Sclerotherapy

Endovenous laser ablation is a treatment that may be used to treat problematic, larger branches of the superficial venous system. Smaller, tortuous, more superficial bulging or spider veins require a different technique, namely sclerotherapy.  During such treatments, a chemical solution is gently injected into the vein.  If the veins are larger and farther below the skin surface, Dr Rosen may use ultrasound guidance to help target such injections. For small superficial veins, specialized lighting and magnifying lenses are used.

A sclerotherapy session typically lasts 30 minutes. The injected chemical is sodium tetradecyl sulfate (STS): a mild, dilute, sterile medical detergent. STS causes the veins to shrink and ultimately get resorbed by the body. It has been used worldwide since the 1940s as it is highly effective and side effects are very rare. Dr Rosen will explain the risks and benefits to you prior to the procedure.

How do I know if I need sclerotherapy?

If you have small or large tortuous varicose or spider veins close to or below the skin surface you may benefit from sclerotherapy. If such veins are associated with symptoms including lower extremity fatigue, heaviness, swelling, cramping, itching or restless legs, further evaluation including an ultrasound performed by Dr. Rosen may be warranted.

Sclerotherapy is contraindicated for patients who are currently pregnant; have an active malignancy or deep vein clot; have a history of allergic reaction to STS and in those using certain medications such as Tamoxifen. Prior to initiating sclerotherapy treatments, Dr Rosen sees patients in consultation to take a very thorough medical history, perform a physical exam and, when required, perform an ultrasound to determine if sclerotherapy is indeed an appropriate first treatment.

How does sclerotherapy work?

A sclerotherapy session typically lasts 30 minutes. The injected chemical is sodium tetradecyl sulfate (STS): a mild, dilute, sterile medical detergent. STS causes the veins to shrink and ultimately get resorbed by the body.

Injections for sclerotherapy are very well tolerated.  Tiny needle marks heal over several days with minimal discomfort. Any minimal bruising that occurs heals within a few weeks. The number of injections and number of sessions needed depends on the number of veins to be treated.

What benefits can I expect?

Realistically, Dr. Rosen tells patients to expect approximately 70% improvement in appearance. Multiple treatments are typically required.  

What are the risks and side effects?

Tell your provider if you or any family members have a history of any blood clotting or bleeding disorders; any migraine headaches; any heart disorders; if you are taking Tamoxifen; if you have had any reactions to previous sclerotherapy injections as such issues, among others, may increase the risks of side effects in sclerotherapy. Also tell your provider if you are currently taking blood thinning medications, such as aspirin or coumadin.  

While minimal bruising is universal in patients treated with sclerotherapy, significant risks are very rare. Side effects may include allergic reaction, bleeding (typically very minimal), infection (extremely rare due to meticulous technique) and skin changes such as hyperpigmentation or matting (new clusters of very tiny vessels) in areas treated with sclerotherapy. Blood clots in deep veins are extremely rare after the treatment of superficial small vessels. Tiny dark clots in the treated spider or varicose veins may occur but pose no significant threat to patients.

How will I look and feel during and after the treatment?

The treated veins will initially look darker and more apparent. Dr Rosen recommends wearing medical grade support stockings for at least 3 weeks after the procedure. Avoid strenuous exercise for 48 hours and extended plane or car trips for 1 month, if possible.

Can this be combined with other treatments?

Yes. Sclerotherapy may be combined with any of our other cosmetic services.

What is the cost of sclerotherapy?

The fee for sclerotherapy depends on the extent of your condition. Sclerotherapy is performed by Dr. David Rosen, MD. To learn more about Sclerotherapy, please call 847-459-6400 or contact us to make an appointment with one of our cosmetic coordinators.