Sclerotherapy Treatment

Varicose veins and spider veins are common conditions affecting the veins. In both conditions, the backflow of the blood is slowed down due to a condition known as ‘venous reflux.’ The resultant pooling of blood causes the veins to become dilated and appear as bluish-black or purple lines on the skin's surface. Gradually, the vein valves get completely damaged, a condition is known as ‘venous insufficiency’. The veins get increasingly dilated and appear as hard, knotty bulges on the skin.

Varicose veins mainly affect the deep veins of the legs. Spider veins affect the superficial veins and are not restricted to the legs. Varicose veins and spider veins can be a source of great discomfort. The affected veins look unappealing, and painful, and itch a lot. 

Sclerotherapy is the first-line treatment option for varicose veins and spider veins. This procedure involves using a chemical solution known as the sclerosant. This chemical is injected into the damaged vein. The reaction to the chemical causes the veins to swell. Swelling leads to the cutting off of the blood supply to the veins, which makes the veins collapse and die. The blood passing through these veins is re-routed to nearby healthier veins. 

Once the procedure is complete, you will feel relief from symptoms. The visible effects take 2 to 3 weeks to show. The larger veins may take 2 to 3 months to show results. 
Sclerotherapy is done as an outpatient procedure in the doctor’s office. The treated veins do not come back after the surgery, but you may develop new varicose veins requiring further treatment.

Sclerotherapy is recommended primarily for people with chronic varicose veins and spider veins. Doctors may also recommend sclerotherapy to you if you suffer from the following conditions-

• Hemorrhoids- This is a condition affecting the veins of your anal area. The veins are dilated and protrude out through the anus causing great agony after passing stools. Sclerotherapy is recommended for grade I and II hemorrhoids. 
• Malformed lymph vessels- These are malformed vessels in the lymphatic system of the body. Sclerotherapy causes the vessels to shrink and collapse.
• Hydrocele- This is a condition where there is fluid collected around the testicle. Sclerotherapy is opted for when surgical intervention is not possible.

Sclerotherapy is not suitable for everyone. There are certain conditions where this form of treatment is not recommended. 

• Future bypass procedure- If you suffer from a heart condition that may require a coronary bypass in the future, sclerotherapy for the great saphenous vein is not recommended. This is the vein that is used for coronary bypass graft surgery.
• Deep vein thrombosis- This is a condition in which blood clots develop in the deep veins of the legs. You will not be eligible for sclerotherapy if you have an active deep vein blood clot.
• Pregnancy- Pregnant and breastfeeding women are not allowed to undergo this procedure.

Sclerotherapy takes place in your doctor’s office. It is a procedure that is completed in 15 to 30 minutes and does not require anesthesia. Preparing for sclerotherapy involves the following-

• Your doctor will thoroughly examine your varicose veins and rule out serious venous problems.
• An ultrasound exam of the affected veins may be recommended. This test helps the doctor to understand the extent of damage to the vein and the blood flow through it.
• Discuss all your past and current health conditions, like blood clots, heart diseases, etc.
• Mention all the medications you are taking currently, including herbs and supplements. You will be asked to stop medications like blood thinners as they increase the risk of bleeding during and after the surgery.
• Mention any allergy to medications that you may have. This is important as sometimes there may be an allergic reaction to the chemical used in the sclerosant.
• There are no dietary restrictions and fasting is to be followed.
• You will be asked not to shave your legs. Moisturizers and creams are also not advised to be used.

Sclerotherapy usually takes 15 to 30 minutes to get completed. But the exact amount of time depends on the number of veins being treated and the size of the area. Here is what will happen to you during the procedure.

• During the procedure, you will be asked to lie on your back with your legs slightly elevated.
• The area to be treated is cleansed before the start of the procedure.
• A single needle is used to inject the sclerosant into the vein. You may feel a slight pinching sensation during this procedure.
• The injection will be done at all the veins to be treated. Sometimes, a single vein must be injected multiple times, depending on the size. 
• The solution causes the vein walls to seal together. The irritation caused by the chemical causes the vein to swell, leading to a block in the blood flow. This causes the vein to collapse.
• The blood is rerouted to the healthier veins nearby.
• There will be slight discomfort as the solution gets dispersed. 
• Once the procedure is done, the doctor will massage the area so that no blood enters the treated vein.
• A compression pad is placed on the treated site so that the area remains compressed.

Once the procedure is done, you will be advised to walk about and be active from the same day. This promotes blood flow to the treated site and also prevents the formation of blood clots. Once the procedure is complete, you will feel relief in symptoms. The visible effects take 2 to 3 weeks to show. The larger veins may take 2 to 3 months to show results. 

You will be sent home with a comprehensive list of Here is what you can expect once you go home after the procedure-

• Once the procedure is complete, you will feel relief in symptoms. The visible effects take 2 to 3 weeks to show. The larger veins may take 2 to 3 months to show results. 
• You will have to wear compression stockings at all times to maintain the compression on the treated vein.
• You will have to avoid sun exposure to the treated area for 10 to 14 days after the procedure. The inflamed areas, along with the skin exposure, can cause dark spots to develop on your leg. Use a sunscreen lotion with SPF of at least 30, in unavoidable situations.
• Avoid hot compression to the treated area, swimming, sauna baths, beaches, and bathing with warm water. 
• Even though you are advised to walk and be active to prevent the formation of blood clots, do not indulge in strenuous activities like cycling, jogging, etc.
• In rare cases, there may be an allergic reaction to the chemical in the sclerosant or you may develop a pulmonary embolism (a condition where one or more arteries in the lungs become blocked by a blood clot), phlebitis (inflammation of veins), or deep vein thrombosis (blood clot in the deep veins of the legs). Contact your doctor if you sense the following symptoms-
  • High-grade fever
  • Shortness of breath
  • Chest pain
  • Excessive swelling and pain in the leg

Sclerotherapy is the first line of treatment for people with chronic varicose veins. As with all procedures, sclerotherapy too comes with its benefits and risks.

Benefits Of Sclerotherapy

• Sclerotherapy is an effective way to get rid of varicose veins and spider veins without surgery.
• Sclerotherapy has an aesthetic appeal factor. The small spider veins and varicose veins treated by this method make your legs and other body parts look clean.
• The recovery period is minimal. You can get back home the same day after the procedure.
• Sclerotherapy is a safe procedure and does not involve too many risks.
• There is quick relief from pain and other symptoms of varicose veins.

Risks Of Sclerotherapy

• It is a procedure that requires multiple injections in the area to be treated.
• There may be pain and discomfort associated with the needle use and irritation associated with the sclerosant.
• The procedure requires multiple sessions, especially if the varicose veins are large and too many in number.
• Though the veins do not grow back, new varicose veins may develop that need further treatment.
• There may be small ulcers on the site of injection which may further get infected.
• Very rarely, there may be allergic reactions to the sclerosant, the chemical used in the sclerotherapy process.

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