Sclerotherapy: What is it, who’s it for, and should I get it?

July 23, 2020 by Shari J. Twigg, MD
Sclerotherapy: What is it, who’s it for, and should I get it?
Sclerotherapy is the treatment used for unwanted spider veins, visible small bluish veins or small varicose veins in the legs.   If you have these, you may be a good candidate for sclerotherapy to improve the aesthetic appearance of your legs.  The treatment or medication I use in treatment is called Asclera.  Asclera is an injectable medication to treat uncomplicated small varicose veins. It is an FDA-approved agent and works by damaging the inner wall of the vein.  With time and possibly multiple treatments, the damaged vein is replaced with fibrous connective tissue and prevents blood flow through the vessel.  If you have large varicose veins, these vessels should be treated first by a vein specialist by other means before this type of treatment can be done on the smaller vessels.

I  get lots of questions regarding why patients get spider and varicose veins.  There are many risk factors associated with this issue.  For starters, it is often hereditary, so it’s another one of those pesky medical issues you can blame on your parents (“Sorry Mom and Dad!”).   However, many other factors can contribute to your spider or varicose veins such as prolonged standing, aging, pregnancy, and obesity.  If you have to stand for your job, then move as much as you can and wear compression socks to keep the veins compressed.  Lose weight if your are overweight or obese.  If you are sitting, put your legs up and don’t cross them. Of course, we can’t do anything about aging or our genes.

For those patients that have large amounts of small spider veins or small bluish veins, it can take multiple sessions to treat, as only a certain amount of Asclera medication can be used at any one session.  In addition, it takes time for your body to fibrous or scar the blood vessel wall and larger vessels may take more than one treatment session.  When starting treatments, the most bothersome vessels are treated first.

You will need to have graduated compression stockings purchased prior to your first treatment session, medium grade of 20-30 mm Hg2, to be worn for compression on the day directly after injection of your veins and for up to 3 weeks after for best results.  For the first 2-3 days you will need to wear them continuously (even in the shower).  Thereafter, you will wear them during the day, but remove them at night to sleep.

The treatment is performed using a very fine needle to inject the sterile medication into the veins.  After the treatment, you will avoid all heavy exercise for 2-3 days, but will need to walk regularly.  You will also avoid hot baths, saunas, and extended periods of sitting or standing.  You also cannot use hot tubs/saunas, or swim for at least 1 week after the procedure. You should have no tanning or sun exposure for at least 2 weeks.  Sunscreen with SPF30+ and/or clothing protection should be worn to prevent hyperpigmentation to the area treated.     

It can take several weeks to see final results.  But as I said earlier, multiple sessions may be needed to treat for closure to occur and not all varicose veins can be treated.  This is based on size and bulging veins are not treatable with this medication.  These should be treated by a vein specialist with a more intensive procedure.   

Treatment with sclerotherapy does not prevent the development of new spider veins or varicose veins from developing.  This is common to recur as you age.  Many individuals will come in after having initial treatments done for a quick touch-up on a yearly basis.

I hope this has given you some great information about sclerotherapy.  You can have beautiful legs again in a few short sessions. 

I hope to see you soon and call for any questions and to schedule an appointment.

Shari J. Twigg, MD
Aesthetic Medicine Board Certified Specialist
Advanced Aesthetics