Varicose veins are often viewed as only a cosmetic concern; however they can cause significant symptoms as well as create serious health problems. These abnormal veins can be treated for health as well as cosmetic benefit through a procedure called sclerotherapy.
Sclerotherapy of larger veins are most often covered under the Ontario Health Insurance Plan (OHIP) and a portion of the treatment appointment can be covered under the Régie de l’assurance maladie Québec (RAMQ). Vein treatments that are not covered under RAMQ or OHIP can be submitted to personal health insurance for possible reimbursement.
What is Sclerotherapy?
Sclerotherapy is a treatment where a solution is injected into a vein. It is a procedure that can treat a wide range of veins, from small spider veins to larger varicose veins. The injection is performed directly into the vein causing irritation to the inner lining which results in collapse and closure of the vein.
Varicose veins are usually treated by ultrasound guided sclerotherapy. The ultrasound machine is a critical part of the treatment for multiple reasons. First of all, it allows direct visualization of the targeted vein to confirm the correct vein is being treated. Furthermore, the vein is accessed under ultrasound guidance to ensure the needle enters the vein correctly. The ultrasound is also important during the injection itself as it allows us to visualize the solution as it flows through the vein. This not only allows us to see that the vein is responding properly to the solution but also allows us to confirm that the entire length of the vein is treated. Finally, the ultrasound is used regularly on your follow up appointments to evaluate the results of the sclerotherapy and ensure that the vein is treated properly.
Once the vein is closed, the previously experienced symptoms start to improve and often within days after the procedure. The time it takes for the vein to no longer be visible after the treatment can range from days for smaller veins to months for larger varicosities.
How should I prepare for the treatment?
Patients should wear clothing that is either short or loose enough to allow the treatment area to be exposed. Compression stockings are an important part of your post-treatment care. Please do not forget to bring your compression stockings to your appointment so they can be put on right after the treatment. You should avoid applying any type of lotion, cream, or gel to the treatment area on the day of your appointment. Although we do clean your skin during your treatment, we strongly recommend that you wash the area at home.
How many treatments will I need?
The number of treatments required varies with each individual. The initial assessment will help give an estimate number of appointments so patients can have an idea. It is always difficult to know the exact number due to the wide range in the type, size and number of concerning veins as well as the variability in response to treatment.
Sclerotherapy of varicose veins can range from a single appointment to treat multiple smaller varicose veins to requiring 1-2 appointments to treat the entire length of a single larger varicose vein.
It is very important for patients to known that the treatments are not a permanent cure of the condition. You can eliminate your presently concerning veins, however you may still produce additional varicose veins in the future. Therefore, it is important to maintain good overall health and continue to practice preventative measures in order to reduce the risk of future varicose veins.
Are the treatments painful?
Sclerotherapy of varicose veins often only requires a butterfly needle which is commonly used for blood tests. Local anesthetic is used when larger needles are required. Most times, patients are unable to feel the solution being injected. This is a great improvement from past solutions, as patients would often feel a burning sensation when these were injected. Certain veins can be sore after the treatment; however most patients don’t find it severe enough to take any pain medication.
What can I expect after treatment?
Following sclerotherapy, bandages will be applied to the treatment area and need to be kept on till the following day. Compression stockings will be applied shortly after the completion of the treatment. Patients are required to wear compression stockings post-treatment to help give the best possible results as well as reduce the risk of complications. The compression stockings are worn for 3 weeks post-treatment unless instructed otherwise. Patients are advised to walk regularly on a daily basis. It is best if you avoid more strenuous physical activity for a few days and possibly up to a week or two following your treatments.
Bruising at the injection site is common. A larger bruise can occasionally form. Bruising at the injection site is common. A larger bruise can occasionally form. Mild tenderness, either at the injection site or along the vein, can be experienced. This can last from days to weeks and occasionally a few months; however it is often not severe enough to require any form of pain medication. Pigmentation along the vein is fairly common but most often temporary. Finally, the vein becomes hard after the treatment and can be felt under the skin as lumps or a rope. This will gradually reduce in size and eventually shrink or flatten to the point that it is no longer felt.