Sclérothérapie

What is sclerotherapy used for ?

• Sclerotherapy is used for the treatment of superficial veins of the legs which are dilated, for small vessels called spider naevi and for telangiectasia.
• Treatable vessels are either red, pink or purple and can be located on the ankles, legs or thighs.
• They are arranged linearly or clustered together.

Why are these vessels present ?

• The exact cause is unknown, but these vessels are more frequent in women.
• Heredity, pregnancy, hormones, excess weight and prolonged sitting or standing positions are causes. Heredity is probably the most important of these factors.

What is sclerotherapy?

• Sclerotherapy consists of the injection of a chemical substance in the cavity of a blood vessel.
• This substance causes an inflammation of the vessels which result in their occlusion.

Can spider naevi be prevented?

• Exercise, weight loss and wearing compression stockings can limit the development of new vessels, but does not stop a susceptible women from developing them.

How does the treatment take place ?

• A fine needle is used for the injection and a slight prick sensation then may be felt, comparable to a mosquito bite.
• A burning sensation can be felt during 15-30 seconds while the sclerosing substance is injected. So as to avoid an allergic reaction, a single vessel may be injected to monitor the appearance or not of an allergic reaction after a few minutes.
• Some patients feel cramps, which typically last a few minutes.
• Injected veins disappear completely when injected, but because of their communication with other vessels, they tend to reappear; on the lighter side, this also means that the injection of one vessel may induce the disappearance of several others.

Are their things to do before the treatment ?

• Aspirin must not be taken before the treatment.
• To avoid a feeling of dizziness during the treatment, it is advisable to eat well before the treatment.

After how long do the vessels disappear ?

• Injected vessels appear lighter and can disappear, but the full effects may take up to 2-3 months to be fully visible.
• The treatment does not prevent new vessels from appearing, and only has an effect in the vascular system of the injected vessels. Vessels grouped together have an important collateral circulation, and thus tend to reappear after treatment.

How much time is needed between each treatment session?

• The same area should not be treated again before 6 to 8  weeks so as to repeat the treatment only if the maximum effect has not been reached.
• Non treated areas can on the other hand readily be treated anytime.

How many treatment sessions are needed ?

• It depends on the extent of the area to treat and the response to treatment.
• As a general rule, 1-3 injections are needed to treat on vessel and 5-15 vessels can be treated each session.

What to do after the treatment session ?

• Put compression bandages on the treated area and keep them in place until the following morning.
• Contact sports, efforts or straining should be avoided for the 48-72 hours following the treatment.

What are the possible side effects ?

• No major side effect but temporary side effects which may occur include:

1. Bruising and swelling: it can occur on injection sites and on the trajectory of the injected vessel. Swelling subsides within 24 hours, and bruising within a few weeks.
2. Increased sensitivity to pain: on the injection site, persists for 1-2 weeks.
3. Hives and itching: it takes place immediately after the injection and looks/feels like a nettle rash. It generally subsides after 30 minutes.
4. Ulceration: a small ulcer can develop on the injection site which changes into a crust which falls off after 1-2 weeks.
5. Pigmentary changes: spider naevi tend to be destroyed during the treatment which can leave a residual hyperpigmentation (post-inflammatory hyperpigmentation) which fades gradually over the following 6 months.
6. Cramps: Following an injection close to the ankle, cramps may appear. By moving the toes and massaging the affected area, the pain will disappear.
7. Development of local telangiectasia: a network of very small vessels may develop close to the injection site. These lesions disappear by themselves or by repeating the treatment.

Advice

• Walk for 30 minutes immediately after the injections.
• If possible, do not drive home yourself after the treatment session. If you have to drive, make sure you move your legs and toes.
• After each treatment session, maintain your regular daily activities.
• Walk at least one hour everyday.
• Do not take any hot bath in the 2 weeks following the treatment session.
• Do not stand up still for long periods. If you have to do so, move your legs and toes.
• If the legs become painful after the injection, walk.