Sclerotherapy is a popular treatment for spider veins and varicose veins, accounting for more than 500,000 vein treatments in the United States in 2022.  This is a medical procedure used to eliminate varicose veins and spider veins. During a sclerotherapy treatment, a specialized solution is injected directly into the vein. The solution is called a sclerosant, and it irritates the targeted vessel, causing it to swell. This swelling cuts off the flow of blood or lymphatic fluid, and the vessel shrinks. Over time, the vessel turns into scar tissue that fades from view.

At Vascular Care Specialists of Los Angeles, Dr. Mathew Cheung and Dr. Peter Lindiscuss this simple and effective vein treatment. In this article, we discuss who should undergo this treatment, what to expect from the procedure, and what recovery process is like.

Spider veins and varicose veins are caused by the same problem, but there’s a big difference between the two. Spider veins arise from tiny capillaries close to the surface of your skin. While spider veins have a big impact on your appearance, they seldom cause symptoms. In some cases, however, they can be the first sign of an underlying venous health concern.

Varicose veins are larger veins that develop in your legs. They’re extremely unattractive, as the veins become enlarged, twisted, and stick up above your skin. When they go untreated, varicose veins can cause complications such as superficial thrombophlebitis, inflammatory skin conditions, and venous stasis ulcers.

Varicose veins are also notorious for causing symptoms. They can be painful and make your legs feel achy. You may develop itchy skin, a burning sensation, muscle cramping, or leg swelling from varicose veins. But all of these symptoms go away after you’re treated with sclerotherapy.

Sclerotherapy is a first-line treatment for varicose veins, which can be a sign of chronic venous insufficiency. Varicose veins refer to veins, usually in the legs, that swell and bulge due to poorly functioning vein valves. As a result, blood pools in the veins. This issue may be painful and itchy and cause skin discoloration. Sclerotherapy shrinks varicose veins until they disappear, and blood reroutes to healthier veins.

Doctors may also use sclerotherapy to treat other health issues, including:

• Malformed lymph vessels: These are abnormal vessels in the lymphatic system. Sclerotherapy creates scarring in the malformed vessels, causing them to collapse.
• Hemorrhoids: Doctors may use sclerotherapy to shrink hemorrhoids. These form when blood vessels surrounding the rectum swell and become irritated, causing pain and making bowel movements uncomfortable.
• Hydroceles: A hydrocele is a collection of fluid around a testicle. Doctors may use sclerotherapy to treat hydroceles, particularly when surgery is unsuitable.

People may consider sclerotherapy to treat varicose veins or spider veins. Some may have the procedure for cosmetic reasons. A doctor can help a person decide if sclerotherapy is necessary or suitable.

People may want to consider other approaches first. For example, people can treat hemorrhoids with strategies such as lifestyle changes, eating more fiber, and not straining when having a bowel movement.

People with varicose veins or spider veins might consider sclerotherapy if the veins are too twisted for other treatments to work or if they have uncomfortable symptoms, such as:

• itching
• aching
• burning
• swelling
• night cramps
• •the legs feeling very heavy or tired

During your sclerotherapy procedure, we clean the skin around the targeted area and inject the sclerosing medication using a fine needle. If your varicose veins are large or deep under your skin, we administer a local anesthetic and use ultrasound to see the vein and guide the needle. You may feel slight cramping as the medication is injected, but you shouldn’t experience pain, especially not when you’re in our capable and skilled hands. You’ll be up and moving shortly after your sclerotherapy procedure. You’ll need to wear compression stockings and avoid strenuous activities for about two weeks. Otherwise, you can get back to your normal daily routine.

Alternately, the doctor may administer an anesthetic and insert a catheter into the affected blood vessel, then use a solution of 90% alcohol to block the vein.

To prepare for sclerotherapy, people should follow any instructions from their doctor. This may involve avoiding certain medications, such as aspirin or blood thinners, or using lotions on the area of treatment.

After the treatment, it is likewise important to follow the doctor’s advice. People may need to wear compression stockings to help with recovery and prevent further varicose veins from forming. Also, some people have some bruising or marks at the site of the injection.

Spider veins usually respond to the treatment in 3–6 weeks, and larger veins usually respond in 3–4 months. If the treatment is successful, the veins will disappear. If not, the doctor may recommend repeated treatments.

A person may need to have a follow-up appointment with their doctor for a physical examination and possibly imaging or blood tests to check the effects of the sclerotherapy.

Sclerotherapy achieves exceptional results using an amazingly simple procedure. We only need to inject a sclerosing agent into the vein. A sclerosing agent is a type of medication that immediately closes the vein by damaging the vein wall.

After the vein collapses, two important things happen. First, your body restores normal blood flow by automatically rerouting the blood to a healthy vein. And second, the treated area turns into scar tissue. Over the next few weeks or months, your body naturally clears away the scar tissue, permanently eliminating your unsightly veins.

Research suggests that sclerotherapy removes problematic veins in 75–90% of cases, but this typically requires multiple treatments. When sclerotherapy does not work, people may require other treatments, such as surgery.

Sclerotherapy may not be effective for everyone. Under 10% of people may not have any response to the treatment, regardless of the size of the veins in question.

If sclerotherapy is ineffective or unsuitable, a doctor may try injecting a different sclerosing solution or recommend another approach, such as cutaneous laser therapy.

When the sclerotherapy is performed by a trained and qualified healthcare professionals, it is a safe and effective treatment. However, having existing medical conditions, not following medical advice, or taking medications that conflict with the treatment may significantly increase the risk of complications. Also, sclerotherapy may not be not suitable for people who are pregnant, breastfeeding, or confined to bedrest. After giving birth, people must wait 3 months before having sclerotherapy.

Possible risks and complications of sclerotherapy include:

• an infection, which requires treatment with antibiotics in under 1 in 1,000 cases
• a skin injury that may result in a small, permanent scar
• severe inflammation
• an allergic reaction to the injected solution
•  a blood clot

Also, if tiny air bubbles from foam sclerotherapy get into the bloodstream, it may cause chest tightness, a dry cough, dizziness, and nausea.

At Vascular Care Specialists of Los Angeles, we strive to provide the best service, care, and results possible. If you are interested in varicose vein treatment, give us a call at 626-275-9566 to schedule an appointment. You can also visit us at www.vcsla.com for more information.