This treatment involves injection of a solution that closes varicose or spider veins. The solution, called the “sclerosant,” such as hypertonic saline, is injected directly into the blood vessel using a very small needle. The sclerosant causes the fragile lining of the spider vein to become irritated and inflamed. As a result, the small vein develops a tiny clot (not a dangerous clot). As the area heals, the clotted vein gradually undergoes what is called “fibrosis.” In fibrosis, the tissue of the vessel grows thick and turns into scar tissue that closes off the vessel, effectively obliterating it. The body reroutes the flow of blood, automatically, and the injected vein(s) fade after several weeks as the dead cells are slowly and naturally removed and excreted. For more difficult veins, several injections may be required. Sclerotherapy does not require anesthesia and can be done at the doctor’s office.
Sclerotherapy is not typically used for large varicose veins because they are too big and will come back. There are, however, other treatment options for all types of varicose veins. For more information, please see the page devoted to varicose veins.
- Itching, burning, and redness frequently occur at the Sclerotherapy site. These reactions are normal and are not considered to represent a true “allergic reaction.” As with any medication, however, allergies can occur. Fortunately, they are quite rare with the medications commonly employed during sclerotherapy.
- The vein may not go away. In this case, the vein is considered “resistant.” Repeat injections may sometimes be needed with a different sclerosing solution (“sclerosant”).
- New spider veins may develop around the sclerosed veins. This is called “Neovascularization,” and occurs in approximately 2-5% of injections. Sometimes they fade away on their own as the inflammation subsides.
- Pigment may be left at the site of the sclerosed spider vein. This is due to the blood pigment “hemoglobin” becoming trapped in the tiny vein as it undergoes fibrosis. When a sclerosed vein becomes dark blue, the doctor or nurse will sometimes “lance” the vein with a needle to allow this trapped blood to escape. Only 2-3% of sclerosed veins will leave permanent pigment staining on the skin.
- Sclerotherapy ulcer is very uncommon. This occurs when the sclerosant is injected outside the spider vein and the overlying skin dies. This can result in a “sore” or “scab” at the site of the injection. A sclerotheraphy ulcer may take weeks to heal and can leave a small scar.