Sclerotherapy is a medical procedure used to treat varicose veins and superficial visible vessels (venectatia, reticular veins). It has no real risks and is guaranteed to be effective, with closure lasting over time.
During this procedure, the doctor injects a special substance inside the vein. This substance irritates the wall of the vessel, causes it to swell and the vessel becomes blocked. In a short time, it turns into scar tissue and is then removed.
Sclerotherapy, as a minimally invasive method of treatment, addresses small superficial venous dilations, occurring in the ankles, calves and thighs, of different appearances: red, blue, purple.
The most commonly used sclerosing agents are polidocanol (aethoxysclerol) and sodium tetradecyl sulphate, which cause an inflammatory reaction in the vessel, which eventually leads to fibrosis and permanent obliteration of the vessel. Sclerotherapy will improve the appearance of the affected lower limb.
Effective treatment may require 2-3 sessions every 2-3 months, so that the uniform appearance of visible vascularity is restored. Sometimes it is indicated to combine laser therapy sessions in a therapeutic protocol.
Directions sclerotherapy:
- telangiectasias (vascular stellate or intradermal veins with a diameter greater than 1 mm)
- reticular veins (blue veins or subdermal, non-palpable veins larger than 3 mm in diameter)
- varicose veins located below the knee
- recurrent varicose veins
- isolated varicose veins
Sclerotherapy is performed on an outpatient basis. Preoperatively, a venous Doppler ultrasound is required to map dilated superficial veins, those with incompetent valves and those with reflux.
The procedure requires no anaesthesia and has minimal local discomfort.
Mark the injection sites with a marker or use a device "veinlight", which highlights the venous pathway.
The patient lies supine, and after disinfecting/sterilizing the tegument with disinfectant tegumentary solution, the sclerosing agent is injected intralumenally into the vein with a very fine needle.
The sclerosing agent will produce inflammation in the vascular endothelium, which will cause a fibrous cord and obliteration of the lumen.
With the injection of the sclerosing agent the vein turns white within minutes.
Postoperatively, sterile dressings and an elastic bandage will be applied to the injected areas for 48-72 hours.
The patient will wear compression stockings for 3 weeks and will be given anti-inflammatories and sometimes even anticoagulants (Clexane, Fraxiparine).
Early mobilization and walking without strenuous exercise is recommended.
A session lasts about 30 minutes.
Possible complications following sclerotherapy are: thrombophlebitis, skin necrosis, unsightly scarring, hyperpigmentation, allergic reactions, neoangiogenesis, inflammatory erythema (redness), ecchymosis (bruising), local itching.
Adverse reactions are rare, provided that the procedure is performed in a standardised manner by specialised medical staff and following a medical history/consultation, noting the patient's history and any absolute/relative contraindications.
Contraindications sclerotherapy:
- large dilated varicose veins with massive reflux (indication for surgical treatment)
- acute thrombophlebitis
- allergy to the sclerosing substance
- immobilized patients
- pregnancy and breastfeeding
Postoperatively, sterile dressings and an elastic bandage will be applied to the injected areas for 48-72 hours.
The patient will wear compression stockings for 3 weeks and will be given anti-inflammatories and sometimes even anticoagulants (Clexane, Fraxiparine).
Early mobilization and walking without strenuous exercise is recommended.
Questions frequent
Sclerotherapy is a minimally invasive procedure in which a substance is injected into the venous lumen (venectomy), which produces an inflammatory process inside the vessel, and over time, within 4 to 6 weeks, the vessel closes, i.e. softens, scleroses. I don't know how old the method is - I have been practicing it for about 3 years.
Performing it involves using a transilluminator, which helps you identify the vein wall, followed by disinfecting the skin with an antiseptic solution, and then injecting these veins using syringes with extremely fine needles, leaving a surplus of substance in the injected vessel. Sterile compresses are used to press on the injected vessel to achieve haemostasis. Post-procedurally, at the injection site, the skin is temporarily inflamed (red) due to the excess substance which causes minimal skin injury.
It is recommended postprocedural application of creams with re-epithelizing effect, administration of an oral venous tonic, wearing compression stockings for a month.
This procedure is intended for people with venectatis (venous dilatations between 0.1-3mm), who have undergone a phlebological consultation and a Doppler ultrasound, investigations which have ruled out the presence of severe venous insufficiency in the superficial venous system (internal or external saphenous vein).
Phlebological consultation: involves clinical examination of the pelvic limbs, performing specific clinical maneuvers, inspection and palpation of the integument to reveal the existence of any dermatitis, ulceration areas, superficial thrombosis.
Doppler ultrasound: mapping of the superficial and deep venous system, which identifies an incompetent closure of a venous valve (venous reflux) and superficial venous dilations, existence of communicating veins.
The minimally invasive procedure takes 30-60 minutes and the amount of substances used (sclerosing agents) is calculated according to the patient's weight. The concentration of the substances used is chosen according to the diameter of the vessel requiring sclerosis. No hospitalisation is required but the patient is encouraged to walk, but fitness and massage are not recommended.
The number of sessions for this procedure is not standard, varying between 4-6 sessions, depending on the strength of the veins, their diameter and age.
After sclerotherapy it is recommended to walk, apply re-epithelializing, haemostatic, anti-inflammatory creams, wear compression stockings (to keep the substance where we injected it).
Yes. It is an irreversible method: the substance acts on the vessel and creates a venous cord that gradually swells and thins.
I practice sclerotherapy in a private clinic - Skinmed Clinic and the session costs between 400-600 ron.
When the patient has reflux confirmed on echo-Doppler examination the method is not indicated before surgical treatment, represented by crosectomy and saphenous stripping, a method that removes the venous reflux.
Aesthetic correction by sclerotherapy of these venectomies, in patients with surgical indication, is performed temporarily because the injected vein is repermeabilized due to the existence of venous reflux.
There is a risk of allergies in people with an allergic background, but also of superficial venous thrombosis in people with clotting disorders (thrombophilia), in which case an injectable anticoagulant is recommended.
There is also a minimal risk of hyperpigmentation at the injection site especially in people with skin type I and those who are exposed to the sun within a month post-procedure.
