Who performs this procedure?

Dr. Gail Nield does all the injectable procedures in our office, including Botox® and soft tissue fillers. Many patients take advantage of their time alone with Dr. Nield to discuss other dermatologic and cosmetic concerns.

What is sclerotherapy?

Developed over 75 years ago, sclerotherapy is one the safest and widely-used treatments for spider and varicose veins. Using a tiny needle, Dr. Nield injects a solution into your vein that replaces the blood and causes the walls of the vein to corrode. Your body’s natural healing process then causes the vein to break down, shrink and eventually disappear.

Am I a candidate for sclerotherapy?

During your initial consultation, we will review your medical history to see if sclerotherapy is a good option for you.

Most sclerotherapy patients see a significant improvement or are completely cleared of their  leg veins. There is, however, no guarantee that sclerotherapy will work in every case; about 10% of patients who undergo the treatment have some remaining veins after the recommended number of treatments. In very rare cases, your condition could get worse after treatment.

Dr. Nield will do a thorough exam of your legs in a standing position, and if she feels that you may have large varicose veins that will not respond to local in-office injections, she will recommend further evaluation such as a non-invasive Duplex scan of your veins. Once the results are available, she will review the findings with you to determine available options.

What is a treatment like?

We start by examining the veins in question, and working up a treatment strategy that will best eradicate them. You may be asked to stand while problem veins are marked and photographed. Then, using a tiny needle, Dr. Nield injects the sclerosing agent into the targeted veins. Treatment lasts anywhere from 15 to 30 minutes, depending on the number of veins being treated in a particular session.

No anesthesia is needed for this treatment – any discomfort you feel will be minimal.

You will see results gradually. Most patients see 60% to 80% of their unwanted veins disappear over a series of treatments.

How many treatments will I need?

Multiple treatments may be necessary to get satisfactory results. The number you’ll need depends on the how many varicose and spider veins you have. The average for most of our patients is 4-6 treatments, though up to 8 treatments may be required.

What is the effect of the treatments?

Spider veins will immediately turn darker after a treatment and will look like small scratches – they will disappear in 3 to 4 weeks. Larger veins may bruise. Facial veins usually require up to 3 sessions to resolve. They can return over time but can be retreated.

What will I need to do after my treatments?

For the first 3 days after each treatment, you’ll be asked to wear tensors (you can take them off at night). You may need to wear support hose or a supportive wrap for a short while after your treatment to improve your response to the therapy and prevent recurrence.

For 3-5 days after each treatment, you should avoid hot baths or any strenuous exercise such as high impact aerobics, running or weightlifting. Walking, however, is highly recommended.

For the first month after treatment, you’ll need to avoid flying (unless you’re wearing support stockings). Tanning should also be avoided while you’re undergoing treatment.

Are there any side effects?

The most common side effects of sclerotherapy treatment are:

• Itching. You may experience some itching along the vein route for 1-2 days.
• Pain. Veins may be tender to the touch after treatment, with an uncomfortable sensation along the vein route. Some patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The pain is usually temporary, in most cases lasting 7 days at most.
• Discolouration. 30% of patients notice light brown streaks. For almost all patients, veins become darker immediately after the procedure. This discolouration is temporary, though in rare instances, it can take 4-12 months to disappear. In 1% of patients, that pigmentation becomes permanent.
• Sloughing. In 3% of patients, a small blister may form at the injection site and become ulcerated. The scar that follows should return to a normal colour.
• Allergic reaction. Some patients may have an allergic reaction to the sclerosing agent, or to the tape used.
• Thrombus. A ropey, painful area may form along the treated vein. This is uncommon, but can be treated with drainage.
• Granulomas. A painful, firm area can form around the treated vein. This is rare, and can be treated with Kenalog injections.
• Neovascularization. Tiny new blood vessels may develop.
• Transient phlebetic-type reactions. The swelling of the vein might cause the ankles to swell.
• Temporary wheals. You may notice bumps that are similar to hives.
• Wound infection, poor healing or scarring. This occurs very rarely.
• Phlebitis. This is a very rare complication (seen in 1 out of every 1000 patients treated for large varicose veins. The dangers of phlebitis include the possibility of a pulmonary embolism (a blood clot to the lungs) and post-phlebitis syndrome, in which the blood clot remains in the leg, resulting in permanent swelling of the leg.

What if I don’t have the therapy and continue living with my unsightly leg veins?

Spider veins pose no health risk; getting rid of them is purely a cosmetic decision. However, large varicose veins (ones greater than 4 or 5 mm in diameter) can cause problems if left untreated. Spontaneous phlebitis or thrombosis can occur, with the associated risk of possible pulmonary embolism (a blood clot to the lungs). If you have long-standing varicose veins with venous insufficiency (when the valves in your leg veins are unable to pump blood to your heart and blood pools in your legs) you can develop ulcerations in the ankle region. Rarely, these ulcers may hemorrhage or become cancerous.

Are there any other procedures for removing unwanted veins?

In Dr. Nield’s experience, leg vein injections are the simplest, safest and most cost-effective treatment for leg veins, so she usually offers this procedure first. However, other options can be discussed during your initial consultation.

Facial, chest and neck spider veins usually respond quite nicely to Laser or Intense Pulsed Light sources. A series of treatments are usually required. Some patients have small 1 to 2 mm blue veins lateral to their eyes known as periorbital reticular veins. These can be treated with our Yag Laser.

Vein ligation and stripping may be an option, but unlike sclerotherapy, it is surgery. In it, the vein is surgically removed (stripped) through several incisions in the skin.

Endovenous laser treatment (EVLT) collapses veins using laser energy delivered from a thin laser fibre placed within the vein.

Laser treatment for smaller veins is also an option, especially for cases of neovascularization (the development of tiny new blood vessels). Laser vein removal is offered in our clinic. Some patients may be candidates for Yag laser vein treatments while others may need Intense Pulsed Light treatments for their leg veins.