SCLEROTHERAPY INFORMATION LETTER
Please find this literature informative with respect to sclerotherapy treatment; to include indications, treatment
options and potential risks associated with this procedure.
What is sclerotherapy?
Sclerotherapy is a popular method for management of
“spider veins” in which a solution, called a sclerosing
sclerosis or the formation of fibrous tissue inside the
process results in vessel lumen scarring, collapse and
several months.
selective varicose veins and superficial telangiectasias
agent, is injected into the veins. The injections cause
vessel subsequent to an inflammatory reaction. This
gradual fading of the treated vessels over a period of
Does sclerotherapy work for everyone?
The majority of individuals who have sclerotherapy performed will be cleared of their vascular irregularities, or
at least see a good improvement. Unfortunately, however, there is no guarantee that sclerotherapy will be
effective in every case. Approximately 10% of patients who undergo sclerotherapy have fair to poor results
(“poor results” means that the veins have not totally disappeared after six treatments). In very rare instances,
the vessel condition may become worse after sclerotherapy treatment. The sclerosing agent used and its FDA
status will be discussed with you during consultation.
How many treatments will I need?
Remember, the number of treatments necessary to clear or improve the condition differs from patient to patient,
depending upon the extent of varicosities and spider veins present. The average number of treatments is three
to four; however, some vessels may require six or more injections.
What are the most common side effects?
The most common side effects experienced with sclerotherapy are as follows:
1. Bruising: Occurs in treated areas and may last from weeks to several months. It may occur in association
with tenderness or nodularity of the treated vessel. The avoidance of alcohol and anticoagulant (blood
thinner) medications for one week prior to each treatment session may minimize bruising.
2. Transient hyperpigmentation: Approximately 30% of patients who undergo sclerotherapy notice light
brown streaks or discoloration after treatment. In almost every patient, veins become darker immediately
after the procedure. There are instances when this darkening of the vein may persist from four to twelve
months. Tanning of the skin when bruising is present after therapy may result in permanent skin staining.
3. Sloughing: Sloughing occurs in less than 3% of patients who receive sclerotherapy. Sloughing consists of a
small ulceration at the injection site that heals slowly. A blister may form, open and become ulcerated. At
times, a lightened scar or dimple may form.
4. Allergic reactions: Very rarely, the patient may have an allergic reaction to the sclerosing agent used. The
risk of an allergic reaction is greater in patients who have a history of allergies. Allow for a 20 minute
observation period at our office after your sclerotherapy session.
Sclerotherapy Info Letter
Page 1 of 2, Last Update: January 22, 2009
5. Itching: Depending on the type of solution used, you may experience mild itching along the vein route.
This itching usually lasts one to two days. Injection sites look like cat scratches or mosquito bites
immediately after injections.
6. Pain: A few patients may experience moderate pain, usually at the site of the injection. The veins may be
tender to touch after treatment along the vein route. This pain is usually temporary, in most cases lasting
from one to seven days.
7. Blood accumulation in the treated vessel: May present as a tender bump at a treatment site. If this
develops, it can be simply drained by Dr. Schmid. The use of prescribed compression hosiery will minimize
this possibility.
8. The appearance of small patches of blush vessels (telangiectatic matting) after injection.
9. No response, recurrence or worsening of vessels treated.
What are the other side effects?
Other side effects include a burning sensation during injection of some solutions, neovascularization (the
development of new tiny blood vessels), transient phlebitic-type reactions (swelling of the vein promoting ankle
swelling), temporary superficial blebs or wheals (similar to hives), and, very rarely, wound infection, poor
healing or scarring. Phlebitis is a very rare complication seen in approximately 1 of every 1000 patients treated
for varicose veins greater than 3 to 4 mm in diameter. The dangers of phlebitis include the possibility of
pulmonary embolism (a blood clot in the lungs) and postphlebitic syndrome, in which the blood clot remains in
the leg vein, resulting in permanent swelling of the legs and ankles.
Are there alternatives or other types of procedures to treat varicose veins and telangiectasias?
1. Vein stripping and/or ligation is often necessary to treat large varicose veins.
2. Ambulatory phlebectomy is a surgical alternative for removed diseased varicose veins. It is performed
under local anesthesia.
3. Laser and filtered flash-lamp therapies can be utilized to treat small spider veins less than 1 mm in size,
which may be difficult to treat with conventional sclerotherapy injections.
Patients with significant coagulation, circulatory problems, chronic leg swelling or diabetes should not undergo
the procedure.
Hopefully the aforementioned material is informative and helpful in your decision to manage your vessel
condition. Additional counseling is available upon request.
Peter M. Schmid, D.O.
PMS/rdc-01/22/09
Sclerotherapy Info Letter
Page 2 of 2, Last Update: January 22, 2009