Sclerotherapy, This Is What You Should Know

What is Sclerotherapy

Sclerotherapy is a procedure to treat varicose veins. This action is performed by injecting a special drug (sclerosant) into the veins affected by varicose veins to shrink or deflate. Varicose veins are swelling or widening of the veins that most often occurs in the legs, especially the calves, because these parts experience pressure when standing or walking. Varicose veins can cause symptoms of pain, muscle cramps and a feeling of heaviness in the legs.

 

Sclerotherapy, This Is What You Should Know

One way to treat varicose veins is sclerotherapy. This treatment is usually effective for small varicose veins.

Purpose and Indications of Sclerotherapy

Doctors will recommend sclerotherapy to patients who experience symptoms of varicose veins in the legs, such as:

• Legs feel heavy and uncomfortable
• Hot and throbbing sensation in the limbs
• Swelling in the feet and ankles
• Leg muscle cramps, especially at night
• Pain that gets worse after sitting or standing for a long time
• The skin in the area of varicose veins itches, becomes dry, or sores develop

Sclerotherapy is also recommended for people with varicose veins who do not improve their symptoms by wearing special stockings or losing weight.

Sclerotherapy Warnings and Don'ts

Sclerotherapy is not recommended for patients with the following conditions:

• Deep vein thrombosis (DVT)
• Pulmonary embolism
• Hypercoagulable conditions (hypercoagulable states), namely blood clots that occur abnormally
• Are pregnant or breastfeeding

In patients with uncontrolled diabetes, sclerotherapy should be used with extreme caution.

Before Sclerotherapy

Before undergoing sclerotherapy, it is advisable to consult a doctor. During the consultation session, the doctor will ask about the patient's medical history, including heart disease, blood clotting disorders, and allergies. In addition, the doctor will ask about the treatment of varicose veins that have been undertaken.

The doctor will also ask about any medications, supplements, or herbal products the patient is currently taking. For patients who are taking drugs, such as aspirin, ibuprofen, or blood thinners, the doctor will tell them when to temporarily stop taking these drugs.

The patient will also undergo an ultrasound examination of the feet. The goal is for the doctor to see in detail the area of the blood vessels to be treated.

On the day of the sclerotherapy, the patient is advised not to shave the legs or apply lotion to the legs. This is to reduce the risk of irritation

Sclerotherapy Procedure

Depending on the severity of the varicose veins, sclerotherapy generally takes around 30–45 minutes. The patient can be asked to lie on his back or stomach, depending on the position of the veins affected by the varicose veins.

To detect an allergic reaction to sclerosant, the doctor will first inject it into a small area of the skin. The sclerosant given can be polidocanol, sodium tetradecyl sulfate, or hypertonic saline solution

If no allergic reaction occurs, the doctor will start the sclerotherapy procedure with the following steps:

• Determine the location of varicose veins by feeling the problematic veins and using ultrasound
• Clean the skin area to be injected using an alcohol swab
• Inject sclerosan into veins affected by varicose veins using a small needle
• Remove the needle, then massage or press on the injected area so that the sclerosant is spread evenly
• Cover the injected area with a plaster

The number of sclerosant injections given can vary, depending on the size and location of the varicose veins. Therefore, the steps above can be repeated according to the severity of the varicose veins experienced by the patient.

After Sclerotherapy

After sclerotherapy, the patient will be asked to lie down for about 15 minutes. This is to ensure that there is no allergic reaction to the given sclerosant. If there is no allergic reaction, the patient can return home and do their usual activities. Patients will be asked to walk frequently or do light activities to prevent blood clots in the legs.

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The doctor may advise the patient to wear compression stockings for 1–2 weeks.

To help the healing process, there are several ways that patients can do, namely:

• Avoid taking certain medications, such as aspirin or ibuprofen, for at least 2 days after sclerotherapy.
• Do not take hot showers or use the sauna for about 2 days after sclerotherapy.
• Clean the injected skin area using mild soap and clean water.
• Do not compress the injected skin area with warm compresses.
• Avoid direct sun exposure to the injected area for about 2 weeks.

Patients are also recommended for regular control to the doctor after sclerotherapy. If necessary, the doctor may advise the patient to undergo further sclerotherapy sessions until the desired results are obtained. Subsequent sessions are recommended as soon as 6 weeks after the previous session.

Side Effects and Complications of Sclerotherapy

When doctors inject sclerosan into a vein, patients may experience side effects, such as burning, cramping, or a burning sensation in the legs. Meanwhile, side effects that generally arise after sclerotherapy procedures include:

• Bruises on the skin where the injection was made
• Swollen
• The skin changes color, for example, becomes darker
• Discomfort in the legs
• Itchy rash
• Brown color in the skin area that has been injected

The side effects above will usually subside within 3−6 months.

Although rare, serious side effects or complications may occur after sclerotherapy. Immediately consult a doctor if you experience the following complaints:

• Blisters or open sores at the injection site
• Swelling, redness and pain at the injection site
• High fever

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