Sclerotherapy
Sclerotherapy has long been the standard of care when treating cosmetic vein issues like spider veins and small varicose veins. Sclerotherapy involves treating the varicose veins by injecting chemicals that cause an injury to the inner lining of the vein resulting in closure of the vein. When treating the veins for cosmetic reasons, patients often find that their legs also feel better. Sclerotherapy can also be used to treat deeper, larger vessels with the guidance of ultrasound imaging. Sclerotherapy is most often used as an adjunct treatment after closure of larger feeder vessels by the laser. It is very important that these feeder vessels are treated first if you want the best possible results.
Our venous system is part of the circulatory system and is responsible for returning deoxygenated blood back to the heart and through the lungs to be recirculated with oxygen rich blood. Our veins have tiny one-way valves that open as the blood flows to the heart and then close to prevent the blood from flowing backwards. When these valves are not functioning properly the blood can pool in the veins. Over time this can lead to venous reflux, or venous insufficiency, which then leads to increasing back pressure that weakens the walls of the veins and causes them to bulge. Eventually, this leads to the development of varicose veins and spider veins on the surface of the legs.
Almost anyone with visible, bothersome veins can be a candidate. Sclerotherapy can be used to treat larger, deeper vessels with the use of ultrasound, or small varicose and spider veins. People frequently seek treatment for the appearance of their legs, but the smaller vessels can also contribute to some of the symptoms of vein disease. In our clinic, we almost always reserve sclerotherapy as an additional treatment after you have treated the underlying feeder vessels with laser ablation. It is rare that this is not needed on a client with visible veins. By treating the feeder vessels you ensure the greatest success rate for sclerotherapy.
Sotradecol, a popular sclerosant, is injected via a needle directly into the vein, which causes irritation and damage to the lining of the vein. This results in the closure of the vein. Over time, that vein will fade from sight as your body heals. This is very similar to how a bruise will disappear. Several treatments may be needed to treat your entire leg. Many different types of sclerosant are available. We choose to use Sotradecol because of its reliability in treating varicose veins. It also has an excellent safety profile. However, it is a real medicine and the dose must be limited at each individual treatment session. This is why multiple visits are usually necessary.
This is a difficult question to answer. Most people will need multiple sessions to treat their varicose veins. The number of treatments differs from person to person, depending on the extent of the problem. We can treat your legs to the point of symptom reduction or until you are satisfied with the appearance. You must remember, however, that the tendency to create varicose veins will not completely go away. Controlling the symptoms of this disease is a life-long process and is very important for reducing the chance of severe leg problems as you age.
The sclerotherapy injections are a very quick in-office treatment. All you need to do to prepare is to bring a pair of shorts to wear during the treatment (or we will provide a blanket). Please also shave your legs. This makes it easier to see the varicose veins. Yes, men should also shave! Avoid using any lotions or oils on your legs that morning. We also ask that you bring your compression hose to be put on after your treatment.
Your sclerotherapy session will be performed by your doctor or one of our nurse injectors. You will receive multiple injections into your varicose veins. We can only inject a certain amount of the Sotradecol at each visit and this will be the limiting factor with respect to how many veins are treated. Larger veins require more medication, so your beginning treatments will have fewer injections than later treatments. Most patients describe the pain as similar to an ant bite. A cotton ball with a hydrocortisone cream will be taped on the injection site. Afterwards, you should put on your compression hose and wear it for two days.
Your office visit will be approximately 30 minutes long. The veins that are treated in most cases will not return. Your body will, however, continue to create varicose veins, so ongoing treatments and annual checkups with our clinic will determine your long-term success.
You may have some itching, stinging and burning at the injection sites. The hydrocortisone cream will help with this. These sensations are normal and indicate that the medicine is working. You can continue with all of your daily activities, although we do recommend avoiding rigorous exercise the day of your injections. We will put your compression hose on after your injections and we ask that you wear them for the next 48 hours. This will guard against blood clots, promote healing and minimize bruising.
Sclerotherapy is often covered when it is an adjunct treatment to the closure of larger veins. You will have to demonstrate a medical necessity for the treatment. Some insurance policies exclude these treatments despite their being medically necessary. If insurance will not cover the treatment, you can still elect to have sclerotherapy to clear up visible veins. Genesis Laser & Vein's policy is to offer a discount off the charge of any non-covered service. If you are interested in pricing for sclerotherapy, our financial consultant can assist you in understanding what the cost per visit will be. She can also help you to determine if your insurance company will cover the procedure and what your out-of-pocket costs will be.
If you would like additional information, we offer a complimentary nurse consultation. During your consultation our nurses will go over all of your treatment options and what you can expect before, during and after these treatments. They will also help you determine if vein disease is a possible cause for your symptoms. You can also meet with our financial advisor to determine insurance coverage.
If you are ready to begin treatment you can schedule a physician evaluation. During your evaluation our doctors will perform a medical exam, go over symptoms, and examine areas of concern to determine a treatment plan. Based on this examination they may order a diagnostic ultrasound done in an accredited lab supervised by radiologists and ultrasound technologists who specialize in these tests. After your initial consultation and ultrasound, our nurses will submit your information to your insurance company to determine coverage. You can again schedule an appointment with our financial advisor to help you determine what your portion of the payments will be. If your insurance company excludes sclerotherapy as a treatment option, we can give you information on continuing on as a cosmetic sclerotherapy patient and get started on your treatments right away.
Varicose veins and spider veins are not a life-threatening condition. Treatment is not mandatory, but will decrease the potential leg problems that occur with age. You can choose to just wear graduated
compression stockings. The hose may offer relief of your symptoms, but they will not cause the veins to disappear. The disease process, however, will continue and will worsen as you age.
