Sclerotherapy

Minimally invasive procedures are gaining immense popularity in medicine since they offer a cascade of benefits. They do not involve anesthesia (numbing agent), incisions (cuts), hospitalization, post-procedure severe complications, or long recovery time. “Sclerotherapy” is a popular minimally invasive procedure for treating varicose veins. These are common medical conditions that cause twisted, enlarged veins, especially in your lower legs, due to venous insufficiency (occurs when your veins do not allow blood to flow back to your heart and get pooled, causing swelling). Sclerotherapy involves injecting special chemical solutions into the affected veins to shrink them.

In this article, we will explore the uses of sclerotherapy, how to prepare for it, what to expect from the procedure, and what recovery entails. 

What is Sclerotherapy?

Sclerotherapy is a minimally invasive, non-surgical procedure for treating varicose and spider veins, usually on the lower legs. It involves injecting a chemical solution, called a sclerosant, using fine needles directly into the affected vein. The injected solution irritates the blood vessel lining, which expands and sticks together, forming a scar. This closes off the affected vein, improving its appearance. 

Who Needs Sclerotherapy?

Sclerotherapy is a first-line treatment for varicose veins caused by chronic venous insufficiency. Varicose veins appear due to poor functioning one-way valves, blocking the blood supply within the affected vein. This results in swelling of the veins, causing itching, pain, and discoloration. 

Sclerotherapy may also be needed in other medical conditions such as:

• Malformed Lymph Vessels: These are abnormal vessels in the lymphatic system.
• Hemorrhoids are abnormal swellings of the blood vessels around your rectum. They become irritated and cause painful symptoms, especially during difficult bowel movements.
• Hydroceles: These are a collection of fluid around a testicle. 

When to Consider Sclerotherapy?

Doctors might consider sclerotherapy if you experience any of the following signs of varicose veins:

• Gnawing pain radiating to your knee and ankle
• Itching
• Burning and tingling sensation
• Swelling 
• Night cramps
• Lethargy 

How Do You Prepare for A Sclerotherapy Procedure?

Your doctor refers you to a vein specialist for further evaluation. The specialist will record your symptoms and medical and family history. Follow the below-mentioned guidelines before your scheduled sclerotherapy treatment:

• Avoid anti-inflammatory medications like aspirin for 48 hours before and after sclerotherapy.
• Avoid taking any herbal supplements at least a few days before the procedure. 
• Avoid applying any lotion or shaving your leg before sclerotherapy to reduce irritation.
• You may be advised to wear compression stockings for several days before the procedure.
• Inform your doctor of any other medical issues to prevent any unwanted compilation. 

What to Expect During a Sclerotherapy Procedure? 

Sclerotherapy is an outpatient procedure (there is no hospitalization) that lasts for 30 to 45 minutes. You can expect the following steps involved in sclerotherapy:

• Your doctor will conduct an ultrasound scan of your legs to assess the severity of your varicose veins and locate the correct vein to be treated.
• An appropriate sclerosant will be selected based on the size of the treated vein. 
• The area around the damaged veins will be cleaned using a disinfectant.
• The skin around the damaged vein will be stretched.
• The sclerosant will be injected directly into your blood vessel using fine needles.
• The number of veins treated in one session will depend on the size and location of your veins and your overall medical condition.

What Happens After a Sclerotherapy Procedure?

You will be kept under observation for an hour before you are allowed to go home. After the procedure, you can expect mild irritation or tingling sensation, which is normal and may resolve gradually. You will return to your routine activities immediately or the following day.  

Furthermore, your doctor will advise you to do the following: 

• Wear compression stockings throughout the day except while showering or sleeping. 
• Take the prescribed pain medications until recommended
• Wash the injection site with mild soap and lukewarm water. 
• Do not apply a hot compress to the treated area. 
• Avoid hot baths and swimming during the first two days after sclerotherapy.
• Avoid direct sun exposure for the initial few days after the procedure. 
• Stay active to reduce the risk of blood clots. 
• Do not engage in strenuous physical activities such as aerobic exercise, running, and weightlifting for at least a week after the procedure.

The results of sclerotherapy for smaller varicose veins usually show in 3 to 6 weeks, while for more prominent veins, it may take 3 to 4 months. However, you might need more than one treatment for the desired results.  

What Are the Benefits of Sclerotherapy?

Benefits of sclerotherapy include:

• No anesthesia required 
• The procedure is quick and safe
• You do not require hospitalization
• There are no cuts or incisions required 
• Sclerotherapy works effectively for smaller varicose veins
• It offers quick and long-lasting results
• It is a painless procedure 
• There is little to no downtime
• You can return to your routine activities early
• The procedure offers quick recovery 
• There are very few complications associated with sclerotherapy 

What Are the Side-effects of Sclerotherapy?

As with any medical procedure, you may encounter side effects after sclerotherapy. These include: 

Common Side Effects 

• Minor cramping
• Bruising 
• Burning sensation 
• Stinging 
• Skin discoloration
• Mild pain

Severe Side Effects 

• Allergic reaction to the sclerosant
• Skin ulceration around the injected area
• Blood clots in the injected veins
• Inflammation causing discomfort 
• Skin infection around the injection site 

Final Note 

Varicose veins can be problematic to live with, but with the advent of minimally invasive procedures like sclerotherapy, you can overcome the painful symptoms. Sclerotherapy is a minor, non-surgical procedure to treat medical issues like varicose veins or hemorrhoids. It involves injecting a sclerosant into problematic veins to shrink and collapse them. The procedure is generally safe and effective if performed by an experienced vein specialist. However, the success of sclerotherapy depends on the severity of varicose veins since advanced stages may require more extensive treatments like surgical intervention. You may need multiple sessions to eliminate varicose or spider veins. 

If you are distressed due to the painful symptoms of varicose veins, consult your doctor and discuss if sclerotherapy is the right choice of treatment for you.