Sclerotherapy

Liquid vs. Foam Sclerotherapy

• Liquid sclerotherapy — used for spider veins and small reticular veins below 3 mm; direct injection causes focal vein wall closure
• Foam sclerotherapy — mixes sclerosant with air or CO₂ for larger varicose veins up to 6 mm; displaces blood to maximise sclerosant contact with the vessel wall
• Ultrasound-guided foam sclerotherapy (UGFS) — real-time ultrasound guides injection into deeper varicose veins not visible at the skin surface

Pre-Treatment Assessment

Venous duplex ultrasound mapping is performed before treating varicose veins to identify any underlying venous insufficiency. Treating reflux at the source before sclerotherapy prevents early recurrence.

The Procedure

Fine needles inject sclerosant under direct or ultrasound guidance. Sessions last 30–45 minutes and patients wear compression stockings for 5–7 days afterwards. Multiple sessions are typically required for complete treatment.

Results

• Spider veins: fade over 4–8 weeks; 2–4 sessions typically required
• Varicose veins: progressive resolution over 8–12 weeks
• Recurrence is minimised by treating underlying venous insufficiency before sclerotherapy

Side Effects & Contraindications

• Common: temporary bruising, redness, hyperpigmentation (10–30% of patients)
• Rare: deep vein thrombosis, allergic reaction to sclerosant agent
• Contraindicated during pregnancy or breastfeeding, in acute DVT, or with known sclerosant allergy