Vein Treatment with Sclerotherapy

What is Sclerotherapy?

In sclerotherapy, an ultrasound unit or special light is used to guide a tiny needle into the abnormal veins. Once in the vein, a small amount of medication is injected that causes the inside of the vein walls to scar together. After these malfunctioning veins close down, they can no longer stretch out causing leg discomfort and prominent skin veins.

Treatment with Sclerotherapy

Sclerotherapy is used to treat a wide variety of abnormal veins—veins as large as an inch to smaller than a millimeter in size. There are some differences in the way we treat these different kinds of veins.

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Which Types of Veins Can Be Treated with Sclerotherapy?

Large Veins

Large varicose veins are the tortuous, bumpy veins often seen along the inner thigh and calf. Sclerotherapy of these larger varicose veins is often combined with procedures that target the source of abnormal blood flow into the leg veins. If the veins of the legs are thought of as a tree, either laser therapy, medical adhesive or another compound are used to close the tree “trunk” (the saphenous veins) while the “branches” of the tree (the varicose veins) are treated with sclerotherapy. The benefit of performing sclerotherapy at the time of truncal (saphenous) vein treatment is that the injected medication spreads throughout the network of smaller branches in the legs, successfully treating these abnormal veins too. It also reduces the likelihood of needing additional vein treatments in the future.

Most sclerotherapy of large veins is performed under ultrasound guidance. With ultrasound, we have the ability to confirm the precise location that the medication is injected as well as its distribution throughout the treated vein. At the Northeast Wisconsin Vein Center, we use a foamed medication, which has been proven to result in better long-term closure of the veins, to require less medication and to improve visualization during the procedure.

Small Veins

Small veins include spider veins (telangiectasias) and reticular veins, both of which appear as a cluster of tiny blue or red lines beneath the skin surface. These are often seen on the outer side of the thigh and leg and around the ankle. These veins are treated using a special lamp and a tiny needle (almost the size of a human hair) to inject a medication that causes them to close down. Multiple patches of these abnormal veins can be treated during a single session. Sherry Konen, APNP, has extensive training and experience in the treatment of these veins and performs them at our Center.

Perforator Veins

Perforator veins are usually invisible at the skin surface but can cause high blood pressure in the veins underneath the skin by abnormally shunting blood to them from the deep veins. Incompetent perforator veins are often treated by ultrasound-guided sclerotherapy and can result in quick healing of skin ulcers and other changes caused by malfunctioning veins.

Follow-Up Appointment

Within 4-6 weeks after your veins have been treated, it is recommended that you come back in for two follow-up appointments with a member of our team in order to examine the treated legs. These appointments are the final step in your journey toward healthier legs and a better quality of life.

What Happens After the Procedure?

After treatment, the leg is dressed with sterile bandages, wrapped, and placed in a compression stocking to help the treated veins fully close down over the next 1-2 weeks. At the follow-up appointment 2-3 weeks after treatment, we examine the leg veins with ultrasound to confirm safe and successful closure of the abnormal veins. We schedule a final appointment in 3-4 months’ time during which we ensure the veins remain durably treated and to address any questions you might have.

What Are the Side Effects of Treatment?

Sclerotherapy is a low-risk procedure. The most common side effect from treatment is some bruising which fades over the course of a few weeks. We take every precaution to avoid complications such as tenderness of veins elsewhere in the leg (phlebitis), blood clots in the deeper veins (DVT), darkening of the skin in the area of treatment (hyperpigmentation) and the development of tiny red veins in the region (telangiectatic matting), all of which are usually temporary and have specific treatments.

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Will I Ever Need A Repeat Sclerotherapy Session to Treat My Veins?

Most of our patients only need a single session of sclerotherapy to achieve the desired results. However, certain veins may need 2 or 3 separate treatments to ensure complete and durable closure. We are also limited by the amount of medication we can administer into the veins at one time, making additional sessions of sclerotherapy sometimes necessary. Our goal at the Northeast Wisconsin Vein Center is to minimize the number of treatments necessary to produce excellent medical and cosmetic results.

Do Most Insurance Plans Cover Sclerotherapy?

Large vessel and perforator sclerotherapy for the treatment of leg discomfort is covered by most insurance plans. Small vessel sclerotherapy for the treatment of spider veins is not covered by most insurance plans and self-pay prices are available.

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