Sclerotherapy is a minimally invasive procedure that treats varicose veins and spider veins. It involves injecting chemicals, known as sclerosing agents, into damaged veins.
In addition to diminishing the appearance of varicose or spider veins, sclerotherapy can also reduce pain or side effects caused by damaged veins.
Varicose veins can cause itching, pain, cramping, and discoloration. Spider veins are smaller and less severe than varicose veins. Varicose veins are more common in women than in men, although anyone can get them.
The main purpose of sclerotherapy is to help people with spider or varicose veins reduce symptoms associated with those conditions, as well as improve the physical appearance of the affected areas. More rarely, doctors may use sclerotherapy to treat hemorrhoids.
Choosing an appropriate treatment depends on your preference and specific symptoms. That said, you may consider doing sclerotherapy because it’s a less invasive procedure. It may significantly help both your symptoms and the appearance of veins that you won’t need further surgical intervention.
In fact, in a 2016 study, 80% of the participants who underwent a sclerotherapy procedure did not need further surgery to address their symptoms.
Speak to your doctor to find out if sclerotherapy is right for you.
The affected veins may be raised, discolored, or swollen, and some may be deeper under the skin and can cause discomfort. Spider veins are smaller in size, are located closer to the surface of the skin, and can appear red, purple, or blue.
Sclerotherapy for the treatment of hemorrhoids is typically used when the hemorrhoids are smaller and internal. It can also be used when the hemorrhoids bleed or when you can’t risk a surgical procedure such as a hemorrhoidectomy due to other health concerns.
Depending on the size of the damaged veins, sclerotherapy can be used to treat varicose and spider veins in the following areas:
- face (frequently the sides of the nose)
Most people with varicose or spider veins can be a candidate for sclerotherapy, though the procedure is most often done on people between 30 and 60 years of age and in women.
This is because these conditions become more visible as people age and tend to be less noticeable in men whose body is more covered with hair.
People who are bedridden, breastfeeding, pregnant, or have given birth in the last 3 months are not candidates for the procedure.
To know if you qualify for the procedure, you’ll undergo an exam by a vascular specialist, who can determine if this procedure is best for you.
Depending on the severity of the condition, sclerotherapy treatment for venous problems can take about 30-45 minutes. If you’re getting treatment on your legs, your doctor may have you lie on your back with your legs elevated.
Depending on how far below your skin the damaged vein is, your doctor may use an ultrasound as part of the procedure.
The procedure begins with your doctor cleaning the skin around the targeted veins. With a fine needle, your doctor will inject the damaged vein with a sclerosing agent, such as:
- sodium tetradecyl sulfate
- hypertonic saline solutions
The liquid or foam solution causes the walls of the injected vein to seal shut, so blood is redirected to unaffected veins. Over time, your body absorbs the damaged vein, making it less visible and uncomfortable.
Based on the size of the treated vein or veins, you may need up to four treatments.
First, you’ll have a consultation with a healthcare professional. They’ll help you determine if this procedure is right for you. Next, you may be advised to do the following:
- Avoid certain medications, such as ibuprofen (Advil) and aspirin (Bufferin), to reduce your risk of bleeding. These medications can affect your blood’s clotting process.
- Avoid applying lotion or shaving your legs before sclerotherapy to decrease irritation.
- Try compression stockings. You may be required to wear them for several days after the procedure.
- Notify your healthcare professional about other medical issues you have before your procedure.
You may experience minor cramping, stinging, or burning in the injected vein during sclerotherapy. The procedure can also be painful, especially if the sclerosing agent leaks into surrounding tissues.
Common side effects of sclerotherapy include:
- skin discoloration
- raised red areas that appear around the injection sites
All of these side effects should subside in a few days. Brown lines or spots can develop near the treatment area as well. These normally disappear within 3 to 6 months, but in some cases this side effect lasts longer or may become permanent.
More serious side effects include:
- allergic reaction to the sclerosing agent
- skin ulceration around the injection site
- blood clots in the treated veins
- discomfort around the injection site, caused by inflammation
- infection in the skin
Checking in with your healthcare professional after sclerotherapy treatment will help you manage potential side effects.
According to the American Society of Plastic Surgeons, the average cost of a single sclerotherapy procedure in 2020 was $413. The overall cost depends on the size and number of veins treated, as well as where you live.
Sclerotherapy is usually not covered by insurance if it’s done for cosmetic reasons. But if you experience medical symptoms related to varicose veins, your insurance might cover the procedure.
To get Medicare coverage for the procedure, you’ll need to submit medical records to show your history of treatment in order to prove that the procedure is not needed only for cosmetic reasons.
There is little to no downtime associated with sclerotherapy. You’ll most likely be able to return to your everyday activities immediately. You may also be advised to do the following:
- Wear compression socks or stockings during the day, except when showering or sleeping.
- Take acetaminophen-based pain medicine such as Tylenol to treat any pain or discomfort.
- Avoid aspirin and ibuprofen.
- Avoid sunlight, hot baths, saunas, swimming pools, and the beach during the first 2 days after treatment.
- Stay active to reduce the chance of blood clots. However, you should avoid aerobic exercise, such as running and weightlifting, for a couple of days.
- In some instances, you might be advised not to fly for several days.
Smaller varicose veins and spider veins respond best to sclerotherapy. You may be able to see improvement within a few weeks of treatment. For larger varicose veins, the visual improvement can take up to 4 months.
You may need several sessions to completely eliminate varicose or spider veins. It’s important to have realistic expectations about the effectiveness of sclerotherapy. Sclerotherapy doesn’t guarantee that there will be no visible traces or side effects of varicose or spider veins after the procedure.