All About Sclerotherapy

Varicose veins can be treated with a non-surgical technique that is safe and effective in the office.

What is Sclerotherapy?

Sclerotherapy is an exciting, non-invasive injection techniques that causes closure of abnormally dilated veins that cause symptoms of leg aching, heaviness, and fatigue and results in a markedly improved appearance.

What Happens

Practitioners trained in the care of varicose veins are often called phlebologists. These are doctors that specialize in the treatment of abnormal veins. During a visit, a general health history is taken and then a detailed venous examination is performed. Depending on the extent of vein disease and symptoms, specialized instruments are used to evaluate the vascular system. These instruments are state of the art and include Doppler for assessing blood flow, duplex ultrasonography for visualizing the veins of the leg and groin, and the VeinViewer that uses infrared light to see veins 4mm or less under the skin. These examinations allow the doctor to determine exactly the problem and to know precisely where the sclerotherapy injections should be performed for optimal results. Once the examinations are completed a treatment plan is discussed which includes nutritional substances, compression stockings, sclerotherapy, and or laser therapy.

Sclerotherapy injection uses special equipment to inject small amounts of the sclerosing agent into the varicose veins under specialized light and usually under magnification. Often, duplex ultrasound is used to guide the injection to very specific veins that are causing the varicosities. After all the veins are treated you will wear specialized stocking to help close the veins, topical creams that will speed the healing, and specific instructions about what to do and what to avoid following treatment. (Jump to Animated Example of Ultrasound Guided Sclerotherapy.)

Immediately after treatment you will be advised to walk for 15-20 minutes in your special stockings to optimize the treatment outcome and can immediately return to your daily activities.

Follow Up

In six to eight weeks you will be re-examined to note the progress of the treated areas. Most treated veins will have closed but some will most likely need to be treated again. Simple spider veins generally resolve in one to two treatments. Deeper reticular veins may need two to four treatments, on average, or more depending on the 1) number and severity of veins involved , 2) the individual’s response to treatment, how well the aftercare advice is followed, and the severity of the venous disease.

Ultrasound Guided Sclerotherapy

Ultrasound technology has made amazing advances in recent years. Dr. Marinelli has been using ultrasound since the mid-90s to diagnose and guide injection therapies. With this technology we can visualize diseased refluxing veins deep below the surface of the skin and guide treatment to the source of the problem. This greatly improves results, requires fewer treatments than non-ultrasound guided injection, and is the state of the art.

Ultrasound-guided sclerotherapy is superior to conventional sclerotherapy

Better, faster, quicker means more satisfaction and less expense. With conventional sclerotherapy, even using specialized light sources, (like the Veinlite, Syris headlamp, or VeinViewer) the deepest veins that can be visualized are ~6mm. If these are the only veins treated then the larger varicose veins won’t be affected and the spider veins will return more quickly. When the deeper, feeder veins are treated with ultrasound guidance, this gets to the source of the problem (reflux) and large veins can go away quickly and completely without surgery. With treating the source of the problem, the treatment results last longer and are less expensive due to fewer treatment sessions.

Ultrasound guided sclerotherapy give better results for small veins, too

Even small spider veins and shallow reticular veins are caused by deeper veins that are refluxing. We can demonstrate this to you at the time of examination and treatment. You will be able to watch on our monitor as your veins disappear with treatment. Treatment of these deeper veins with even a single session of ultrasound guided sclerotherapy vastly improves results and allows for overall less treatment and longer lasting results.

Animated Example of Ultrasound Guided Sclerotherapy

(It may take a minute for the animation to load in your web browser.)