Have you noticed that as you age you are developing tiny squiggly purple veins on your legs? Perhaps one of your parents had them, or they developed during pregnancy, or you have a job where you are required to stand a lot and that seems to have exacerbated them? Whatever the case may be, if they are causing you distress, scelrotherapy may be the solution you’ve been looking for.
Sclerotherapy involves using a tiny needle to inject a substance into those tiny veins to eradicate them. The substance injected is a “sclerosant” which causes “sclerosis” of the vessel wall, meaning that it collapses the vein so that it is no longer patent and blood cannot flow through it anymore. When this happens your body naturally dissolves the vein as it serves no purpose if blood cannot flow through it.
As you can imagine, depending on the number and size of the veins that concern you, this process can be lengthy and it often takes more than one treatment to achieve the desired result. It’s also important to remember that as someone with these kinds of veins you will ALWAYS be susceptible to forming new ones. Obviously the new veins can be treated, and the veins that have already been treated shouldn’t come back, but you should be realistic about the outcome of your treatment.
With every medical procedure there are pros and cons to consider. With this procedure the pro is the cosmetic effect which may broaden your wardrobe choices and boost your confidence. With correct injection at the correct concentration adverse reactions are rare and usually limited to bruising, however it is always important to be informed of all cons before paying for a procedure. The cons are:
- Bruising: there will almost always be some bruising after this treatment since the aim of it is to pierce blood vessels to deliver a product into them. After the product has been injected the blood will flow back into the vein and will clot there since it can no longer flow due to the intentional damage caused to the vessel. This results in a “bruise” inside the vein which leaves dark brown/purple/black marks in the pattern of the treated vein on the skin. This can be minimized by adequate compression, but despite compression these marks can still occur. They are all temporary and differ vastly in different patients, occasionally lasting up to 6 weeks in fair skin types. They WILL go away.
- Ulceration: rarely an ulcer or a small sore may occur at the site of injection. This happens when product escapes from the vein into the surrounding tissues, where it causes “sclerosis” or breakdown of the skin around where the vessel is seen. If this happens you should report back to the doctor or nurse who treated you immediately for further care. Any ulcers on the legs are notoriously difficult to treat due to the decreased vascularity or blood supply to the skin on the legs compared to elsewhere on the body, and so swift identification and treatment of these ulcers is imperative to minimize damage and duration.
- Staining: occasionally the blood that escapes from these vessels after they have been treated can cause staining to the skin where the bruise was seen. This is uncommon and temporary, but can last 12-18 months in about 1% of cases so it is important to note. This kind of staining can sometimes be treated with laser therapy and if this happens to you you should discuss this option with your doctor or nurse.
- Sensitivity or Allergy: You should always notify your doctor or nurse about any allergies or sensitivities you may have. Allergic reaction to the products used in sclerotherapy is rare, however if you experience itching, tightness in your chest or nausea during your treatment you should notify your doctor or nurse so that they can assess you for the cause before proceeding.
After your procedure it is important that you maintain adequate compression of the vessels, as 3 out of 4 of the “cons” we have listed are directly related to compression and will be minimised by adequate compression post-treatment. Depending on the size and number of veins you are having treated your doctor or nurse will either recommend compression bandaging alone, or in conjunction with pressure stockings like the ones used in DVT patients. For smaller veins about a week of compression post-treatment is recommended, while for larger veins continuous use of the DVT stockings is recommended for 7 days, and then at night only for a further 7 days thereafter.