INJECTION SCLEROTHERAPY

The principle of injection sclerotherapy is to inject a substance that irritates the inside lining of the vein, causing it to become “sticky”. Compression (with stockings) then pushes the walls of the vein together so that it is sealed off with scar tissue and blood clot.

Compression is required after injection to stop large blood clots from forming inside the veins. However, compression is not required if you are only having spider veins treated. Compression should be applied for two days for small veins and for one week for larger veins.

This method has been used for thousands of patients over the past 40 years. In carefully chosen patients, it is safe and effective.

Injection treatment is suitable for:

  • spider and reticular veins
  • isolated varicose veins
  • varicose veins that recur after surgery
  • primary varicose veins

Injection therapy is usually not recommended for people who:

  • have many large varicose veins;
  • have obese legs (compression is difficult to achieve)
  • are not able to walk very much

Injection therapy has the advantages of:

  • avoiding surgery;
  • avoiding a general anaesthetic; and
  • little or no time off work, home duties or sports.

However, its main disadvantage is that treatment will take longer to achieve the final desired cosmetic outcome.

PREPARING FOR INJECTION TREATMENT

On the day of treatment

  • wear loose slacks or trousers;
  • wear comfortable, low-heeled shoes or sandals;
  • allow 60 minutes for the appointment and a further 15 minutes for a walk to slightly loosen the stockings; and
  • bring someone to drive you home.

Consent

You will need to sign a consent form prior to your procedure.
You can view this consent form here: Consent – Injection Sclerotherapy

PROCEDURE

The surgeon will examine the veins on the skin while the patient stands. The veins are then injected with the patient lying down.

The needles used are very fine. The procedure is not very painful, but there may be some discomfort.

The elastic stockings at first feel tight but soon loosen slightly, becoming more comfortable. Patients often have some discomfort on the first night after treatment.

The patient should walk for approximately 30 minutes immediately after the treatment.

POST-TREATMENT CARE

Do NOT take off the stockings for 48 hours except to shower.

Walk for approximately half an hour every day (not including walking about the house) to reduce swelling in the treated leg. This is important.

It is usually not necessary to take more than one day off work.

Even if the veins seem to have closed off, a follow-up visit is needed so that the surgeon can see if the treatment is progressing as expected.

RELIEF OF PAIN OR DISCOMFORT

The best treatment is to do more walking. Sometimes painkillers such as paracetamol or anti-inflammatories may help. If you need advice, ask your pharmacist.

SIDE EFFECTS

Most side effects do not last long, however, the surgeon will wait for a few months before judging the final result. Side effects might include the following:

  • Brown stains along the treated veins are common (1 in 10 patients). These usually fade, however rarely some patients may have stains that are permanent and unsightly.
  • Some patients develop a “flare” (or blush) of very small blood vessels around the point of the injection.
  • Sore lumps can develop near the vein despite compression but they usually heal within a few months.
  • Allergic reactions (either local or widespread) are rare. They may appear as:
    • redness and inflammation;
    • a rash;
    • itching or swelling;
    • pains in a joint; and/or
    • severe weakness and discomfort.
  • Allergic reactions must be reported to your surgeon at once. They can be teated with medicines.
  • An allergic reaction is usually a sign not to repeat the treatment.
  • At the site of the injection, a small skin ulcer can occur even with the best of care. The skin ulcer is usually sore and slow to heal. However, healing almost always occurs.
  • Deep venous thrombosis +/- pulmonary embolus