Sclerotherapy for Varicose & Spider Veins
Sclerotherapy are medical vein treatments used at our Austin Texas vein center to treat painful or unsightly varicose veins and spider veins. The abnormal veins are treated by our vein physicians by the injection of a dilute medication, called a sclerosant, directly into the damaged veins. An extremely small needle is utilized, even smaller in diameter than an acupuncture needle. Following the vein injection, the medication flows through the sections of abnormal varicose or spider veins and leads to a chemical reaction within the vein walls, causing irritation and eventual collapsing and disappearance of the diseased veins. Sclerotherapy has been used safely on patients across the world since the 1930s and remains a very effective treatment for both varicose and spider veins.
How is Sclerotherapy Performed?
Sclerotherapy is often performed at our Austin vein treatment center with the use of ultrasound-guided imaging to ensure proper and precise injections. The number of vein injections required during each session depends on the number and length of the damaged veins. Typically, one injection is made for every square inch of spider veins. This procedure is performed in the comfort of our office and takes less than an hour. More than one treatment may be required to achieve the desired results. Our preferred sclerotherapy medication is Asclera (polidocanol), due to the excellent cosmetic results and minimal side effects. To view a short video about sclerotherapy, click “play” below.
No anesthesia is needed for this quick and safe procedure. The majority of our patients report only minimal pain. With the newer sclerotherapy medications that we utilize, such as polidocanol, there is no burning sensation associated with injection since the medication is formulated with a numbing anesthetic quality. After sclerotherapy treatment, the damaged veins collapse and turn into scar tissue that eventually fades and is absorbed by the body. The blood flow is rerouted into the adjacent healthy veins. Depending on the extent and anatomy of your varicose and spider veins, our doctor may recommend other treatments in addition to sclerotherapy, such as laser therapy or the VeinGogh surface thermolysis device.
The Latest Advances in Sclerotherapy
At Austin Varicose Vein & Spider Vein Specialists, we take advantage of the latest technologies during sclerotherapy by using the VeinViewer by Luminex™, the Syris™ subsurface illumination system, and the VeinLite™ by Translite. These are advanced vein visualization devices that use near-infrared and magnified high-powered light to produce extremely detailed images of your veins, allowing your doctor to see all of your small damaged veins with extreme clarity, both within the skin and beneath the skin surface. With these modern technologies, your doctor can actually see through the surface of the skin, ensuring more precise injections during your sclerotherapy procedure (see demonstration video below).
Austin Varicose Vein & Spider Vein Specialists only utilizes the most modern of FDA approved sclerotherapy solutions, such as sclerotherapy with Asclera (i.e. Polidocanol) and Sodium Tetradecyl Sulfate (i.e. Sotradecol). These newer medication, along with our specialized technique of performing the vein injections, allows for much less discomfort than traditionally associated with sclerotherapy treatments of the past. These modern scientifically formulated sclerotherapy medications are associated with superior cosmetic results, less discomfort during vein injections, and fewer risks of side effects. Polidocanol is formulated to not only effectively eliminate veins, but it also has a numbing anesthetic quality. Therefore there is no burning or stinging associated with the injection of the medication. And since we also utilize the smallest possible micro-needles for injections (as small as 32 gauge), there is very little discomfort associated with the injections (literally just a small ant “bite” sensation at each injections site). We strive to achieve the best possible cosmetic results while minimizing discomfort and the risk of side effects.
What About Saline Sclerotherapy Injections?
Hypertonic Saline sclerotherapy utilizes very concentrated salt water solution to treat spider veins. Traditionally it has been a popular sclerosant since it contains a naturally occurring body substance (sodium chloride or salt) with the false assumption of no toxicity. However, with the advent of new pharmaceutical sclerosant medications available for sclerotherapy, saline has fallen out of favor due to its high side-effect profile. Hypertonic Saline sclerotherapy has a higher rate of skin necrosis (skin death and ulceration) and temporary hemosiderin staining (skin area treated with sclerotherapy appears brown or “stained”). This occurs because of massive fluid shifts within the cells and tissues that occur when low concentration salt water in the body interacts with the very high concentration salt that is being injected. Additionally, saline does not work well in treatment of larger varicose veins since it gets diluted quickly by blood and becomes ineffective. The other problem with hypertonic saline sclerotherapy is that it is typically rather painful, with a fair amount of burning and stinging sensations during injection.
Foam sclerotherapy is a specialized technique of performing sclerotherapy which is commonly performed at Austin Vein Specialists. With this technique, the FDA approved medications of Polidocanol or Sotradecol are mixed with small micro-bubbles of oxygen in order to create a sclerotherapy solution that is the consistency of shaving cream. This medication is then injected into the abnormal spider, reticular, or varicose veins under direct visualization. Some of the advantages of foam sclerotherapy is that it can often be used to treat larger veins that may otherwise not respond as well to standard sclerotherapy solutions. The micro-bubble emulsion tends to increase the contact time of the sclerosant medication with the vein wall and therefore can increase the effectiveness of the treatment. In addition, due to the white coloration of the foam, the movement of the foam within the veins can be easily seen and followed with special lighting or ultrasound for more precise injection of the chemical.
Recovery & Results After Sclerotherapy
Following sclerotherapy, patients can typically return to relatively normal activities immediately, although exercise and other strenuous activities should be avoided for 7 to 14 days to improve the efficacy of treatment. Compression stockings or support bandages may need to be worn for up to 2 weeks after the procedure, based on the recommendations of your doctor. Most patients experience some degree of mild bruising and some may develop skin pigmentation changes at sites of injection. These side effects usually subside on their own over time.
Since bruising may occur, it can take several weeks before the true results of sclerotherapy are visible. It is reported that up to 80 percent of damaged veins can be eliminated during each sclerotherapy session. Most patients are satisfied with the results of this procedure. Patients can help preserve the results of sclerotherapy and prevent new veins from appearing by maintaining an active lifestyle after the procedure.
Although sclerotherapy is a safe procedure that has been successfully performed by physicians for decades, there are certain risks and side effects associated with any medical procedure. During your consultation our doctor will discuss these possible side effects with you and answer any other concerns that you may have about the sclerotherapy procedure.
Candidates for Sclerotherapy
Most patients with spider or varicose veins are good candidates for sclerotherapy, although the procedure should not be performed on pregnant women or patients who have had a recent history of blood clots. If you are interested in the sclerotherapy procedure or other vein treatments and live in the Cedar Park, Lakeway, Pflugerville, or Round Rock area, please call or email Austin Varicose Vein & Spider Vein Specialists today to schedule a consultation.