Sclerotherapy Treatment

Sclerotherapy Treatment

Pre- care instructions

  • Plan your treatments six weeks apart in the cooler months. 2-4 sessions are usually required.
  • You will need to be measured and fitted for your Compression Stockings before your treatment.  The stockings require a prescription (Can be covered by Medical Aid) Good quality stockings are available at the Rosebank Orthopaedic Supply Centre or from Linksfield Clinic (George Wolhuter Room 102 Linksfield Park Clinic Medical Suites) You will need to be measured for size, and the degree of compression depends on the nature of the veins being treated.
  • On the day of your treatment wear soft loose pants or a skirt which will be comfortable over your bandages. No skinny jeans!
  • Have something to eat before your treatment to reduce the chance of feeling lightheaded or faint.
  • Don’t shave on the morning of your treatment otherwise, the disinfectant will sting. Please don’t slather cream or oils on your legs either as it makes the treatment difficult (slippery) for the doctor.
  • If possible, avoid anti-inflammatory drugs (e.g. Celebrex, Myprodol, Brufen, Nurofen, Voltaren) as well as Aspirin, Omega’s, Arnica and vitamin E supplements a week before sclerotherapy.  They thin the blood, which increases your chances of bruising. If you are on Cardiac Aspirin for medical purposes, continue as normal.
  • Analgesia: Take 2 Stopayne half an hour before your before sclerotherapy treatment. Magnesium supplements the day before and on the morning of your treatment also helps reduce pain. Taking analgesia depends on your pain threshold.

Post-care Instructions

  • Antibiotic ointment: Bactroban will be applied to the areas treated immediately after treatment.  Re-apply Bactroban if any areas look red or inflamed.
  • Bandages: You will be bandaged with elasticated self-adhesive bandages. Bandages need to be worn for two days 24/7. Bandages can irritate and rub behind knees or feel too tight. Please adjust them if necessary to be firm but comfortable. If they cause itching you might have a latex allergy. Remove them and go straight into stockings.
  • Stockings: Once bandages come off start wearing your compression stockings. Wear these for 5 days if you had spider veins, 2 weeks if you had varicose or feeder veins. It is not necessary to sleep in them but put them on before getting out of bed in the morning.
  • Expected results: Veins look worse before they look better. Results are not immediate. After sclerotherapy, there is gradual resolution over time. Three or more sessions are needed for good results. The goal is to remove unsightly visible veins. There will never be 100% resolution of every tiny spider vein and expectations must be realistic. 
  • Expected after-effects include bruising, itching, mild swelling and tenderness. These are all temporary. Take an antihistamine for the itching and paracetamol or a mild pain killer for tenderness as needed.
  • Thrombus formation: When treating larger feeder veins and varicose veins you may develop a hard lump (or thrombus) which is drained at your two week follow up. This is an expected and normal part of sclerotherapy and is caused by clotted blood trapped in the sclerosed vein.
  • Side effects include hyperpigmentation in the treated area, this is due to haemosiderin pigment in the blood seeping into the tissues. This is usually temporary and fades within 6 months. But rare instances it is long-lasting for up to 2 years or even permanent.
  • Telangiectatic matting: Certain types of clustered veins can become worse and even more matted before they get better.  This is a side effect that is managed with more sclerotherapy and the matting usually resolves with further treatment.  
  • Complication: A rare complication is the development of small inflammatory lesions (ulcers) due to the sclerosant solution irritating the tissues. Should this happen please report it to me ASAP. Apply Bactroban and a plaster and come in to see me.  Although infection is uncommon after sclerotherapy, bacterial viral or fungal infection can occur
  • Follow up: A two week follow up appointment is required when treating varicose and feeder veins. A one month follow up is needed after spider veins.
  • What to avoid:
  • Avoid sun- tanning. Apply sun-protection if there is any risk of sun exposure in between sclero sessions.
  • Avoid any exercises that will pump blood into your legs and “pop” the veins open again for two weeks after treatment. e.g. aerobics, power walking, spinning, jogging, cycling. Avoid stomach exercises as well. Normal walking, stretching, toning, pilates, yoga etc are fine (not Bikram yoga)
  • Avoid tight fitting clothes and girdles that impair circulation.
  • Avoid hot baths.
  • When working in a standing position, wear heels 2-5 cm high. High heels impair the venous pump action of the legs and feet.
  • Do not fly for 6 weeks after sclerotherapy.

Annual follow up

An annual follow up is suggested to see if any new veins have formed and to compare your legs with the previous year. Sclerotherapy will remove the current veins but it will not prevent new veins developing or free you from your hereditary traits. If you treat any new veins relatively quickly i.e. every year or two, the treatment session will be far shorter and the chances are good that only one session will be needed. The longer a vein goes untreated the larger it gets.