Understanding Sclerotherapy and Ultrasound-guided Sclerotherapy

Treatment of Spider and Reticular Veins

Spider veins and reticular veins (deep blue veins under the skin) are best treated with a combination of sclerotherapy and skin lasers. Sclerotherapy is a procedure in which the spider or reticular veins are injected with an FDA approved solution. This treatment involved minimal discomfort and is performed in the office. Each treatment may take up to 20 minutes, and numerous veins can be injected. The injected veins often disappear immediately, or over the course of 1-2 months. Often, up to 4-5 sessions are required to treat these veins, depending on the severity of the veins and the stubbornness they exhibit in responding to treatment. Dr. Stephanian also uses a Lyra 1064 YAG laser that he uses in tandem with sclerotherapy for management of spider and reticular veins.

Risks of Sclerotherapy

The main complication of sclerotherapy is ulceration, but this problem is very unusual. Allergic reactions to the solution being injected have occurred, but this type of event is extremely rare.

After the Sclerotherapy Procedure

Following the treatment, compression stockings or ACE wraps are applied, and should be left in place until the following morning. Activity immediately after sclerotherapy should be limited to normal routines, but no exercising or heavy activity is advised. You can take off the compression dressings the day after treatment, and shower as normal, but try to avoid hot baths. Once the dressings are removed the day after treatment, you can resume your normal routine. It is a good idea to wear compression hose during the period of treatment of your spider veins. The treated area may have a sunburned appearance, raised, or itchy for approximately 1 to 2 weeks. Bruising and slight staining is normal and will disappear after 3 to 6 weeks. Some of the veins may become dark, hard, and lumpy, but these will resolve within 1-3 months. Over the counter analgesics can be used for any discomfort as needed. Avoid direct sun exposure while in treatment. If you must be in the sun, use sunscreen (SPF 30) on your legs for the next 2-3 months to avoid a darkening of the skin where you have been treated.

Ultrasound-guided Sclerotherapy

Ultrasound-guided sclerotherapy is the same as regular sclerotherapy, but using ultrasound guidance for deep veins. This procedure is rarely needed, and local anesthesia is used prior to injection. Post treatment dressings and activities are the same as for regular sclerotherapy.