Sclerotherapy, or the injection of unwanted leg veins, is one of the oldest procedures in dermatology, going back to the 1950’s, and was actually one of the original cosmetic treatments in the field. Believe it or not, even with all of the advances in technology including laser devices, sclerotherapy remains the gold standard for treating spider leg veins. The main reason for this is that when a vein is injected with a sclerosing chemical, it is able to travel through the entire vein and block many of the branches and connections to other veins. Since a laser delivered through the skin is only able to treat the visible veins, often times the veins receive blood flow from another source and remain open or re-open. Besides being effective, Sclerotherapy is practically painless, especially when compared to laser devices.
What agents are used in Sclerotherapy?
There are a variety of agents available. Hypertonic saline was the first used and still preferred by some sclerotherapists. Other agents include Sotradecol (STS), recently FDA-approved Asclera (polidocanol), and Sclerodex.
How do they work?
Sclerosing agents used in sclerotherapy whether hypertonic saline or one of the detergent-based products work by irritating the lining of the vein, causing it to collapse and clot. The vein then undergoes a fibrosis and wound healing process until your body breaks down the unused vein.
How long is a Sclerotherapy session?
A typical session of sclerotherapy lasts 15-45 minutes. Dr. Mott and Tammy Wolf use a magnified polarized light so that the smallest of veins can be treated. The veins are entered at multiple sites with a tiny needle and the sclerosing agent is injected. Often, the veins immediately disappear momentarily before becoming inflamed and visible again to begin the healing process. Repeat sessions are usually necessary and can be repeated in 1-2 months. Tip–winter is a great time to treat leg veins to allow time for healing before shorts and dress-wearing season returns!
Post treatment Care
Following treatment compression stocking or support hose should be worn for 2-3 days and for at least two weeks during the day time. Walking is encouraged immediately after treatment and daily. For 2-3 days after treatment avoid heavy exercise, sunbathing, long plane flights and hot baths or sauna.
What are the risks of the treatment?
Overall, Sclerotherapy is a very safe treatment. There have been rare reports of allergic reactions to one or more of the agents used in treatment. Since sclerotherapy is an injectable “needle” procedure, there are risks of bleeding, bruising, and rarely skin infection.