Sclerotherapy is a procedure in which a chemical solution is injected into veins to cause them to collapse and form scar tissue that permanently closes them. Nearby veins take up re-routed blood flow. Sclerotherapy1 requires multiple treatments to close off all affected veins. Additional treatments may be needed from time to time as newly enlarged veins appear. Side effects of sclerotherapy may include slight swelling, bruising, and redness, and itching at injection sites.
The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps.
Sclerotherapy works well for most patients. After several treatments, most patients can expect a significant improvement. Fading will gradually occur over months. The disappearance of treated spider veins is usually achieved, but similar veins may appear in the same general area.
It is estimated that most injected veins may be eliminated with each injection session. A minority of the people who have sclerotherapy do not respond to the injections at all. In these instances, different solutions or a different method, such as laser therapy, may be tried.
There are four categories of veins which are of interest in an examination by a sclerotherapist:
The deep veins are buried beneath skin, muscle, and bone and cannot be seen except during surgery. The superficial veins are the ones you can see just under the skin. The perforator veins connect the two systems. Reticular veins are incompetent superficial veins. Varicose veins are superficial veins that are not only incompetent but are swollen, elongated (and thus serpentine) as a result. The most fundamental problems must be fixed first and these are, in order: incompetent deep veins, incompetent perforator veins, incompetent superficial veins (reticular and varicose veins), and finally the spider veins.
In general, spider veins respond to treatment in a few weeks, and larger veins respond in a few months. If the veins respond to the treatment, they will not reappear. However, new veins may appear over time. If needed, you may return for injections.
Sclerotherapy is a chemical injection2 that causes targeted veins to collapse and permanently close them. The blood flow is directed to nearby veins and is used for those that have spider veins. Sclerotherapy can treat as many as 50 to 80 percent of the injected vein after several treatments, which are eliminated at each injection session.
Patient’s pain tolerances vary greatly. Most people find minimal discomfort and even those who are sensitive or afraid of injections rarely experience anything more than just discomfort.
Total erasing of spider veins is usually achieved, however, the results are slightly different depending on the size of the vessels being injected. Some vessels may require more than one injection weeks apart, while others require only one treatment session.
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1 Skin and Sclerotherapy. Available: https://www.webmd.com/skin-problems-and-treatments/sclerotherapy.
2 Injection Sclerotherapy. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036277/.