What is microsclerotherapy?
Micro sclerotherapy is the gold standard treatment for thread veins and has been shown to be the most effective type of treatment for thread veins when carried out by skilled practitioners. In many cases, other providers will attempt to treat thread veins using IPL which although effective for facial thread veins is not an effective treatment for leg thread veins. Similar to foam sclerotherapy, microsclerotherapy utilises the same type of chemical sclerosant but differs in that it is much more diluted and it’s also only used in a liquid form and not as a foam which is used for the treatment of larger veins.
Similar to varicose veins, thread fans need a comprehensive medical assessment including an ultrasound examination to determine if there is a possible underlying cause including the presence of valve failure. In many cases there will be the presence of reticular veins that are supplying the thread veins and these can be effectively treated with foam sclerotherapy or long pulsed Nd:YAG laser. In some cases of assessment for thread veins, there is found to be damage to the underlying deeper veins and this may require EVLA for effective treatment before tackling the thread veins.
What does microsclerotherapy involve?
Very fine micro needles are used to access the thread veins followed by the injection of diluted liquid sclerosant. Micro sclerotherapy is similar to phone sclerotherapy in that there is a maximum safe limit that can be injected in a single treatment session. For patients with multiple extensive thread veins, it may be recommended to have a second treatment for adequate clearance. Once the treatment is complete compression stockings are applied to each leg and must be worn for seven days. Please view the video below for an in-depth account of the microsclerotherapy procedure and what it involves.
It is commonly accepted that despite being much smaller than varicose veins, thread veins are more difficult to effectively treat. Most cases patients will need more than one treatment of micro sclerotherapy and duration of treatment will differ for each patient depending on how extensive the thread veins are. In most cases, patients need between 2 to 5 treatments only in some cases as one treatment adequate and in the most extensive cases patients can require more than 15 treatments to effectively clear thread veins using a combination of micro sclerotherapy and laser thread vein removal.
Aftercare instructions after microsclerotherapy
For patients who have had microsclerotherapy, it is important to follow the aftercare instructions below:
- Patients are recommended to carry out light exercise such as a short in the park for twice a day for one week following leg vein removal treatment. This aids in the veins that been injected to close more effectively and contributes increased success rates in eradication of leg veins. It is also important not to overdo physical exercise as this can worsen outcomes following leg vein removal treatment
- The dressings that are applied following treatment to the injected areas should be kept on until the next day. If the area becomes acutely itchy then the dressings should be removed earlier
- All patients should wear well fitting class 1 thigh length compression support stockings for a full one week following treatment. This helps in optimising successful outcomes following treatment. If you are able to wear the stockings continuously for the first 3 days, this certainly helps further in increasing success rates but if you find them difficult to tolerate then the stockings may be removed at night time.
- You should avoid hot showers and avoid hot baths completely for the first 7 days following leg vein treatment. Lukewarm water is fine for the first 7 days.
- It is very important to avoid direct sun exposure to the legs following treatment for a full 6 weeks to avoid the risk of hyperpigmentation.
- If hyperpigmentation does develop in the treated areas of the legs, it is very important to avoid sun exposure for a full one year to avoid the risk of permanent hyperpigmentation developing.
- Our clinical support team are available around the clock to answer any questions you may have. If you think you may be experiencing adverse side effects then please get in touch for further advice. If you are experience leg or calf swelling or chest pain/shortness of breath, you must seek immediate medical attention at your local emergency department to rule out a DVT or PE.
- Patients should bear in mind that the healing process after microsclerotherapy and laser leg vein removal can take a few weeks. It is not uncommon to experience tenderness, discolouration, hardening or telangiectasia (spider veins) but they settle without active treatment after a few months.
- Leg vein treatment takes a number of sessions and it is important to avoid shaving the legs for a minimum of 24 hours before your next treatment and avoid all use of creams or lotions to the legs before treatment.
- It recommended to avoid flying for a full 4 weeks after treatment.
- If you have any further questions, please ask your aesthetic practitioner at your face to face consultation.
Risks and complications of microsclerotherapy
- Post-inflammatory hyperpigmentation. PIH is the most common complication after leg vein removal but in the vast majority of cases, it settles within a few months provided the legs are kept out of sunlight. The risk of PIH can reduced by wearing well fitting compression stockings continuously for the first 3 days following treatment. PIH can develop following both microsclerotherapy and laser vein removal.
- New vessel formation or matting. This complication develops when the body reacts to leg vein destruction by forming new smaller veins in the vicinity of treatment and can happen after both microsclerotherapy and laser treatment. These new smaller veins often settle and disappear without active treatment after a few months. Persistent small veins can be efficiently removed with long pulse Nd:YAG laser.
- Skin breakdown / ulceration. This is a rare complication of microsclerotherapy but does not occur with laser treatment. Ulceration occurs when the sclerotherapy liquid enters a small artery and not a vein. This occurs more commonly at the ankle as the the arteries and veins are often in closer proximity to one another in this region. Our specialists will often prefer to use laser treatment for leg vein removal in these areas to avoid this risk. Ulcers once formed can be a cause of discomfort and take about 6 weeks to heal completely. Any resultant scarring is often inconspicuous and often no larger than 3-4 mm.
- Deep vein thrombosis. This risk only applies to microsclerotherapy treatment only. Thankfully it is a rare occurrence (less than 1 in 1000) and is related to the following risk factors: patients who smoke, use of the combined oral contraceptive pill, those who are overweight or obese, those with a personal or family history of DVT, patients with cancer or are undergoing cancer treatment, diabetic patients.
- Burns. The risk of burns arises from the use of laser treatment. It does not occur with microsclerotherapy. Avoidance of this risk os related to skill with laser treatment which is why it is important to choose a practitioner with plenty of experience in using laser for leg vein removal.
- Tissue staining caused by haemosiderin. This is a rare complication caused by leakage of iron containing pigment from veins that have been previously treated. It takes time to appear and is often appears as a permanent bruise over the area of treatment. Although it can develop as a result of treatment with both microsclerotherapy and laser, it is more common with microsclerotherapy treatment.
Microsclerotherapy before and after