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Sclerotherapy is a medical procedure used to eliminate varicose veins and for superficial leg veins, also known as spider veins, telangiectasia, or starburst blemishes which are small, dilated surface veins that can be pink, red, or purple and appear as lines or clusters on ankles, lower legs, or thighs. Sclerotherapy treatment is for Superficial Leg, Hand, and Chest Veins.Dysfunction of the valves within veins contributes to spider veins, and several factors may play a prominent role in their development, including heredity, pregnancy, hormone replacement therapy, oral contraceptives, obesity, and trauma. Although exercise, weight loss, and support hose may limit the number of new vessels, it will not prevent their development.

What is Sclerotherapy and How Do I prepare for the Treatments?

Performed on an outpatient basis, sclerotherapy involves the injection of a sclerosing solution, (such as hypertonic saline, glycerin or Sotradecol) into the dilated vessels. This causes the lining of the vessels to swell and close, resulting in both a lighter color and improvement in the appearance of the vessels. In many cases, the veins can be completely eliminated.


Pre-Treatment Precautions

  • Do not take Vitamin E or non-steroidal anti-inflammatory medications, such as Advil® or Motrin®, or aspirin at least one week prior to treatment. Tylenol is a good substitute.

  • You may also want to consider bringing comfortable shorts to wear during treatment and/or loose-fitting pants or a long skirt to wear home.

What Can I Expect During Treatment?

Most people experience mild discomfort for about 15-30 seconds, similar to a mosquito bite. The injected veins completely disappear for a few minutes as blood is pushed out by the solution, but they reappear when the blood flow returns. 

Since many vessels are interconnected, one injection may eradicate several dozen vessels at once by washing over the cells lining the inner wall of the vessel, causing them to shrink. They will slowly disappear, as your body's natural response to injury clears them.

How Soon Will the Veins Disappear?

Veins will fade over six to eight weeks after treatment. Smaller vessels may disappear completely and large vessels should decrease in size.

Are there Any Side Effects Associated with Sclerotherapy?

Serious side effects from this procedure are extremely rare; however, some temporary side effects may occur.

  • Local swelling and bruising may occur at the injection site and along the vessel. Swelling usually lasts no more than 24 hours; bruising fades within several weeks. Brown discoloration may infrequently develop. This usually lasts approximately three months, slowly fading away.
  • Tenderness may occur at the injection site and along the vessel, and may persist for a few days.
  • Immediately following injection, a hive-like reaction may develop at the site, usually lasting no longer than 30 minutes.
  • Following injection of the ankle or calf, cramping similar to a "charley horse" may occur.

What are the Post-Treatment Instructions?

Pressure gauze bandages may be placed over the treated vein and remain overnight after treatment. You should avoid contact sports, aerobics, and use of leg weights during this treatment. A 30-minute, moderately paced walk may be substituted for your regular workout.

Thereafter, ace bandages or compression support hose (available at our office) must be worn continuously (except to shower) for five days after treatment.

Medium-weight compression support hose are recommended for daytime wear during the one to twoweeks following treatment; either Jobst sheer support pantyhose or Sigvaris Delilah pantyhose. Both are nonprescription, fitted by height and weight and available in several colors.

How Many Treatments will I need?

Treatment will depend on number, size and location of the veins as well as the level of cosmetic result you desire.

Are There Reasons Why I Should Not Have Sclerotherapy?

Patients with a history of inflammation of the veins (thrombophlebitis), blood clots in the legs, diabetes, arterial or other vascular problems, or previous leg ulcers are not treated with sclerotherapy. Pregnant women are almost always advised to postpone treatment until six months after delivery.

Do Other Treatment Options Exist?

Yes! Sclerotherapy remains the treatment of choice for spider veins but if sclerotherapy does not fade veins appreciably, if the veins are too small to be treated by sclerotherapy, or if you are fearful of needles, lasers and light sources are highly effective treatment options.

The pulsed dye laser (V-Beam), and the long pulsed Nd:YAG laser (Lyra, Gemini, and GentleYAG) are effective in treating red, superficial, fine veins and also some bigger, deeper blue veins. The options will be discussed during your consultation.

Hand/Chest Veins

Few patients are aware that unwanted hand and chest veins can be treated just as effectively. The hands can be a telltale sign of aging. Over time, as the skin thins and muscle tissues and fat deposits in the hands decrease, veins appear larger, making the hands appear aged or masculine. Likewise, a number of women tend to have visible breast veins especially after breast augmentation surgery. If deemed unsightly, breast veins can easily be treated with sclerotherapy.

How is the treatment performed?

Like treatment of leg veins, injection sclerotherapy offers a fast, simple, and virtually painless way to eliminate unwanted hand veins and chest veins with no significant risks. The treatment is done in the office and requires no anesthesia. It involves the injection of a solution into the vein with a fine needle. The solution causes the veins to slowly collapse over time. Two hours after treatment, the patient can resume all activity without limitations. The results are dramatic and long lasting.

Is the treatment safe?

The procedure is safe for healthy patients. Once the target veins are eliminated, blood flow is rerouted to other existing veins without compromising circulation. Some mild bruising and swelling may occur after treatment, but quickly resolves. Patients who have undergone radical mastectomy, those who have a dialysis shunt, or patients who have had any significant trauma to the hands, arms, or chest are poor candidates for this procedure.

I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. My goal is, quite simply, to provide the type of dermatology care which I  would seek for my own family. This is a very important point, since physicians often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their hair and skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results.

Dr Gary sees every patient himself and  believes in personalized care. The Doctor does not employ any physician assistants, nurse practitioners, or other physician substitutes to do his treatment. He sees every patient himself at every visit.

A significant percentage of my Hair Loss,Dermatology and Cosmetic Dermatology Conditions are diagnosed  on listening to the medical history of the patient alone, a further percentage on examination and the remainder on further detailed or careful examination and my patients teach me the rest. It is clear to me that history and examination skills remain at the very core of my dermatology practice. Older Dermatologists like myself rely on history and physical to a greater degree than the younger dermatologists.  I think that the pendulum has swung too far towards all these cosmetic procedures where the younger dermatologists are just doing cosmetic procedures and not listening to their patients.  This is an important point because if the Dermatologist does not spend enough time with the patient during the consult the cosmetic procedures will probably not work.

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Park Avenue Dermatology & the Non-Surgical Rejuvenation Center

Board Certified Dermatologist