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Dermatology
> Cosmetic
Procedures > Sclerotherapy
The best
candidates for sclerotherapy
Women of any age may be good candidates for sclerotherapy,
but most fall in the 30-to-60 category. In some women,
spider veins may become noticeable very early on - in the
teen years. For others, the veins may not become obvious
until they reach their 40s.
If you are pregnant or breastfeeding, you may be advised to
postpone sclerotherapy treatment. In most cases, spider
veins that surface during pregnancy will disappear on their
own within three months after the baby is born. Also,
because it's not known how sclerosing solutions may affect
breast milk, nursing mothers are usually advised to wait
until after they have stopped breastfeeding.
Spider veins in men aren't nearly as common as they are in
women. Men who do have spider veins often don't consider
them to be a cosmetic problem because the veins are usually
concealed by hair growth on the leg. However, sclerotherapy
is just as effective for men who seek treatment.
What to expect from sclerotherapy
Sclerotherapy can enhance your appearance and your self
confidence, but it's unrealistic to believe that every
affected vein will disappear completely as a result of
treatment. After each sclerotherapy session, the veins will
appear lighter. Two or more sessions are usually required to
achieve optimal results.
You should also be aware that the procedure treats only
those veins that are currently visible; it does nothing to
permanently alter the venous system or prevent new veins
from surfacing in the future.
Before you decide to have sclerotherapy, think carefully
about your expectations and discuss them with your doctor.
Risks related to sclerotherapy
treatment
Serious medical complications from sclerotherapy are
extremely rare when the procedure is performed by a
qualified practitioner. However, they may occur. Risks
include the formation of blood clots in the veins, severe
inflammation, adverse allergic reactions to the sclerosing
solution and skin injury that could leave a small but
permanent scar.
A common cosmetic complication is pigmentation irregularity
- brownish splotches on the affected skin that may take
months to fade, sometimes up to a year. Another problem that
can occur is "telangiectatic matting," in which fine reddish
blood vessels appear around the treated area, requiring
further injections.
You can reduce the risks associated with treatment by
choosing a doctor who has adequate training in sclerotherapy
and is well versed in the different types of sclerosing
agents available. A qualified doctor can help you select
which type of sclerosing medication is most appropriate for
your needs.
Planning your sclerotherapy treatment
During your initial consultation, your legs will be
examined. Your doctor may draw a simple sketch of your legs,
mapping out the areas affected by spider veins or other
problems. During the examination, you will be checked for
signs of more serious "deep vein" problems, often indicated
by swelling, sores, or skin changes at the ankle. A
hand-held Doppler ultrasound device is sometimes used to
detect any backflow within the venous system.
If such problems are identified, your surgeon may refer you
to a different specialist for further evaluation. Problems
with the larger veins must be treated first, or
sclerotherapy of the surface veins will be unsuccessful.
Your doctor will ask you about any other problems you may
have with your legs, such as pain, aching, itching or
tenderness. You will also be asked about your medical
history, medications you take, or conditions that would
preclude you from having treatment. Individuals with
hepatitis, AIDS or other blood-borne diseases may not be
candidates for sclerotherapy. Patients with circulatory
problems, heart conditions, or diabetes may also be advised
against treatment.
It's important to be open in discussing your history and
treatment goals with your doctor. Don't hesitate to ask any
questions or express any concerns you may have. Your doctor
should explain the procedure in detail, along with its risks
and benefits, the recovery period and the costs. (Medical
insurance usually doesn't cover cosmetic procedures.)
Preparing for the procedure
You will receive specific instructions from your physician
on how to prepare for your treatment. Carefully following
these instructions will help the procedure go more smoothly.
You'll be instructed not to apply any type of moisturizer,
sunblock or oil to your legs on the day of your procedure.
You may want to bring shorts to wear during the injections,
as well as your physician-prescribed support hose, and
slacks to wear home.
When scheduling your procedure, keep in mind that your legs
may be bruised or slightly discolored for some weeks
afterward. You probably won't be comfortable wearing shorts,
a swimsuit or a mini skirt until after your legs have
cleared up a bit.
Where your sclerotherapy treatment will
be performed
Sclerotherapy of spider veins is a relatively simple
procedure that requires no anesthesia, so it will be
performed in an outpatient setting, most likely your
doctor's office.
About the sclerotherapy procedure
A typical sclerotherapy session is relatively quick, lasting
only about 15 to 45 minutes. After changing into shorts,
your legs may be photographed for your medical records. You
will be asked to lie down on the examination table and the
skin over your spider veins will be cleaned with an
antiseptic solution. Using one hand to stretch the skin
taut, your doctor or nurse will begin injecting the
sclerosing agent into the affected veins. Bright, indirect
light and magnification help ensure that the process is
completed with maximum precision.
Approximately one injection is administered for every inch
of spider vein - anywhere from five to 40 injections per
treatment session. A cotton ball and compression tape is
applied to each area of the leg as it is finished.
During the procedure
During the procedure, you may listen to music, read, or just
talk to your practitioner. You will be asked to shift
positions a few times during the process. As the procedure
continues, you will feel small needle sticks and possibly a
mild burning sensation. However, the needle used is so thin
and the sclerosing solution is so mild that pain is usually
minimal.
After your sclerotherapy treatment
In addition to the compression tape applied during the
procedure, tight-fitting support hose may be prescribed to
guard against blood clots and to promote healing. The tape
and cotton balls can be removed after 48 hours. However, you
may be instructed to wear the support hose for 72 hours or
more.
It's not uncommon to experience some cramping in the legs
for the first day or two after the injections. This
temporary problem usually doesn't require medication.
You should be aware that your treated veins will look worse
before they begin to look better. When the compression
dressings are removed, you will notice bruising and reddish
areas at the injection sites. The bruises will diminish
within one month. In many cases, there may be some residual
brownish pigmentation which may take up to a year to
completely fade.
Activity after treatment
Although you probably won't want to wear any leg-baring
fashions for about two weeks, your activity will not be
significantly limited in any other way from sclerotherapy
treatment.
You will be encouraged to walk to prevent clots from forming
in the deep veins of the legs. However, during the period of
time to complete your treatment program, prolonged sitting
and standing should be avoided, as should squatting, heavy
weight lifting and "pounding" type exercises, including
jogging.
A one-month healing interval must pass before you may have
your second series of injections in the same site. After
each treatment, you will notice further improvement of your
legs' appearance.
Treatment results
Most patients are pleased with the difference sclerotherapy
makes. The skin of your legs will appear younger, clearer
and more healthy-looking. If you've been wearing long skirts
and slacks to hide your spider veins, you'll now be able to
broaden your fashion horizons. Often, patients are surprised
at the dramatic difference in appearance between a treated
leg and an untreated one.
Although sclerotherapy will obliterate the noticeable veins
for good, it's important to remember that treatment will not
prevent new spider veins from emerging in the future. As
time passes, you may find that you need "touch-ups" or full
treatments for new veins that surface. But even if you
choose not to have further sclerotherapy, your legs will look
better than if you never had treatment at all.
Ned Snyder IV, MD
/ Plastic Surgery
Renee
Snyder, MD / Dermatology
901 West
38th Street, Suite 410
Austin,
Texas 78705
Phone:
512-533-9900
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