When you look at your legs, do you sometimes see blue or purple veins, and in some places the veins look like they are knotted? Some people feel pain, heaviness, and itching in their legs because of this. Especially when wearing a dress or shorts, this appearance may make you feel a little uncomfortable. We medically call this condition `(Varicose veins)` and `(Spider veins)`. So today we are going to talk about a very successful, simple, and popular treatment for this. That is `Sclerotherapy`.
What exactly is sclerotherapy?
Simply put, Sclerotherapy is an injection treatment for varicose veins and spider veins in your legs. It is not surgery. What happens here is that your doctor uses a very fine needle to inject a special chemical solution into the vein that is showing.
Think of this liquid as glue. When it gets into the vein, it causes a small irritation to the vein walls. What happens is that the vein walls stick together, the blood flow inside the vein stops, and the vein becomes like a scar and closes off. Over time, your body absorbs and removes this blocked vein. Then the unsightly vein gradually fades away. Along with it, the pain and discomfort it caused also disappear.
This is like putting a special liquid inside an old, useless water pipe and sealing it from the inside. After a while, just as the pipe rots away, this vein also disappears from the body.
Who is this treatment suitable for? Who is it not suitable for?
Sclerotherapy is a safe treatment that can be done by many people, but it is not for everyone. Your doctor will decide whether this treatment is right for you. He or she will examine you before performing the treatment.
This treatment is generally not performed on the following people:
- For pregnant mothers: This treatment cannot be done if you are pregnant. You can only consider it again after at least three months after giving birth.
- For breastfeeding mothers: It is not advisable to do this while breastfeeding.
- For people with blood clotting disorders: This cannot be done if you have active blood clots in your veins (active deep vein thrombosis or superficial vein thrombosis).
- For those who are confined to bed: This treatment is not performed on someone who is bedridden and unable to walk in any way.
However, if you are taking birth control pills, it is not a problem , you can do `Sclerotherapy`. Also, even if you have ever had a blood clot before, depending on the cause and its severity, it may be possible to treat it. You should talk to your doctor about this.
Another important thing is that sometimes this treatment is not done on veins that may need bypass surgery in the future, such as coronary artery bypass graft surgery. However, if the vein is already too damaged to be used, it is treated.
What you need to know before treatment and how to prepare
There are things you need to prepare on your part before going for treatment, as well as medications you need to stop taking. Following these things exactly is very important for the success of the treatment.
| Advice | Important information |
|---|---|
| Medications to stop | Do not take painkillers and blood thinners such as aspirin , ibuprofen (such as Advil®, Nuprin®), and other NSAIDs for 48 hours before and after treatment. These can increase bleeding. However, it is okay to take paracetamol (Tylenol®, Panadol®) for pain. |
| Be careful with antibiotics. | Antibiotics such as (Tetracycline) or (Minocycline) may cause skin discoloration if taken 7-10 days before or after treatment. Tell your doctor if you are taking any other antibiotics. |
| Inform about Prednisone | If you are taking a steroid medication such as Prednisone , it may reduce the effectiveness of the treatment. Therefore, ask your doctor if you can stop taking it 48 hours before your treatment. |
| Do not apply anything to the skin. | On the day of treatment, do not apply any lotion, cream, or oil to your legs. |
| Think about the dress. | Bring comfortable shorts to wear during treatment. |
| Bring compression stockings. | If you have compression hosiery from a previous treatment, bring it with you. The doctor can check it to see if it will fit this time. |
Most importantly: Before stopping any medication you are currently taking, it is imperative to talk to the doctor who prescribed it for you and seek his advice.
What happens during treatment?
This treatment is done in the doctor's office. It doesn't require much preparation or anesthesia. The entire procedure takes about 30 to 45 minutes.
1. Position: Depending on where the vein being treated is, you will be asked to lie on the bed either on your side or your side.
2. Skin cleansing: The skin around the injection site is thoroughly cleansed.
3. Vein Identification: Sometimes, when treating deep veins, the doctor may use an ultrasound scan to locate the exact vein.
4. Injection: Next, the doctor or an assistant will pull your skin taut and then, using a very fine needle, they will carefully inject the special liquid or foam into the vein.
