Sclerotherapy remains the primary treatment for small-vessel varicose disease of the lower extremity. Spider Veins (telangiectasias) are small red, blue and purple blood vessels that appear most frequently on the thighs and the lower legs. Varicose Veins are usually larger in diameter and may appear raised with a bluish or greenish color.

INDICATIONS
The major indications for sclerotherapy are to improve the cosmetic appearance and to reduce the associated pain and burning.

CONTRAINDICATIONS
Contraindications to sclerotherapy include pregnancy, thrombophlebitis, pulmonary emboli, hypercoagulable states, and allergy to the sclerosing agents.

WORKUP
Imaging Studies
Duplex ultrasonography is the diagnostic method of choice for diagnosing venous disease.

TREATMENT
How does Sclerotherapy work?
A sclerosing solution is injected into the vein to be treated through a micro-needle. The solution causes the vein to blanch (turn white), then shrinks until it gradually disappears with time. Cotton balls with plaster bandages are placed after each injection and are removed around 4 hours after the procedure.

What is the treatment like?
A typical Sclerotherapy session lasts 15 to 20 minutes. There is nothing to fear as the tiny needles generally cause very minimal discomfort. The numbers of sessions, which are spaced every two to three weeks, vary depending on the severity of the condition and the patient’s response rate.

What results can I expect from it?
Realistically, 80 to 90 percent of the veins will disappear. While the veins that have been treated are permanently gone, new veins may appear in time and should be treated as early as possible to prevent worsening.

What should I do after the treatment?
Patients may be asked to wear vascular stockings for 3-4 days after treatment.  Normal activities may be resumed immediately.  Walking is encouraged because it increases blood flow to other veins but strenuous leg work is minimized for a week.

What are the adverse reactions?
Post-Sclerotherapy:   It is common to experience heaviness on the legs. There may be bruising and pigmentation on the veins treated which resolve anywhere from a couple of days to a few months.