Our Vein Sclerotherapy in St Louis uses a tiny needle to inject a solution called sclerosant into veins, irritating the lining of the veins which causes them to close. Sclerotherapy is used to treat both varicose and spider veins that are seen on the surface of the leg. Smaller surface veins are often referred to as “spider veins.”
Sclerotherapy can be an important part of healing symptomatic varicose veins, or may simply be a cosmetic treatment on spider veins. Before sclerotherapy is indicated, an evaluation is conducted to determine venous health.
If deep vein issues have been resolved or are not present, treatment addresses superficial veins in topmost layer of the skin, “spider veins.” Spider veins are caused by dilation of the most superficial veins in the skin. A vein light is often used for these tiny veins to illuminate hidden vessels that feed the spider veins. This ensures a more complete and accurate treatment. Sclerosant is introduced to close veins and eliminate symptoms. Visual Sclerotherapy of spider veins is usually considered cosmetic. Most insurance will not cover this last type of treatment because it is not deemed medically necessary. Veins are treated with the sclerosant, and with the use of compression stockings, the veins begin to close. Several treatments (often three sessions) are usually required to close veins and eliminate them completely.
One of the major advantages of sclerotherapy is that it is able to treat veins of many different sizes, and on any skin type or tone. It eliminates annoying spider veins and gives a more pleasing appearance. It is minimally invasive and easily done in our St. Louis vein center. It often takes two or three treatments on a given vein to achieve a long-lasting closure that results in the entire disappearance of the vein.
Each sclerotherapy injection closes a small section of a vein at a time. Sometimes part of the closed segment of the vein will recannulate or reopen, making it necessary for the vein to be treated again. It can be hard to predict how many treatments it will take to completely eliminate the vein, but generally results are cumulative. Multiple treatments successfully eradicate the spider veins, leading to a greatly improved appearance without unsightly veins.
After evaluation, the best course of vein treatment addresses the largest veins first. Sometimes treating vein issues begins with laser ablation (EVLT) of varicose veins. Once the underlying problems are treated in a refluxing saphenous vein through ablation, the remaining branches below the skin are treated either with ultrasound-guided sclerotherapy or sclerotherapy.
Sclerotherapy can help banish spider veins. Sclerotherapy of spider veins is usually done without ultrasound guidance. Ultrasound guided sclerotherapy vein treatment is called for when veins are experiencing medical issues (see below).
If deep veins are healthy and the issues are simply cosmetic, sclerotherapy varicose and spider vein treatment is a minimally invasive way to eliminate these visually unappealing veins. The treatment is comfortable and takes just a short time. There are no restrictions on who can benefit from sclerotherapy. Unlike laser treatments for spider veins, sclerotherapy is safe for all skin tones and types.
Ultrasound guided sclerotherapy is performed with either a liquid or “foamed” sclerosant while Dr. Wright monitors the vein during treatment on an ultrasound screen. Ultrasound guided sclerotherapy enables treatment of unseen veins below the surface of the skin. With this procedure, veins can be dealt with at an early stage, helping to prevent further complications.
What advantages does the VeinWave offer over other treatment options such as sclerotherapy and other light and laser based treatments?The VeinWave offers immediate results, is non-invasive, leaves no bruising or scarring, does not require bandaging or compression stockings after treatment, is simple and affordable and has no adverse reaction to immediate exposure to sunlight following treatment.
Is it alright to shower the day after a Sclerotherapy treatment? When can I remove the bandages?I use compression hose for three days to three weeks and tell patients it is fine to shower without them on. So for my patients they can shower the day after sclerotherapy.This will depend upon the treating physician. It may depend on what type of bandages your doctor prescribed. Typically any post-procedure dressing is removed the following morning, and patients may take their first shower at that time. You should contact your vein doctor and have them review their specific post-instructions with you. But I don’t use bandage, and only use compression stockings.
My friend had sclerotherapy a few days ago, and now she has blisters around the area that was treated. Is this a normal side effect? She said her specialist never mentioned anything about possible blisters.Your friend may be experiencing skin breakdown which can happen with any sclerotherapy. It will heal fully but it must be treated properly. I would contact the doctor right away to let them know.
