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By Mayo Clinic staffSclerotherapy is typically done in your doctor's office and doesn't require anesthesia. It generally takes less than an hour to complete.
During the procedure
For the procedure, you'll lie on your back with your legs slightly elevated. After cleansing the area to be treated with alcohol, your doctor will use a fine needle to slowly insert a solution into the appropriate vein. The solution, usually in liquid form, works by irritating the lining of the vein, causing it to swell shut and block the flow of blood. Eventually, the vein will become scar tissue and disappear. Some doctors may use a foam version of the solution, particularly when a larger vein is involved. Foam tends to cover more surface area than liquid.
Some people experience minor stinging or cramps when the needle is inserted into the vein. If you have a lot of pain, tell your doctor; it may be because the solution has leaked from the vein into surrounding tissue.
Once the needle is withdrawn, your doctor applies compression and massages the area to keep blood out of the injected vessel and disperse the solution. A compression pad may be taped onto the injection site to keep the area compressed while your doctor moves on to the next vein.
The number of injections depends on the number and size of veins being treated.
After the procedure
After the procedure, you rest on your back for 15 to 20 minutes. Your doctor checks your injection sites for any immediate side effects. You can then get up and walk around. Walking and moving your legs is important to prevent the formation of blood clots.
You'll be asked to wear compression stockings or bandages — usually for about three weeks — to maintain compression on the treated veins.
Most people return to their normal activities on the same day, but it may be wise to have someone drive you home after the procedure. Your doctor will probably advise you to avoid strenuous exercise for two weeks after the procedure. You'll also want to avoid sun exposure to the treated areas during that time. The inflammation caused by the injections combined with sun exposure can lead to dark spots on your skin, especially if you already have a dark skin tone.
- Sclerotherapy of varicose veins and spider veins. Radiological Society of North America. www.radiologyinfo.org/en/info.cfm?pg=sclerotherapy. Accessed May 13, 2010.
- Varicose veins and spider veins. National Women's Health Information Center. http://www.womenshealth.gov/faq/varicose-spider-veins.pdf. Accessed May 13, 2010.
- Vein treatments: What to expect before, during, and after. American Academy of Dermatology. http://www.skincarephysicians.com/agingskinnet/vein_treatments_expect.html. Accessed May 13, 2010.
- Parsons ME. Sclerotherapy basics. Dermatologic Clinics. 2004;22:501.
- Greenberg DL, et al. Liquid and foam sclerotherapy techniques for lower extremity vein ablation. http://www.uptodate.com. Accessed May 14, 2010.
- Jia X, et al. Systematic review of foam sclerotherapy for varicose veins. British Journal of Surgery. 2007;94:925.
- Tisi PV, et al. Injection sclerotherapy for varicose veins (review). Cochrane Database of Systematic Reviews. 2006:CD001732. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001732/frame.html. Accessed May 14, 2010.
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