Liquid Sclerotherapy by direct injection
1. About the treatment.
Injection (sclerosant) therapy is usually only suitable for direct injection of relatively small varicose veins, reticular veins and thread veins, that are unsightly but usually cause no symptoms. It works by making the vein wall stick to itself, thus obliterating it, and the compression applied after the injection is an important part of the therapy. Larger veins are injected using foam. Ultrasound is used to identify and inject underlying "feeder" veins.
2. Before your next visit.
Ideally you should have stopped taking the combined oral contraceptive pill (those containing Oestrogen plus Progesterone), which theoretically could increase the risk of a serious thrombosis. This should be stopped one month before your appointment but it is very important to think about other contraception methods. There is little evidence that low dose “mini-pills” and hormone replacement therapy (HRT) need to be stopped.
3. At the clinic.
A small amount of fluid is injected into the vein at one or more sites and a cotton wool or rubber pad applied. At Plymouth Veins we often use ultrasound to identify underlying "feeder" veins beneath the skin in order to target the veins more effectively. A compression bandage or stocking is then put onto the leg. Usually a few visits and/or repeat injections will be required if both legs are affected or you have many veins on one leg.
After the first set of injections you will normally be asked to sit down for a while and have a drink. Thereafter, it is best to take a few short walks and try to avoid standing still for any length of time during the first 24 hours. Also, sitting with the feet elevated above the level of the hips is helpful. You will be advised to remove the compression bandage 1-3 days after treatment.
5. What to expect after the injections.
Over the first few weeks following the injection, any slight discomfort, hardness or tenderness at the injection site(s) should gradually subside. If there is excessive redness, swelling or tenderness, you may have phlebitis. Sometimes this requires treatment with an anti-inflammatory drug e.g. Ibuprofen and/or wearing a compression stocking.
After injection of thread veins an initial inflammatory reaction is common with the overlying skin becoming red and raised. The veins may initially appear more prominent and darker in colour. These changes resolve over a period of weeks. It is important to appreciate that the full response to treatment may take around 4-6 weeks.
While most patients experience no problems after injection of varicose veins, a small number may experience one or more of the following:
A persistent hard "cord" in the line of the vein.
Brown staining of the skin in the line of the vein.
Rarely, ulceration of the skin at the injection site.
Failure of the injection to obliterate the vein.
As you are predisposed to formation of varicose veins, new or recurrent varicose veins may develop in the future. Therefore, it may be advisable for you to wear light support stockings or tights to try to prevent the occurrence of further varicose veins.