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How safe is the injection during sclerotherapy for varicose veins?

I have some varicose veins I want to get rid of and I keep hearing that sclerotherapy is the best treatment. From what I understand, some type of solution is injected into the veins. My question is, what exactly is in that sclerotherapy solution? Is it toxic? Are allergic reactions common? Are there other options that are just as effective as sclerotherapy if I do not want something injected into me?


Doctors Answers (4)

The solutions that are used for the vast majority of sclerotherapy are sterile, non-toxic, medical-grade detergents such as sotradecol and polidocanol. There are no proteins or allergic potential that have been reported and it is well-tolerated. The effect is very limited and localized to the portion of vein being injected. The sclerosant acts to remove surface proteins and strip the inner single cell layer from the vein. This can be temporary, as the body can easily replace this lining, or can be permanent if the vein stays closed for about four weeks. This is why we recommend wearing compression hose after treatment, and avoiding heat and hot water on the legs for four weeks following treatment for lasting results. Other options include laser, but these are typically more painful and less effective than sclerotherapy and are limited to smaller surface veins on non-tanned skin. Lasers are most often used on veins of the face, neck, and chest (which are smaller and drain spontaneously downhill to the heart) but are seldom used on medium and small leg veins (which are more dilated from venous congestion and draining uphill toward the heart).

Sclerotherapy is very safe. It one of the most versatile and one of best treatments for varicose veins. There are several medications used; the most common and the ones we use are Sodium Tetradecyl Sulfate and Policodocanol. Both of these medicines are essentially soaps or detergents. Allergic reactions are very, very rare. There a few options for the smallest veins - cutaneous laser - and the largest veins - surgery - but for most varicosities, sclerotherapy is the only option.

Sclerotherapy is safe for small varicose and spider veins. They are medical-grade solutions that damage and collapse veins. The two most common solutions, sodium Tetradecyl Sulphate (Sotradecol) and Polidochanol (Asclera) had been in use for over 20 years and have a high success rate. In safe volumes, dilutions, and with a skilled practitioner, they are not toxic and allergic reactions are rare. If the veins are larger, I recommend microphlebectomy, which is removal of the veins through tiny punctures under local anesthetic. No stitches are needed and cosmetic healing is good. They are treated in one setting whereas sclerotherapy will take several treatments and there may be additional visits to remove trapped blood.

Sclerotherapy is the gold standard for treating the veins. It is extremely safe and has been performed for decades and decades and decades. The medications have been around for decades as well. Allergic reactions can occur with ANY medication. It is injected into the vein, but dilutes very quickly and clears out of the system very rapidly. There are several different solutions from strong saline, glycerin, dextrose, polidocanol, and sotradecol. There are lasers that treat veins as well. You should see a vein specialist to decide what is best.

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