Sclerotherapy

Sclerotherapy, a proven medical procedure that has been in use since the 1930s, is used to eliminate varicose veins and spider veins. During the procedure a solution is injected directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together and the blood to collapse. Over time, the vessel is absorbed, and eventually fades from view.

Are you a candidate for Sclerotherapy?
Prior to sclerotherapy, you will have an initial consultation who will determine if the procedure is right for you.
Answering yes to any of the following questions may indicate that you are a candidate for varicose vein treatment. Ultimately, it is best to have a varicose vein specialist provide you with a personal exam and consultation in regards to your varicose veins.

Q: Have you or anyone in your family previously been diagnosed with varicose veins or venous reflux?
Q: Do you have varicose veins which exhibit any of the following characteristics:
           • Large, bulging veins on your legs
           • Swollen, red, or warm to the touch
           • Skin discoloration or texture changes
Q: Are you experiencing any of the following symptoms in your legs, ankles, or feet:
           • Pain (an aching or cramping feeling)
           • Heaviness/tiredness
           • Burning or tingling sensations
           • Tender areas around the veins
           • Sores or skin ulcers near ankle
           • Swelling
Q: Have you previously had skin ulcers on the leg (or areas that were slow to heal)?
Q: Have you previously attempted conservative treatments without success (e.g. exercise, weight loss, elevating legs, avoiding long periods of standing/sitting, compression stockings)?

          If you answered YES to any of these, you may be a candidate!

Sclerotherapy is not recommended in the following circumstances.
           • If you are pregnant
           • If you have had a blood clot in the past, your eligibility will be decided on an individual basis, and will depend on the overall health of the area needing treatment as well as the reason for the clot.
Veins that are potentially usable for future heart bypass surgery will generally not be considered for sclerotherapy, unless they are already deemed unusable.

How Is Sclerotherapy Done?
During sclerotherapy, the solution is injected through a very fine needle directly into the vein. At this point, you may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected.
Sclerotherapy is performed in the doctor’s office and the procedure itself takes approximately 15 to 30 minutes. The number of veins injected in one session varies, and depends on the size and location of the veins, as well as your general medical condition.

What You Need To Do Before Sclerotherapy
Prior to sclerotherapy, you should avoid certain medications. Talk to your doctor about all medicines (including over-the-counter drugs, herbs, and dietary supplements) you are taking before the procedure. We recommend avoiding aspirin, ibuprofen (for example, Advil, Motrin and Nuprin), or other anti-inflammatory drugs for 48-72 hours before sclerotherapy.
If you need to take an antibiotic before sclerotherapy, contact your doctor.
No lotion should be applied to the legs before the procedure (tape will not stick) and it is best to wear shorts to the procedure.

What Side Effects Are Associated With Sclerotherapy?
You may experience certain side effects after sclerotherapy. There are milder effects, such as itching, which can last for one or two days after the procedure. Also, you may experience raised, red areas at the injection site, which should disappear within a few days after the procedure. Bruising may also occur around the injection site and could last several days. Brown lines or spots may appear at the vein site. In most cases, they disappear within three to six months. Also, new, tiny blood vessels may occur at the site of sclerotherapy treatment. These tiny veins can appear days or weeks after the procedure, but should fade within three to twelve months without further treatment. If any of the following side effects occur, notify your doctor immediately: inflammation within five inches of the groin, a sudden onset of a swollen leg, or formation of small ulcers at the injection site. Allergic reactions to the injection fluid may occur at the time of the procedure which are rare but should be taken very serious. If you have a history of allergies, you have a greater chance of experiencing an allergic reaction to the agents. A minor allergic reaction will cause itching and swelling. To avoid any serious complications, your doctor will likely test the agents on a small area before applying the solutions to a larger area. If you have any concerns or questions following this procedure, contact your doctor.

What Happens After Sclerotherapy?
After sclerotherapy, you will be able to drive yourself home and resume your regular daily activities. Walking is encouraged; however, aerobic activity is not.
You will be instructed to wear support hosiery to “compress” the treated vessels. If you have compression hosiery from previous treatments, you are encouraged to bring them with you to be certain they still have adequate compression. Department store support stockings will not be adequate if a heavy compression stocking is needed. Your doctor’s office can recommend where to purchase heavy compression stockings.
Following the injections, avoid aspirin, ibuprofen, or other anti-inflammatory drugs for at least 48 hours. Tylenol may be used if needed.
Also, for 48 hours after treatment, you should avoid:
           • Hot baths
           • Hot compresses to the treated area
           • Whirlpools or saunas
           • Direct exposure to sunlight
Showers are permitted, but the water should be cooler than usual. The injection sites may be washed with a mild soap and tepid water.

How Effective Is Sclerotherapy?
Studies have shown that as many as 50%-80% of injected veins may be eliminated with each session of sclerotherapy. Less than 10% of the people who have sclerotherapy do not respond to the injections at all. In these instances, different solutions can be tried. Although this procedure works for most people, there are no guarantees for success.
In general, spider veins respond in three to six weeks, and larger veins respond in three to four months. If the veins respond to the treatment, they will not reappear. However, new veins may appear at the same rate as before. If needed, you may return for injections.

Does Insurance Cover Sclerotherapy?
If you have questions, please call your insurance company. Your insurance company may request a letter from your doctor concerning the nature of your treatment and medical necessity.

Whether it’s being engaged in daily activities or spending time doing the things you really love, like traveling, being outdoors or participating in your favorite hobbies, you can continue to engage in daily activities while receiving the therapeutic benefits of compression.

Compression stockings are designed to provide support to the legs and veins, assist with circulation, and minimize swelling. The compression is graduated, with the strongest support starting at the ankles and gradually decreasing towards the top of the garment. This gradual support works in conjunction with the pumping action of the calf muscles, which also assist with circulation.

A common myth is that compression stockings will cut off circulation. When fitted and worn properly, compression stockings help with your circulation, not reduce or restrict it.

Compression garments are categorized by classes. These classes consist of compression ranges, which are measured in mmHg—meaning millimeters of mercury, the universal form of measurement used for this type of garment. There are designated medical indications for each compression class. Before you can get your Juzo compressions you must come in and get measured for the right compression and size for you.

Resources:
http://www.webmd.com/skin-problems-and-treatments/sclerotherapy
http://www.varicoseveinspecialists.com/candidate.php
http://www.juzousa.com/Why%20Compression%20Therapy