Can anyone undergo Sclerotherapy?Everyone with unsightly spider veins is eligible for treatment unless the individual has one of the following:-they are pregnant or breastfeeding-has a skin infection-uncontrolled diabetes-history of deep vein thrombosis
Can dermatologist perform Scleotherapy or only Phlebologists? What kind of certification is required?Although sclerotherapy may be performed by any type of physician, you will likely experience the best results with someone who is both highly experienced and a specialist in treating venous disease, and in the use of sclerotherapy specifically.Look for someone who is a vein specialist, with years of experience, board certified in phlebology, vascular surgery, or vascular medicine, and one whose practice is devoted to treating veins, as well as one who has multiple treatment options available depending on the patient’s underlying issues.
Is it bad for your health to have sclerotherapy? It seems dangerous to inject chemicals like that directly into the bloodstream. Couldn’t they spread and cause damage to other veins/areas of the body?The known risk of toxicity from foam sclerotherapy is extremely low. The effects of sclerotherapy are generally quite localized to the treated veins and the communicating veins nearby. The injected solution is quickly diluted a few centimeters from the injection sites, and generally does not cause damage to other areas.
If the chemical is injected directly into the vein and stops it up, couldn’t the blood clot and cause problems? Is sclerotherapy safe if someone has a blood clotting disorder?The intention of sclerotherapy is to create inflammation within the lining of the vein, causing it to collapse and seal closed. This process frequently involves trapping and subsequent clotting of small amounts of blood within the involved vessel, which the body slowly re-absorbs over time. This process is perfectly normal, and is not dangerous. The dangerous types of blood clots are called “deep vein clots”, these vessels are all superficial, and very superficial, and involve small vessels. However, common sense would dictate that we would simply exercise more caution, and be more conservative with someone who has a known clotting disorder, depending on what type it is.
There is a large vein on my face that doesn’t appear to be a broken capillary or spider vein. Could sclerotherapy be used to treat it, or would something else be better?Sclerotherapy is an excellent treatment for large bluish veins that are usually on the temples. Sclerotherapy, however, is not very good at treating the fine reddish vessels in the center of the face.
Is sclerotherapy a possible treatment method for hemorrhoids?Yes, but there are other options more commonly used.
Is it common to use sclerofoam to treat spider veins? I’ve heard conflicting answers.While some physicians may used foamed solution to treat smaller veins, typically the spider veins and pale green reticular veins are treated without foaming the solution being used. In my practice we use a weak sclerosant that works nicely will little discomfort. It is not foamed. When treating large bulges and varicose veins, foamed solution is necessary.
I am scheduled for an MRI with contrast (by injection) for a hamstring tear and lesion, this will be done 10 days after I have Asclera Sclerotherapy injections in the same leg (thigh and calf). Is there any conflict with these 2 treatments & agents?You can safely have an MRI with contrast 10 days after foam sclerotherapy.
Could some or all of the cost of sclerotherapy be covered by my provider?It depends on what type of vein is being treated: Bigger veins that are symptomatic might be covered by an insurance company; smaller asymptomatic spider veins generally are not.It also depends on the individual benefits of the insurance plan you have. Policies regarding vary depending on the insurance company.Finally, sometimes it depends on whether the sclerotherapy treatment is done as part of a larger treatment plan that includes treatment of the saphenous vein. Our experience has been that insurance does not cover any sclerotherapy unless it is completed following an endovenous laser procedure.
Do drugs affect the Sclerotherapy procedure? I am on Accutane.Unlike certain light based treatments that should be avoided while on Accutane, Sclerotherapy treatment can be done. There are no warnings about interactions of the medication used in sclerotherapy and Accutane.
Is Foam Sclerotherapy the best procedure for the removal of spider veins? Or are others more recommended?Sclerotherapy is the best method of eliminating small veins. Foam is not necessarily used. It is physician and vein size dependent. At our St. Louis vein center, we only do foam sclerotherapy on larger vessels using ultrasound guidance. The spider veins are treated with non-foam sclerotherapy.
