What is Sclerotherapy?
- Posted on: Aug 28 2019
What is Sclerotherapy?
Sclerotherapy is a technique used by physicians and nurses to eradicate varicose and spider veins. The fundamental skills of sclerotherapy include inserting a needle inside an unwanted vein, then injecting a medication (called a sclerosant) into the vein. The sclerosant causes irritation and spasm of the vein, which results in vein closure. Once the vein closes your body begins the process of resorption, or breaking the vein down. This is the end results regardless if we are treating large, bulging varicose veins, or teeny tiny spider veins.
One of the first questions we need to determine prior to pursuing sclerotherapy is “are these varicose veins or spider veins?” Astute and seasoned observation skills are put to use here, and more often than not, it involves the use of duplex ultrasound. Veins typically are more than what meets the eye. The duplex ultrasound allows us to “see” under the skin at what is really happening. Duplex ultrasound is used as the gold standard to diagnose or rule out a diagnosis of varicose veins.
Once we have confirmed the diagnosis, treatment can begin. For varicose veins sclerotherapy is employed under the guidance of duplex ultrasound. This is often referred to as ultrasound-guided compressive sclerotherapy. The ultrasound acts as our eyes and allows a needle to be inserted into the varicose veins located in the subcutaneous tissues. Sodium tetradecyl sulfate and polidocanol are the two sclerosants approved for use in varicose veins by the FDA. One of these medications is then slowly injected into the varicose veins, all under the guidance of ultrasound to ensure maximum efficiency and safety.
If a diagnosis of spider veins is made then visual sclerotherapy is used. Visual sclerotherapy, or just sclerotherapy, involves treating the veins located closer to the skin surface. Sometimes this uses a special light to illuminate the veins better and aide in visualization for treatment. The sclerosant and strength is chosen based on the vein’s size. Once the medication is drawn up in a syringe the needle is gently inserted into the unwanted vein and the medication is slowly injected. Treatment of large spider vein patches often involves a series of treatments in order to achieve the best outcomes.
It is important to keep in mind that every patient is unique in their presentation of veins, thereby necessitating a unique treatment plan. The number of treatments is always individualized because it is based on their unique concerns and problems. While most people can safely undergo sclerotherapy treatment there are some individuals who may not be good candidates due to other medical conditions. During your initial consultation your medical history will be reviewed, so it is imperative you answer questions honestly and tell us if you are currently in treatment for other conditions.
Sclerotherapy is only as good as the person holding the needle. It is a medical procedure, and a skill that must be practiced and used regularly to maintain it. They say medicine is an art, and that is most certainly true for sclerotherapy.
Written by: Chelsea Campbell, MSN, FNP-BC, RPhS