Sclerotherapy is the injection of a chemical agent into a vein with the intent to destroy the vein. There are four agents most commonly used and they are sodium tetradecyl, polidocanol, hypertonic saline and glycerine. They work by damaging the inside lining of the vein causing an inflammatory response that results in the vein walls swelling, sticking together and eventually turning the vein into a scar.
Will any of my medications interact with the chemicals used for sclerotherapy?
There are no known drug interactions with these agents so no routine medications need to be stopped or dosages changed. Sclerotherapy can be safely performed on people taking anticoagulation but iron supplementation may result in skin discoloration overlying the veins treated that in some cases may be permanent so it is recommended that iron supplementation be stopped about six weeks before having sclerotherapy performed. People who take anti-inflammatory medications routinely may not have as good a response as expected because successful treatment relies on the inflammatory response.
Who should not have sclerotherapy done?
Sclerotherapy should not be done on pregnant women, nursing women, children or people who are bed-ridden. It should also not be performed on people who have underlying venous insufficiency in larger veins that has not been treated. An ultrasound evaluation should be performed prior to any sclerotherapy treatment to determine if venous insufficiency is present.
How quickly should I get sclerotherapy done?
Sclerotherapy never needs done on an emergency basis. If the veins are diseased to the point sclerotherapy is recommended, those veins will not go away if not treated but it isn’t an urgent matter.
What if I have other health conditions?
It is not recommended to be done when there are any acute illnesses occurring or if a chronic illness is uncontrolled. Examples of acute illness that would prevent sclerotherapy from being performed include infections such as cellulitis, blood clots in any veins or arteries, illnesses associated with fevers and respiratory illness associated with cough and shortness of breath. Uncontrolled chronic illnesses that may prevent sclerotherapy treatment would be things like asthma or chronic lung disease, cancer, diabetes or abnormal heart rates or rhythms that are not controlled.
Special considerations need to be addressed for people with frequent migraines, asthmatics or chronic breathing problems, and people who have a known hole in their heart but it does not mean they cannot be treated. Another special consideration is treatment of people who have immobility of the limb being treated, such as casting or splinting.
What is the difference between medical and cosmetic sclerotherapy?
Sclerotherapy is a medical procedure whether it is done for medical or cosmetic purposes so everyone should have a medical evaluation prior to treatments.
Medical sclerotherapy is performed for the purpose of alleviating physical symptoms caused by venous insufficiency. These symptoms may include but are not limited to swelling, heaviness in the legs, aching legs, skin discoloration, skin ulcerations or bleeding veins. In most cases insurances will cover treatment if it is medically indicated.
Cosmetic sclerotherapy is an elective procedure and is performed for the purpose of eliminating unsightly veins and is not covered by insurance. It should not be done if there are any underlying medical conditions that have not been treated.
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