Sclerotherapy is a safe and well established treatment for thread veins on the legs. Although there are a number of alternative treatments, it remains the most successful.
A solution is injected with a very tiny needle into the veins, causing the lining of the vein to swell and become sticky allowing blood to adhere to the vein wall. Compression is then applied to close the veins, usually in the form of a graduated medical compression stocking but bandages are also used. Over a period of time the vein will heal and fade away.
Once a region of veins has been injected they look a little bruised and either blue or brown in colour. Thread veins usually fade completely over a 4-8 week period. Associated blue veins may take a little longer. Not all veins in a treated region will be cured after a single session – further treatment is always needed to improve the result.
Though safe, it is not entirely without risk. The two most common side effects are brown discolouration over a treated vein and telangiectatic matting.
Brown discolouration is due to haemosiderin deposition in the skin when the vein is not entirely closed, blood is trapped and clots. In some people iron pigments leak from the clot and stain the skin brown. These brown marks are usually not permanent but may take 6 – 18 months to fade. They darken when exposed to the sun and will take longer to fade if tanned.
Matting occurs if the fragile vessel is injured during the injection, leaving a mat of tiny veins that look like a bluish or a red bruise. Matting usually disappears completely after 6 – 12 months, but if it persists, it can be treated with sclerotherapy by using a fine needle to treat these veins. Other risks are extremely rare but these include:
Allergic reaction – any drug carries risk of allergic reaction but these are very uncommon with modern solutions. It is common for patients to experience some itching and redness in the treated areas just after injections have been done. This is not an allergy but a mild inflammation in response to the injection. This will pass within an hour. Infrequently, a small ulcer may arise at the site of an injection. This will heal on its own without specific treatment and may leave a tiny white scar.
A course of treatments is required to obtain a good result. You should budget for about 4 treatments but the number of sessions required depends on the extent of veins and how well they respond to injection treatment. People with just a few veins may be cured after one or two sessions but those with very extensive veins may take 6 or 8 sessions. Your practitioner will be able estimate how much treatment will be required. The time between session depends upon the advice of your practitioner but usually varies between 2 and 8 weeks.
The response to treatment varies considerably from patient to patient but in general an excellent result can be obtained with the disappearance of most veins once sufficient treatment has been done. Resistant veins may be due to underlying varicose veins or other “feeding veins”. These can be detected by ultrasound imaging or with the more superficial veins, can be demonstrated by passing a special light through the skin (“VeinLite”).