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Sclerotherapy for Varicose Veins

Treatment Overview

Sclerotherapy uses an injection of a special chemical (sclerosant) into a varicose vein to damage and scar the inside lining of the vein. This causes the vein to close.

During this procedure, the affected leg is elevated to drain blood, and the sclerosant is injected into the varicose vein. The procedure is done in a doctor's office or clinic and takes 5 to 30 minutes, depending on how many varicose veins are treated and how big they are.

After the injection of sclerosant is given, pressure is applied over the veins to prevent blood return when you stand up. You may need to wear compression stockings for several days or weeks to maintain the pressure.

The sclerotherapy injection may be painful, and the chemical (sclerosant) that is injected can cause a feeling of burning or cramping for a few minutes in the area where the shot was given. You may need repeated sessions and many injections each session, depending on the extent of the varicose veins and type of sclerosant used.

A newer, minimally invasive technique allows your doctor to inject sclerosant with a catheter. The catheter and sclerosant are guided to the affected vein with the help of duplex ultrasound. This process allows sclerotherapy treatment to be used on larger varicose veins that previously could only be treated surgically with ligation and stripping, in which larger varicose veins are tied off and removed.

What To Expect

Sclerotherapy generally does not require any recovery period. You will likely be able to walk immediately after the treatment. Avoid strenuous exercise for 1 week after the procedure. Walk every day for at least 10 minutes. Try not to sit or lie down for long periods of time.

Avoid exposing your legs to the sun for the first 2 weeks after the procedure.

You will probably have to wear compression stockings for a short time after having sclerotherapy.

Why It Is Done

Sclerotherapy is used to treat:

  • Spider veins and small veins that are not causing more serious problems.
  • Smaller varicose veins that come back after vein-stripping surgery.
  • Larger varicose veins, when minimally invasive techniques are used.

Sclerotherapy may be done alone or as a follow-up to surgery.

Sclerotherapy should not be done if you:

  • Are pregnant or nursing. It is not known whether the chemical (sclerosant) causes birth defects or gets into breast milk.
  • Have a history of allergy to sclerosant or similar substances.
  • Have blood clots or inflammation in the deep leg veins (deep vein thrombosis).

How Well It Works

Sclerotherapy costs less than surgery, requires no hospital stay, and allows a quicker return to work and normal activities.

Sclerotherapy can reduce symptoms and improve the look of the skin. It works in about 80 out of 100 people. It doesn't work for about 20 out of 100 people who have the procedure.footnote 1

Risks

The risks of sclerotherapy include:

  • Skin color changes along the treated vein. This is the most common side effect of sclerotherapy. The discoloration may take 6 to 12 months to disappear. In some people, it may be permanent.
  • Failure of treatment to prevent varicose veins from returning.
  • Itching, bruising, pain, and blistering where the veins were treated.
  • Scarring resulting from ulcers or death of the tissue around the treated vein (skin or fat necrosis) if sclerosant is injected outside a vein or sclerosant escapes through the wall of a weakened vein.
  • A mild or severe (anaphylactic) reaction to the sclerosant. (Severe reaction is very rare but can be life-threatening.)
  • Blood clots or damage in the deep vein system.

What To Think About

If it is done for cosmetic reasons, sclerotherapy is usually not covered by insurance.

If you are considering sclerotherapy, you might want to consider some questions about treatment. These questions might include: How much do the exam and treatment cost? How many treatments does the doctor think you will need?

For help deciding whether to have a procedure for varicose veins, see:

In some cases, laser therapy or freezing (cryotherapy) may be used instead of sclerotherapy to treat small veins and spider veins.

References

Citations

  1. Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230–239.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
David A. Szalay, MD - Vascular Surgery

Current as ofNovember 21, 2017


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