Sclerotherapy What is sclerotherapy? This is a technique to remove the small purple lines that occur on the legs over time. How is this done? A tiny needle is threaded into the blood vessel and a small amount of a sclerosing agent is gently injected. This may sting for 20-30 seconds or cause a slight cramp. The injection “flushes” out the red blood cells temporarily, leading to an inflammatory reaction. This reaction causes “sclerosis”, or the formation of fibrous tissue within the vessel, leading to the gradual disappearance of the vessel. This fading can take from a few weeks to a few months. Most areas will require between three to five treatments to fade. Who performs the treatment? Our physicians perform the treatments. How long will each treatment last? We schedule 30 minute blocks of time for appointments. Is laser a better option? Sclerotherapy remains the standard of care for the small purple telangiectasias that time brings. Laser is better for “mats” of vessels and larger “rope” like vessels of the leg. Other techniques are available for the larger vessels. We do not offer treatment of the larger vessels and would be happy to refer you to an excellent vein specialist. What do vein specialists offer? Most of the vein centers offer treatment for the larger green vessels that protrude due to venous reflux disease. They may use laser or heat inside the vessel to close them. Sclerotherapy will still be necessary to remove the fine lines. Your doctor will determine whether treatment of the deeper veins is necessary prior to your sclerotherapy. What are the potential side effects from sclerotherapy? Brown spots and lines may appear temporarily but will resolve over the next 2-4 weeks. Rare allergic reaction or ulceration at injection sites. Development of a pink blush of the skin. This is not permanent, and can be treated. What patients should not have sclerotherapy due to increased risks? People with significant circulatory problems or diabetes. Patients with asthma should pre-treat with the appropriate inhaler. How do I prepare for my sclerotherapy appointment? Wear or bring shorts. Purchase medical support hose at any medical supply store and bring to your appointment. A prescription is needed from your doctor. Avoid iron supplementation. What can I expect at my appointment? You will be asked to review and sign a consent form. The treatment will be done by your physician. The treated area will be supported by gauze and a wrap and/ or your support hose. What can I expect after the treatment? There will be some post-treatment bruising and possible discoloration that will gradually fade. The treated areas will often look worse before better. It may take 1-3 weeks for any improvement to be seen in the treated vessels. Sunscreen and sun avoidance while fading is important to avoid unsightly Hyperpigmentation. What are my post op instructions? 20-30 mm Hg support hose are recommended continuously for the initial 48 hours and as much as possible for the following 3 weeks. Avoid heat, prolonged sitting or standing, or strenuous exercise for the first 48 hours. Elevation of the leg while sitting is recommended. After the initial 48 hours, patients are encouraged to walk, but no aerobic exercise for one week. Ice packs and Tylenol help to alleviate any possible discomfort. Gentle massaging and walking help alleviate muscle cramps. Remove bandages as soon as they feel loose or uncomfortable, and replace immediately with support hose. How often should I consider sclerotherapy? Treatment intervals vary, but waiting 4-6 weeks between treatments will help minimize the number of treatment sessions. Most areas require 3-5 treatments. Will maintenance treatments be necessary? You will continue to develop these purple veins over time. Many patients choose to have yearly treatments to remove new veins that form.