What exactly is foam sclerotherapy, is it more effective than traditional sclerotherapy?Foam sclerotherapy means combining the sclerotherapy medication with air to generate a foamed solution. This is then injected into the veins to promote absorption and resolution. Foam is generally used for the treatment of larger varicose veins that your doctor feels would be under treated with the sclerosing agent alone.
Is the foam a separate ingredient? What are the chances of an allergic reaction?Foam is created when a sclerossant is mixed with air or gas. Typically, room air is mixed with the solution to create the foam. This technique is very safe when done properly. The risk of any type of allergic reaction is due to the solution being used, not the air.
I had a phlebectomy that was not successful, then laser ablation and sclerotherapy within 2 months of each other. i now have shooting pain in my leg… is this something that is normal?This is not typical. If the phlebectomy did not give you any improvement in the appearance of the varicose veins, that probably means they were not removed. If you notice immediate improvement but then new varicose veins appeared, that would indicate that the underlying cause (a leaky vein) was not treated. That would be the purpose of laser ablation. Shooting pains in the leg could be part of the healing process or it is possible that a nerve injury has occurred. I would recommend discussing these symptoms with your doctor.
Who is legally allowed to perform Sclerotherapy? I’ve seen the procedure advertised at medspas, and wondered who is qualified to perform it legally?Ideally you should seek for a phlebologist, someone with the experience and training to perform those procedures. In experienced hands you have the best chance for optimal results.
How long does the Sclerosing agent remain in bloodstream after a procedure? I had it done while breastfeeding and was told to just disregard and continue.Sclerotherapy solutions are safe in general. Saline solutions pose no risk to a breastfeeding infant. STS and other sclerosants, if used, are cleared fairly quickly. Usually within a few hours. There are no standards established regarding breastfeeding and sclerotherapy. But because it is cleared quickly, I recommend to nursing mothers that they pump the next 2 times their child would feed and discard the milk. They would supplement during this time of course. Then they may resume breastfeeding.
How long do sclerotherapy chemicals stay in the bloodstream? I would like to become pregnant, but would like to know what’s safe.I am asked this question many times. You can safely get pregnant immediately after a treatment. But if you do get pregnant in the middle of a series of treatments, you should stop all treatments until 3 months after you deliver. This is a wide safety margin for the prevention of blood clots. The medications that are used by almost all experts, Sodium Tetradecyl Sulfate and Polidocanol, are very safe. They are fatty acid esters similar to lidocaine. They are cleared out of your system in 24 hours or less and present no difficulties.
I had sclerotherapy yesterday, but I can still see a few of the veins that were treated. How long until all the veins disappear?It is quite variable from patient to patient and from vein to vein. Most of the times takes at least 3-4 weeks before some results can be appreciated, however could go as long as 3 months before improvement can be noticeable. Some go away right away some look worse and slowly fade. It rarely is done in one treatment.
How long does it take to show an improvement after the Sclerotherapy is performed?It is variable. Most patients will see the veins looking much worse for the first 2 weeks. After that, they see some improvement.Some patients can enjoy great results as soon as 4 weeks after injections, others might take up to 3-4 months. Things usually look worse for a month or so then fading starts, and it can take several months before significant improvement is noted. It also usually takes more than one treatment.
Will the length of time to recover from sclerotherapy be longer than two weeks?In terms of functional recovery, such as the ability to continue on with your life there usually is no down time at all. You just put on your compression stockings and you are back to your your normal routines. The next question you might ask is when will is see results? This depends on the amount and strength of solution used, the types of veins being treated, your skin type, your genetic propensity to develop hyperpigmentation. You get the drift. It is different for everyone. The rule of thumb is about 6 weeks between large treatments and it could take many months before all of the pigment changes clear and everything fully heals.
What machine is used in Ultrasound Guided Sclerotherapy? Is it the same one used to view babies in the womb?Essentially “YES,” it is the same principle and even the same equipment. It requires special software and a different probe than the one used in Obstetrics to be vein-specific.
