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Sclerotherapy involves injecting a detergent-like material (the sclerosant) into the veins which in turn causes the veins to shrivel up and eventually disappear.  The sclerosant can be injected as a liquid form into thread veins and/or small reticular veins (micro-sclerotherapy) or mixed with air to form foam and injected into larger reticular veins and/or trunk veins (foam sclerotherapy).  Making the sclerosant into foam enables the treatment of much larger and extensive varicose veins using very small volumes of the sclerosant.  
  • Foam sclerotherapy
This is usually performed in a consulting room or treatment room under local anaesthetic.  The procedure is also performed under ultrasound guidance, which allows the surgeon to see the foam filling the superficial veins of the leg and helps guide the required injections.  Usually several injections of foam are required, but if both legs require treatment, this is usually done on two separate occasions.  After treatment, a tight compression bandage is applied to the leg with a full length surgical compression stocking over the top.  The bandage and stocking has to stay in place permanently for the first 3-5 days.  The bandage can then be removed and the stocking only worn permanently for a further 2-4 days, then daytime only for the next 7 days.  At the end of 2 weeks you will usually be seen back in the clinic and receive further injections to any residual varicose veins, if required, plus advice on your further compression regime.  If no additional treatment is given, you will still need to wear the compression stocking for a further 3-6 weeks in the daytime only. 
After foam sclerotherapy, most patients are able to leave hospital almost immediately and to return to most of their normal daily activities, other than vigorous activities such as running or going to the gym.  It is normal for there to be some lumpiness and bruising of the leg where the varicose veins were and this can take several months to fully resolve.  In the first few weeks after treatment, it is also common for patients to experience some skin discolouration, particularly if you have pale skin and/or slim legs.  This discolouration usually fades but can persist for 3-6 months and in rare cases may be permanent. 
  • Liquid or micro-sclerotherapy
Up to 80% of the adult population of the United Kingdom have thread veins on their legs.  These thread veins are not associated with any particular health risks or complications but a significant number of people find them cosmetically unappealing.  These small reticular veins and thread veins actually lie within the skin itself and so cannot be removed by surgery.  The preferred treatment for these veins is liquid or micro-sclerotherapy.  Many patients will have a combination of trunk, reticular and thread veins.  If the small thread veins are treated by sclerotherapy without first dealing with the large trunk varicose veins, the long-term results are normally disappointing.  Micro-sclerotherapy is performed in a consulting or treatment room requires no anaesthetic or stay in hospital and is generally very safe.  Many patients have quite a large number of thread veins affecting both legs, and each small area of thread veins requires a separate injection.  Treatment therefore normally consists of perhaps 10-15 tiny injections into the leg at a treatment session, and it is normally only practical to treat one leg at a time.  Depending on the extent of the thread veins in the leg, several sessions may be required to achieve a satisfactory result, with each session typically lasting for 30 minutes.  Most patients require 2-3 full 30 minute sessions to treat each leg.  Typically, the treated area can often look worse, immediately after treatment, before it looks better.  Normally after micro-sclerotherapy you will be issued with a full length compression stocking which you will be advised to continue to wear for 4-6 weeks.  After treatment, some bruising and inflammation around the treated area is quite common and this may last for a week or two.  About 1 in 3 patients having this treatment do notice some slight discolouration of the skin over the treated areas and this may take several weeks to fade.  In rare cases this skin discolouration may persist for several months and occasionally it may be permanent.