Sclerotherapy is an effective treatment for spider veins (red) and reticular veins (bluish green) on the legs. It can be effective for certain types of varicose veins (veins that bulge) but this has to be evaluated by a trained dermatologist and often requires referral to a vascular surgeon. Sclerotherapy involves the injection of medication into unwanted leg veins. Various medicines can be used including hypertonic saline, glycerin, sotradecol, and polidocanol.
Allergic reactions to sclerotherapy cannot occur and it does not cause permanent staining of the skin at the injection sight. This is because we use hypertonic saline, which is 23.4% sodium chloride, containing no preservatives and no heparin. Hypertonic saline does cause stinging and short-term (minutes) discomfort in some persons, but it is very safe and very effective.
Sclerotherapy is considered to be a safe procedure, but side effects are possible. They include brown spots or small crusts or ulcerations at the injection sights. These typically fade but permanent discoloration and scarring is possible.
Thrombophlebitis of the treated vessel occasionally occurs, but it is superficial and responds well to aspirin (or other similar anti-inflammatory drugs), heat, and antibiotics (infrequently needed). Infrequently, tiny new vessels develop at treatment sights. They are treated the same way the original vessels were. Rarely, an ulcer may need to be excised in order to speed-up healing. It is also possible to have an allergic reaction to the medication.
Generally, patients go directly back to work. No work should be missed.
The number of treatments varies and is determined by the severity of the problem, the goals of the patient and the individual response to treatment. Many patients experience a 50% improvement or better with each treatment, but responses cannot be guaranteed. Treatments are usually done at four to six-week intervals, until patients are satisfied with the results.