How many months after sclerotherapy is it safe to become pregnant?I am asked this question many times. You can safely get pregnant immediately after a treatment. But if you do get pregnant in the middle of a series of treatments, you should stop all treatments until 3 months after you deliver. This is a wide safety margin for the prevention of blood clots. The medications that are used by almost all experts, Sodium Tetradecyl Sulfate and Polidocanol, are very safe. They are fatty acid esters similar to lidocaine. They are cleared out of your system in 24 hours or less and present no difficulties.
I’m considering sclerotherapy, but want to know if patients typically need more than one treatment to get rid of all of the spider veins in an area.Yes, it’s very common. It usually takes several treatments. Each treatment session should be separated by at least 4 weeks . If you have more that very few veins in a small area it usually take 2 or three treatments and will often require “touch ups ” in a year or two.
How is polidocanol related to Sclerotherapy? I’ve heard conflicting accounts. What exactly is polidocanol?Polidocanol is a sclerosing agent, drug used to treat veins. It works quite well. Currently, it is available only from compounding pharmacies in the US, although it will be available from a manufacturer soon. The drug most commonly used in the US is Sotradecol, which works well also. This is the FDA-approved drug available here. All of these drugs work by injuring the vein wall causing the vein to scar down and close off, thereby removing the varicose/spider veins.
Is it possible to do sclerotherapy on veins on the hands/wrist/arms?Yes, you can have sclerotherapy on your hand and wrist. I don’t advise getting sclerotherapy on your arms as you may need those veins for IV or blood draws.
I am taking a number of medications for high blood pressure and was wondering if it is safe to have sclerotherapy or if another treatment would be better.Sclerotherapy solutions in general are very safe. They have very limited side effects and risks. There are typically no big concerns with solutions and most daily medications including high blood pressure medications. Minocycline (an antibiotic) should be avoided due to increased risk of pigmentation problems and if you are on blood thinner you should consult with the doctor performing the sclerotherapy and discuss the reason for the blood thinners. The judgment to use a sclerossant should be made by your vein specialist on an individual basis.
I have a lot of redness and small veins on my nose. Is sclerotherapy the best option?While sclerotherapy may work well for small veins, a new device called VeinWave may be a better choice. VeinWave uses a tiny needle tip to deliver heat to the vein and works very well for many small facial veins with much less pain and discoloration than sclerotherapy. Another option is IPL (Intense Pulsed Light) which can be painful, more expensive and takes several treatments but is able to treat other skin changes as well as the veins.
I have both spider veins and varicose veins, and I was hoping to find a treatment that works on both. Is sclerotherapy effective for varicose veins?Yes, sclerotherapy can be used to treat both varicose and spider veins. However, the most important issue in dealing with varicose veins is to make sure the underlying cause is treated in addition to the varicosities. An ultrasound is needed to see if there is a leaking vein and if so this should be ablated (closed down). Usually it is best to treat the underlying cause with either laser or radiofrequency ablation prior to performing sclerotherapy. Sclerotherapy may take several sessions to be effective.
Does Sclerotherapy have to be performed with ultrasound or can it be done without?Foam sclerotherapy is typically used for larger veins that are not visible on the skin surface and therefore the answer is yes, ultrasound is necessary. The tiny superficial veins that are treated with sclerotherapy do not require “foaming.” Making a sclerosant foamed causes it to be stronger. Some physicians like to treat the veins known as reticular veins with foam. These are the visible veins that are larger than spider veins but smaller than varicose veins. They “feed” the spider veins. In this circumstance, ultrasound would not be necessary.
Is sclerotherapy safe for those with Celiac Disease? Does the sclerotherapy solution contain any gluten? I want to avoid any bad reactions.I am not aware of any reason why a person with Celiac disease needs to avoid sclerotherapy. The solutions are very safe, including one popular choice that is just salt water. These medications are all quickly cleared from the body.But ultimately that is something that needs to be discussed with the physician providing treatment.
