SCLEROTHERAPY

Varicose veins and spider veins affect an estimated 40% of women. For some the problem is simply their unsightliness but others experience symptoms associated with varicose veins and spider veins. Fortunately, most of these unwanted veins - including large varicose veins - can be removed non-surgically by Sclerotherapy. Dr Green has specialized in the treatment and management of varicose veins and spider veins through Sclerotherapy for more than 25 years. During this time he has successfully treated thousands of women and men by Sclerotherapy. Dr Green has lectured and educated other physicians on Sclerotherapy and the management of varicose vein disease locally, nationally and internationally and has had many scientific articles on this subject published in prominent medical journals.

What is Sclerotherapy?
Sclerotherapy - introduced 150 years ago - is the most consistently effective non-surgical procedure to eradicate unwanted, non-functional varicose veins and spider veins. Although used primarily to remove varicose veins and spider veins of the legs and thighs, unwanted veins at other sites - including facial veins and prominent veins of the hands and feet - can also be treated by Sclerotherapy.

How is Sclerotherapy performed?
Using a very small needle, a sterile solution (called a sclerosant) is injected into the vein. The purpose of the solution is to produce irreversible alteration to the vein wall. If this is achieved, the vein will be absorbed, weeks to months after treatment, as is illustrated below.

SCLEROTHERAPY TREATMENT OF VARICOSE VEINS SCLEROTHERAPY TREATMENT OF SPIDER VEINS SCLEROTHERAPY TREATMENT OF FACIAL VEINS

Is there any harm in removing these unsightly veins by Sclerotherapy?
No. Varicose veins and spider veins are non-functional and their removal by Sclerotherapy does not adversely affect circulation. In fact, the use of Sclerotherapy to remove unwanted veins may actually improve the local venous circulation. By the time varicose veins and spider veins have appeared, normal veins, in the same vicinity, have taken over their function without the need for the body to develop new veins after Sclerotherapy.

Does Sclerotherapy and removal of varicose veins and spider veins result in the appearance of new varicosities?
No. The removal of varicose veins and spider veins does not, in and of itself, stimulate the development of new varicose veins. However, anyone who has varicose veins and spider veins is likely predisposed to this condition and can expect new varicose veins and spider veins to develop in the future, whether or not pre-existing veins have ever been treated by Sclerotherapy.

What solution is used for Sclerotherapy?
The sclerosant most commonly used is sodium tetradecyl sulfate, which is FDA approved specifically to remove varicose veins and spider veins.

Can anyone be treated?
With few exceptions, almost anyone with unwanted varicose veins and spider veins can be treated by Sclerotherapy. Women who are pregnant or nursing are, usually, not treated with Sclerotherapy. Treatment is postponed until after delivery and lactation are completed - except under unusual circumstances.

What can I expect after Sclerotherapy?
Usually mild redness, swelling and tenderness appear along the course of the vein treated by Sclerothereapy. This may persist for a few hours, days, weeks or longer depending upon the size and location of the underlying vein. Less commonly, there may be some bruising. After Sclerotherapy, the vein may be palpable as a firm cord within the skin until it has been completely absorbed - this can take weeks to months.



Are there restrictions after Sclerotherapy?
No. After Sclerotherapy all normal activities may be resumed, without any need for limitation of activity. There is no need for leg elevation or any specific exercise program. Compression hosiery may be required, after Sclerotherapy, for a few weeks or longer.

How many Sclerotherapy treatments are required?
The number of Sclerotherapy treatments required depends upon the number and extent of unwanted veins. Usually a vein will respond after one treatment with Sclerotherapy. However, because there is a limit to the quantity of sclerosant that can be administered during any one treatment, if there are numerous veins present, several treatments may be necessary. The number of Sclerotherapy treatment sessions required will be estimated at the time of your initial consultation.

How often are Sclerotherapy treatments performed?
If more than one treatment session of Sclerotherapy is required, they can be scheduled at intervals of 24 hours.

How will I feel after Sclerotherapy?
You should not feel any different after Sclerotherapy and you may immediately resume normal activities. Many patients schedule their Sclerotherapy treatment during their lunch break and return to work after leaving the office.

Is any testing necessary prior to Sclerotherapy?
Sometimes ultrasound testing is necessary to determine the extent of the varicose veins as well as the condition of the deeper veins that may not be visible. The need for such testing is based upon Dr Green's findings at the time of your initial examination. Testing is recommended when indicated - it is not routinely ordered for everyone, avoiding unnecessary expenses. In the presence of uncomplicated spider veins, testing is rarely necessary before having Sclerotherapy.

Should I wait until after I have all of my pregnancies before treating my veins?
No. There is no need to wait until having all of your anticipated pregnancies before beginning Sclerotherapy, although this is a common misconception. In fact, it is wise to treat varicose veins and spider veins prior to pregnancy so that they are gone and cannot become worse. Of course, new varicose and spider veins can develop during subsequent pregnancies, but at least those that have been treated would be gone.

Are there any side effects associated with Sclerotherapy?
Sclerotherapy, as with any medical intervention, has the potential for unwanted side effects. Fortunately, serious side effects from Sclerotherapy are rare. The most common change associated with Sclerotherapy is temporary discoloration along the course of the treated vein. It appears as a tan or brown line and should be expected, to some extent, in almost everyone who is treated by Sclerothereapy. It disappears spontaneously, but can take months or longer. Less commonly, dilated capillaries or redness can develop adjacent to treated spider veins. These usually fade spontaneously and only uncommonly persist. A rare complication is the development of an erosion at a treatment site that can take weeks to months to heal, often resulting in a scar.

Is laser treatment an option instead of Sclerotherapy?
Sclerotherapy is, always, more effective than laser and intense pulsed light for the treatment of varicose veins and spider veins. These light sources, which target veins transdermally, remain ineffective for removing varicose veins and minimally effective for removing spider veins. For the treatment of dilated capillaries - which are usually not responsive to Sclerotherapy, including those on the face and legs - Dr Green does, indeed, use vascular lasers and intense pulsed light sources. The introduction of intraluminal (also known as endovenous, i.e., placed within the vein) radio-frequency and laser emitting energy sources, to remove varicose veins, is a recent development and their long-term success has not been determined. Although not as invasive as vein stripping, these intraluminal procedures are still invasive compared to Sclerotherapy. As with surgery, these techniques are not options to remove spider veins. Sclerotherapy is still the most effective non-surgical method for removing varicose veins and most spider veins. For further information on laser treatments see Laser Treatment of Vascular Lesions.

Is surgery an option instead of Sclerotherapy?
Yes. Surgical removal of varicose veins, i.e., vein stripping, continues to be performed. However, with only a few exceptions, removal by Sclerotherapy is usually more complete without producing scars that, invariably, are associated with surgical removal. There is no surgical option to remove spider veins.

Why should I be treated by Dr. Green?
Dr Green has successfully treated thousands of women and men by Sclerotherapy. He has extensive experience treating - and managing problems associated with - varicose veins and spider veins, and has written and lectured extensively on this problem. Dr Green personally evaluates each person - this is not left to assistants. Most importantly, Dr Green administers all Sclerotherapy injections - these injections are never left to anyone else.

Do you have a question?
You may E-mail your questions to us at: rejuvenate@laserderm.net

Schedule an appointment:
You can schedule an appointment for a consultation by calling the office at: (301) 907-7250