Sclerotherapy

What is sclerotherapy?
Sclerotherapy is a treatment for varicose veins and spider veins. It is used for treatment of symptomatic (painful) varicose veins as well as for cosmetic purposes. The treatment involves a series of injections of medication into the veins. When injected into the vein, the medications irritate the lining of the vein, making it sticky, the vein is then compressed with large pads to make the vein walls stick together. The needle used for the injections is very small.

What are the medications used for sclerotherapy?
The medications used at UCLA include ehtanolamine and sodium tetradechol. These were chosen because they have fewer side effects than some of the other medications.

Do you use a local anesthetic?
No local anesthetic is used because those injections tend to be more painful than the sclerotherapy injections. The needle used to inject the solution is very small.

I am afraid of needles; can this be done under general anesthesia?
This procedure is not performed under anesthesia unless done in combination with a surgical procedure such as vein ligation and stripping.

How long does the treatment take?
The treatment takes about one hour depending on how many veins are treated.

What kind of dressing is used?
A thigh-high compression stocking is applied to each treated leg after the injections and is worn for 1-3 weeks, depending on the size of the vessels treated. The stocking must be prescribed and obtained by you prior to the procedure date. It must be brought with you to your appointment. This can not be removed during prescribed weeks, not even for a shower. Garbage bags or cast shower bags purchased from medical supply stores can be worn for showering or a sponge bath may be taken.

Can I drive myself home?
You should be able to drive home after the treatment.

Do I need to take days off from work?
You may want to take the day of treatment off to keep your legs elevated but should be able to return to work the next day. Exercise is limited due to the need to wear the compression stocking for so long. You would want to avoid perspiring in the stocking to avoid itching and odor.

How much does it cost?
Most charges for sclerotherapy run between $450 and $1500, depending if one or both legs are treated, how many vessels are treated, and how big those vessels are. The cost for sclerotherapy is broken down in the following manner:
$450 per leg for the procedure
$79 for each stocking (the cost for stockings for two legs would be $158)
$50 for supply tray (needles, foam pads, gauze, bandages, tape, sterile basin, betadine, alcohol, ace bandages, etc.)
The cost of medication will depend on how many vials are needed for adequate treatment and can be up to $600.00.

Does insurance pay for this?
Some insurance companies will pay for this treatment. In our experience, about 40% of insurance companies will pay. If the treatment is denied, we do not appeal; however, you have that option.

What are the possible complications?
Possible complications include:

1. Hyperpigmentation, or brown staining, down the treated vein or at the injection site. This is from the breakdown of blood in the tissue. This usually goes away in 3 to 6 months. This is the most common side effect. About 30% of patients will have some degree of hyperpigmentation.
2. Residual clots in the veins are also common. These are not dangerous and will go away in 3 to 6 months as well. If the clots are large, they can be drained.
3. Skin reaction to the medication can occur if the medicine gets into the tissue. This will result in a blister progressing to a scab and will go away in a few weeks. This is more common if very large veins are treated.
4. Superficial thrombophlebitis, or an inflammation of the vein, making it red and tender. The treatment for this is bed rest and Advil.
5. The treated vessel can re-open and re-cannalize.
6. You most likely will develop new veins over time.

What will my legs look like after the stockings are removed?
You will most likely have some bruising, some redness, and maybe some hyperpigmentation. The cosmetic results are not immediate. It takes about 3 months for the bruising and pigmentation to go away.