vein clinic - spider veins
What is Sclerotherapy?Sclerotherapy is the process of injecting a solution called a sclerosant into a varicose vein, or other unsightly blood vessel, in an attempt to make it disappear. The sclerosant damages the cells lining the blood vessel wall which then undergoes scarring and is reabsorbed by the body (shrivels up!) This reaction is slow, taking at least six weeks, with improvement continuing beyond this time, but the reaction varies between individuals. Usually, some form of compression of the injected area with a bandage or stocking is necessary, for a variable length of time (usually 5-14 days).
What Sclerosant is used at the St Marks Vein Clinic?
We use a sclerosant called Polidocanol. It was initially developed as a local anaesthetic but once its sclerosant properties were understood, it was used for this purpose only. There is evidence that Polidocanol has the least potential for side-effects, compared with other sclerosants. Given its local anaesthetic quality it is generally painless to inject. The injections are given through a very small, sterile needle, again resulting in little discomfort. However, some areas may be more sensitive than others.
Can Sclerotherapy be used on all Veins?
No. It is essential to establish whether the valves at the junctions between the superficial and deep veins are working. If they are not working (incompetent) this results in a high pressure leak from above. In this situation, sclerotherapy is unlikely to be effective and an operation will probably be required, if treatment is desired. If the problem is simply on the surface then ‘yes’. If there is an underlying invisible vein feeding the surface veins then the veins are assessed by performing an ultrasound scan. All the problematic veins are identified and mapped. A decision can then be made as to the best treatment options.
Is Sclerotherapy Safe?
The side-effects are mainly cosmetic and usually resolve. Severe allergic reactions to Polidocanol have been reported, but they are extremely rare. No deaths have been recorded following the use of Polidocanol. DVT, (a clot in the deep veins) has been reported after sclerotherapy, but again very rarely.
What are the most common side-effects of Sclerotherapy?
Discomfort:Usually mild. An itching or mild burning sensation is not uncommon but is short-lived.
Discoloration:This is caused by pigmentation leaking from red blood cells along the course of the blood vessel injected. It occurs unpredictably and has the appearance of an old bruise. Up to 30% of people get some pigmentation. Usually, it disappears with time, but it may take up to 12 months. We know that the use of a compression bandage following sclerotherapy is very important in minimising the occurrence of pigmentation.
Telangiectatic: Refers to the appearance of new, very fine red blood vessels, in response to sclerotherapy.
Matting: This happens in a small minority of patients and can occur after surgery as well. Its cause is unknown, and it may not be easy to treat.
Skin Ulcers: Either at the injection site or away from the point of injection. These are very rare with Polidocanol, but can occur even with meticulous technique.
Haematoma: This is a small quantity of clotted blood within the injected vessels which sometimes may need to be released. Its occurrence is more common in larger veins. It causes a dark discoloration along the course of the vein but disappears within a month usually.
Others: Temporary swelling about the ankles, usually due to the compression bandage; tape blisters or infected hair follicles under the bandage. These are all very uncommon.
If you have any questions about sclerotherapy, or if you are uncertain in any way about the process, please ask to discuss the matter further. It is important to us that you are satisfied with your visit.