Sclerotherapy is a common, non-surgical treatment for abnormal veins. These veins can range in size from very small and hair like and red in color (spider veins or telangiectasi)s to larger blue veins (reticular veins) to prominent blue tortuous vessels (true varicosities). Most of these vessels are just under the skin and are visible.
These vessels can be an indicator of deeper vein malfunction or can be mostly congenital, and not due to underlying venous incompetence. Every patient is different, and if there are symptoms, a duplex scan may be necessary prior to sclerotherapy. Sclerotherapy uses injectable sclerosant solutions, both liquid and foam, to treat abnormally dilated or cosmetically unacceptable veins. Sclerotherapy for spider veins and reticular veins is mostly considered cosmetic. The agents we use (Polidocanol and Sotradecol) are FDA approved. They work by causing the vessels to close, then shrink and then become less visible.
Two things about sclerotherapy must be considered. First, sclerotherapy takes time and does show results immediately. Secondly, patients with extensive spider and reticular veins usually need more than one treatment.
Post procedure compression stockings are recommended to enhance results from sclerotherapy.
Most insurance companies do not cover sclerotherapy. Please refer to your own insurance benefits regarding coverage. However, most insurance policies state that treatment using sclerotherapy or various laser treatments of the Telangiectatic dermal veins, which may be described as “spider veins or “reticular veins,” is considered cosmetic and not medically necessary.
Ultra-Sound Guided Sclerotherapy
Sclerotherapy can be done for vessels that are not on the surface of the skin under ultrasound guidance after venous abnormalities have been diagnosed with duplex ultrasound. Sclerotherapy under ultrasound guidance and using microfoam sclerosants has been shown to be effective in controlling refluxing varicose veins. This can be done with minimal invasiveness.