You will only feel a slight stinging sensation from the needle . You may feel a slight burning sensation as the medicine goes in. When the medicine is injected into a larger vein, you may feel a slight numbness in your leg for a minute or two. These are all normal, so don't worry about it.
The number of veins treated in one session depends on the size and location of your veins, and your overall health.
What should I do after treatment?
After the treatment is over, you will be asked to stay in bed for about 15 minutes. This is to see if there is any allergic reaction to the medicine. After that, you can get up and drive home on your own . You can also do your usual activities. Walking is especially good , because it improves blood circulation.
There are some special instructions you need to follow within the first 48 hours after treatment.
| Do's/Don'ts | Description |
|---|---|
| Wearing Compression Stockings | The doctor says you should continue to wear these support hosiery or compression wraps for 3 to 7 days. This will help the treated veins to tighten and heal faster. |
| Avoid hot things | Avoid hot baths, saunas, and whirlpools. Showering with normal water is fine, but lower the water temperature a little. Do not place hot water bottles on the injection sites. |
| Avoid sunlight. | Avoid exposing treated areas to direct sunlight. Also avoid tanning. |
| Cleanliness | Wash the injection sites with lukewarm water and mild soap. |
| Painkillers | If you have pain, take Paracetamol. Do not take medications like Aspirin or Ibuprofen. |
What are the benefits of Sclerotherapy treatment?
- No anesthesia required: Since this is not a surgical procedure, you will not need to be anesthetized.
- High success rate: Many people get good results with this. It is especially effective for small varicose veins and spider veins. Between 50% and 80% of the veins can be removed in one session.
- Quick results: Small spider veins fade within 3-6 weeks. Larger veins can take 3-4 months.
- Permanent results: A successfully treated vein will not reappear . However, new veins may appear. In that case, they will need to be treated separately.
- Less pain: Wearing compression stockings after treatment can significantly reduce pain. It also helps control bruising and swelling.
Are there any risks or side effects to this?
As with any medical treatment, there are some minor side effects that can occur. However, serious ones are very rare.
| Side effect | Description |
|---|---|
| Common, non-serious side effects | |
| Vein constriction/stiffness | When large veins are treated, they may feel lumpy and stiff for a few months. This will gradually go away. |
| Redness | The redness at the injection site will disappear in a few days. |
| Brown spots | Brown streaks or spots may appear in the treated areas. These usually fade within 3-6 months. However, in a small percentage of people, about 5%, these may remain permanently. |
| Bruises | Bruising may occur at the injection site. These will disappear in a few weeks. |
| Allergic reactions | It is possible to have an allergic reaction to the medicine, but it is very rare. Symptoms may include itching and swelling. |
| Symptoms that may occur rarely and should be reported to the doctor immediately | |
| Groin swelling | If you develop swelling in your groin area. |
| Sudden leg swelling | If the treated leg suddenly starts to swell. |
| Small wounds | If small wounds (ulcers) develop at the injection site. |
| Red stripe | Especially if red streaks appear running towards the groin. |
If something like this happens, you should call your doctor immediately .
Will insurance cover this? Is laser treatment better?
Insurance companies do not usually cover sclerotherapy treatments for cosmetic reasons. However, if you have medical reasons for the varicose veins, such as pain or heaviness in your legs, some insurance companies may cover it. This will require a letter from your doctor. It is best to call your insurance company before having the treatment and ask about this.
Laser treatment, or endovenous thermal ablation, is another good treatment for varicose veins. It can also cause side effects. However, it is difficult to treat very tortuous and twisted veins with laser treatment. Your doctor will determine the best treatment for you based on the condition of your veins.
Take-Home Message
- Sclerotherapy is a very effective and safe treatment for varicose veins and spider veins in your legs.
- It is essential to tell your doctor about your health condition and all medications you are taking before treatment.
- For best results, follow your doctor's instructions carefully after treatment, especially wearing compression stockings.
- It takes some time to see results. Don't expect your legs to look great overnight. Be patient.
- If you experience a serious side effect (such as sudden swelling or bruising), do not panic and inform your doctor immediately.
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