.As for new spider veins, these often appear after treatments due to an inflammatory response.  Again, these will often fade with time, usually within 6 months.  If they do not resolve, additional sclerotherapy may be needed.I am curious as to whether you had venous reflux in veins below the surface, and would suggest a full venous doppler/ evaluation if it was not done.  If there was larger veins below the surface that did not close, then this could contribute to the issues.Last you mentioned thrombosis.  I often have my patients come back in 1-2 weeks after sclerotherapy, and if there is thrombosis we drain it to help speed up the recovery.Good luck to you,Dr. Powell

5 months after sclerotherapy, is my doctor right? (photos)

Answers (4)

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