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What happens to varicose veins post-sclerotherapy?

I have a bunch of varicose veins and want to get them all treated in one session. How many veins can I get treated at one time with sclerotherapy? What happens to the varicose veins after being injected during sclerotherapy?

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Doctors Answers (3)

Sclerotherapy is a good choice for treating reticular veins and spider veins (medium and small sized veins) but is of limited use in treating the larger varicose leg veins. The best choice for treating refluxing varicose veins is by some combination of endovenous ablation, micro-phlebectomy and sclerotherapy. Following treatment by any method that closes the vein, the vein will be reabsorbed by the body over time and disappear. Veins that fail to close will have the inside lining of the vein repaired and will not disappear. You can have a great number of leg veins treated at one time or you may have to go for several visits. Sclerotherapy is an injection of a medical grade detergent that removes the inside lining of the veins and induces venous spasm and vein closure. This may be temporary with the vein being re-opened and repaired or may be permanent if the vein is kept closed (for approximately one month). To help ensure the vein remains closed, it is recommended you wear compression hose for two to three weeks and avoid heat/hot water such as baths after your sclerotherapy treatment for four to six weeks.

As a board certified surgeon, I prefer to remove larger varicose veins using an in-office procedure called microphlebectomy. The veins are removed in sections through tiny punctures and it is cosmetically pleasing also. Injecting larger varicose veins leads to areas of "trapped" blood which must be drained between treatments or permanent pigmentation can occur. It can also be quite painful as the veins become inflamed. This results in extra visits to your treating physician's office and sometimes incurs charges. Small veins called reticulars can be injected successfully with minimal complications in most people. Treating with sclerotherapy is usually multiple treatments (average 3-5) whereas most larger veins can be removed in one treatment. I would advise that you be evaluated by an experienced surgeon including ultrasound examination to determine if there is an underlying reflux causing these vein, especially if you have symptoms. This usually occurs in either the long or short saphenous veins.

Sclerotherapy causes the vein to scar down upon itself, stopping blood flow and making them smaller. The veins typically become smaller and fibrotic.

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