Sclerotherapy is the treatment of choice for most unwanted spider veins and on occasion for larger veins as well. This outpatient procedure involves a series of injections using a tiny needle to administer small amounts of a solution into the vein. This solution irritates the inner lining of the vein and, for most patients, causes the vein to collapse and eventually disappear.
The procedure can be mildly uncomfortable. While patients may also experience minor discomfort during the recovery period following sclerotherapy, any pain you experience should quickly improve with the healing process. Several types and forms of solution are available for injecting and the solution most appropriate for you will be discussed prior to treatment.
Before the procedure
If possible, avoid aspirin or similar medications for five days prior to treatment, as it can be associated with increased bruising. If you have been advised by another physician to take aspirin daily, please discuss stopping your use of it with your vein center physician prior to doing so.
It is important to get the prescribed compression stockings and bring them with you to your sclerotherapy session. You can find compression stockings at a number of medical supply stores or we can often fill your stocking prescription in our clinic. Plan ahead and get your stockings well in advance of your procedure as the correct size may need to be ordered for you. Try on your stockings prior to your procedure to be sure they fit—although they will be very snug, they should be long enough that they come to the very top of your leg (to your groin).
Lastly, please do not shave your legs the morning of your treatment as it leaves the skin mildly irritated and may make your spider veins more difficult to inject.
After the procedure
Following sclerotherapy treatment, you will wear compression stockings for a duration ranging from several days up to two weeks, but can generally return immediately to most routine activities. The maximal outcome is about six to eight weeks following treatment. A successful course of sclerotherapy will eradicate about 75 to 80 percent of treated veins. Multiple sessions may be needed to attain your desired results.
After your sclerotherapy session you will have compression dressings on underneath the compression stockings. Leave all the dressings and the stockings in place until the following morning. In the morning, remove the stockings and all of the dressings. Leaving the dressings on longer will not give you a better outcome and in fact may increase your risk of infection. After you have showered and dried off completely, put on only the stockings. No additional dressings are needed.
Keep in mind that your legs could look quite bruised following sclerotherapy. When bruising is present, it is very important that you avoid exposing the area to sun (including artificial sun or tanning) as you will increase your chances of developing hyperpigmentation skin changes. Avoid soaking in water or a tub for the first week after the treatment to prevent infection. Check your legs daily for signs of healing. While rare, infection is a remote possibility. Red streaks beyond the areas treated, extreme tenderness, pus, drainage, widespread leg swelling, or pain while walking are not normal. If you experience any of these or other concerning symptoms, call your physician immediately.
The purpose of compression stockings is to ensure that the treated veins heal shut and do not re-open. They may also aid in decreased bruising. Wearing the compression stockings as prescribed is very important to the success of the procedure. The duration of use will vary from patient to patient but as a general guideline, you should wear the stockings for a total of one week following the procedure. For the first 24 hours following the procedure, wear the compression stockings around the clock, just removing them daily when you shower. For the remaining six days, you can take the stockings off when you go to sleep at night but should otherwise wear the stockings all day. You will likely be wearing the stockings for a total of one to two weeks following the procedure.
For the first week after sclerotherapy, avoid high-impact aerobic activities like running and jumping. However, you should walk a minimum of 30 minutes a day following your sclerotherapy to promote the growth of new, healthy veins. After one week, you may slowly return to your normal level of exercise but be sure you are still wearing the compression stockings as prescribed—even while exercising.
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