I haven’t had it evaluated by a doctor, but I do bruise extremely easily and the bruise usually stays for at least three weeks, even for a minor bump. Is this something I should have checked before undergoing sclerotherapy?Sclerotherapy is generally safe for the vast majority of patients, even for those who may bruise easily. Obviously, there are multiple injections performed with treatment, so bruising is not at all uncommon, and may last for variable amounts of time afterward. However, in your specific case, if you bruise with even minor trauma, and it lasts for an extended period of time, you may want to have your physician evaluate you for any potential bleeding disorders, just to make sure there is not something significant going on.
While pregnant with my first child I’ve developed a large number of spider veins on my legs/thighs. Are spider veins more prevalent during pregnancy? Do they go away after delivery? Can I get sclerotherapy while I’m pregnant?Sclerotherapy should be avoided during pregnancy. Spider veins may develop more rapidly during pregnancy and may subside some afterward though they usually will not disappear entirely. Wait until you and your baby are doing well and then see a phlebologist. Elastic support hose are a good idea during pregnancy to help keep up blood flowback to the heart from your legs.
Is sclerotherapy safe to have while pregnant?Cosmetic sclerotherapy should not be done during pregnancy or breast feeding. It’s not worth taking any potential additional risks.With regards to facial spider veins, I prefer the Veinwave device to sclerotherapy!
Does the sclerotherapy treatment relieve or help vein disease symptoms?Yes. Sclerotherapy which is an injections of a medication to close veins can help or relieve symptoms such as tenderness, aching, and burning caused by varicose veins. However, it is best to have an evaluation by a doctor with an ultrasound to know the full extent of your vein problems before starting sclerotherapy for symptomatic veins. The evaluation is important! If you have symptoms associated with your varicose or spider veins. You may have reflux in your saphenous vein which should be treated before you have sclerotherapy.
Is Sclerotherapy used to treat spider veins?Sclerotherapy is a common form of treatment for spider veins. It’s a simple procedure performed in our St. Louis vein center where the veins are injected with a solution, using a tiny needle. This procedure can improve the cosmetic appearance and the associated symptoms as well. Depending on how many veins are involved the procedure usually takes 20-30 minutes. Keep in mind that a few sessions may be needed to obtain the maximum benefit. There can be some bruising right after sclerotherapy and the results of the treatment can take weeks or longer to be noticed.
Is it possible to use sclerotherapy to treat vascular lesions like hemangioma? Seems like it’d be safer than surgery.Depending on the type of vascular lesion, sclerotherapy could be an option. There are other non-surgical options as well for vascular lesions, such as laser treatment. Consultation with a vein specialist will help determine the most appropriate option for your situation.
What is Sclerotherapy?Sclerotherapy is treatment with a chemical sclerant, which irritates a vessel’s lining, making it become inflamed, harden, and eventually fade away completely. This treatment is used for the removal of spider veins and smaller varicose veins.
What are the side effects of Sclerotherapy?Some minor itching and burning immediately after treatment is normal. Hyperpigmentation occurs in about 2-8% of treatment. This usually resolves in time. Matting of veins in a reddish area can occur, which will require additional treatment, but usually goes away. Rarely, infection and skin breakdown can occur. These also resolve in time, though skin breakdown may result in some scarring.In very rare cases, allergic reactions are possible.
When will Asclera, the new Sclerotherapy treatment, be available?I heard that Asclera (Polidocanol) was recently FDA approved. When can patients expect this sclerant to be widely available in the US?Not sure about when the FDA will approve this. I have been told it is expected soon. Possibly it will be available in a few months.– UPDATED: It was approved and is now available.
I’ve heard that birth control pills can have an effect on the vein walls, softening them and causing problems. Is this true? Could being on the pill then create problems with sclerotherapy?There is not strong data suggesting that BCP’s effect the results of sclerotherapy. The major concerns would be a possible increased incidence of DVT and increased blushing or matting, but no data to date has shown this.
Today was my last treatment by Dr. Wright for varicose veins in my right calf. He was able to relieve the pain after the first treatment and, the veins have virtually disappeared. If fear is causing you to put off treatment, don’t wait any longer. At the initial exam and consultation, Dr. Wright and his assistant went out of their way to make sure I understood what was needed. They took care of getting a pre-approval from my insurance in just a few days. Scheduling was easy and, I resumed my normal activities immediately following each appointment.