MicroSclerotherapy (leg thread vein removal)

Microsclerotherapy is used to treat small to very small veins on the legs
Microsclerotherapy involves injecting a “sclerosant” directly into each vein with very fine needles. Multiple treatment sessions may be required for complete removal. Most patients can expect at least a 70 – 100 percent improvement in the appearance of their legs. This may take up to 3 months depending on the number and density of veins.

How does the treatment work?

You will lie down on a treatment couch. Using very fine needles, a solution is injected into the spider veins. This irritates the lining of the vein causing the two opposing sides to stick together. You will rest for several minutes after the injections with the leg elevated and then be asked to put on your compression stockings. You should keep the leg elevated as much as possible for the first 24 hours. Maintain normal daily activities, but avoid standing still for long periods.

Compression stockings are an essential part of treatment, as they:

• Reduce pigmentation
• Reduce the number of treatment sessions needed
• Reduce the risk of deep vein thrombosis
• Reduce the frequency of recurrence

Depending on the treatment performed, the length of time that the stockings will have to be worn will vary. You will be advised at the time of treatment. If smaller thread veins are treated, then the stockings should be worn for 3 days continuously and 4 – 7 days during the day only.

Compression stockings can be purchased via the following links. Please note, local chemists can measure your leg and order stockings which can take up to 72 hours to arrive. So please ensure you purchase well in advance of your appointment. You will need compression Grade 1 stockings. Flight stockings are also useful, but most are ‘below knee’ and the majority of people will need full length stockings depending on the location of the thread veins.

http://compressionsockshop.co.uk/category/medical-compression-stockings-28/

http://shop.mediuk.co.uk/duomed-soft-thigh-length-compression-stockings.html

What to expect after microsclerotherapy treatment

Usually the veins look worse for a period of time before they start to look better. Improvement is often seen in a couple of weeks, but it may take 6 – 12 weeks to show the maximum effect.

Are there any side effects?

Overall, microsclerotherapy is a safe, effective and well tolerated treatment. It produces excellent cosmetic results, and side effects are mild and temporary. However, as with all medical and injectable procedures, there are some potential risks which you need to be aware of listed below.

Potential side effects related to using a needle for the procedure include:

• Temporary discomfort – very brief – can be reduced with Emla cream. The degree of discomfort is partly related to the initial size of the veins. This is usually improved by walking, paracetamol or Ibuprofen. Soreness can occur behind the knee from the rubbing of the bandage or stocking
• It can feel itchy afterwards – an antihistamine e.g. Cetirizine or Piriton is useful to ease this
• Redness at the site (typically 20 – 40 minutes after the procedure)
• Bruising (fades within 1 week – maximum of 2 weeks)
• Swelling (common – up to 48 hours after treatment)
• Infection (very rare – approximately 1 in 100,000 patients)

Potential side effects related to injections with Sclerovein include:

• Incomplete resolution. Most veins will require 2 – 3 treatment sessions
• Allergic reaction / hives appearance – normal and settles down over 24 hours
• Pigmentation (1 in 10 cases). Most disappear within 3 – 12 months
• Reduced blood pressure or fainting during the procedure – please let the Dr know if you feel faint, do not try and stand up!
• Swelling of the leg or ankle (2 in 100 cases). This can appear for a few days post procedure
• Deep Vein Thrombosis (DVT) – 1 in 2000 treatments. Blood clots extending into the deep veins can occur. Please let us know ASAP if you develop a red swollen tender calf area
• Ulceration (rare)
• Nerve injury (3 in 1000 cases) – irritation of surface sensory nerves – settles in 2-4 weeks

The results from treatment to individual veins will appear permanent, but it will not prevent more thread veins developing in the future.

After Care

The following advice is intended to help ensure the best results from the treatment and to minimise the occurrence of side effects. The closer you adhere to this advice, the happier you will be with the results.

• Take a 10 minute walk immediately following treatment
• Wear the support hosiery (full length) day and night for 3 days (72 hours). Wearing the support hosiery constantly is crucial – it may be a nuisance, but it makes all the difference! You can take it off for short periods to have a cool shower or bath
• Do not be alarmed if the treated areas look worse when you remove the hosiery – this is completely normal at this early stage
• Wear the hosiery during the day for a further 5 – 7 days if possible, removing it overnight
• Avoid extreme temperatures for 14 days i.e. very hot baths, saunas, sun beds, ice-packs
• Avoid sun exposure for 4 weeks – pigmentation may be enharnced and take longer to fade
• Avoid high impact exercise for at least 2 weeks
• Avoid waxing the legs for 4 weeks
• Elevate your legs as much as possible for the first two weeks
• Do not take long – haul flights within 4 weeks of treatment and short haul for 2 weeks after treatment

If you are having microsclerotherapy treatment, please ensure you buy some compression stockings to wear immediately after your treatment and for the following 3 days. They should be of moderate compression strength, thigh length and the correct size for your legs. Your local chemist will be able to measure you. However, please do so well in advance (2 – 3 days before) to allow for ordering and delivery. Stockings can also be purchased online from Mediuk and the Compression Sock Shop. They should be compression class 2 (CCL 2), but grade 1 will suffice if grade 2 is not available. Prices start from £120 depending on the number of vessels and time spent doing the treatment.