Frequently Asked Questions – Vein Care Melbourne

Side Effects of Sclerotherapy:

Transient hyperpigmentation (Brown Staining). Approximately 10-percent of patients who undergo sclerotherapy notice discolouration (light brown streaks) after treatment. In almost every patient the veins become darker after the procedure. Once the trapped blood is drained 2-3 weeks after treatment, this temporary discolouration fades away.

• Telangiectatic Matting. This is the development of tiny new blood vessels in the treatment area. This temporary phenomenon occurs 2-4 weeks after treatment and usually resolves within 4-6 months. It occurs in up to 18-percent of women receiving oestrogen therapy and in approximately 3-percent of all patients.
• Skin ulceration. Sloughing is uncommon, but it can happen even in the hands of an experienced physician. Skin ulceration is due either to abnormal connection between small veins and arteries or escape of solution into the surrounding skin. Injection ulcers are small and heal very well over weeks, sometimes leaving a small pale scar.
• Allergic reactions. Very rarely a patient may have an allergic reaction to the sclerosing agent used; this typically presents as a skin rash. At worse (and very rare) an anaphylactic reaction may occur. This is treated by an injection of adrenaline or cortisone.
• Deep venous thrombosis (DVT). DVT may occur occasionally and may manifest itself with pain in the calf or swelling of the ankle or foot. The approximate risk is 1-in-2000 for sclerotherapy and even less in EVLT. Compression stockings and daily walking are very important following the procedure, as this significantly reduces the risk. Hormone therapy (i.e. the pill or hormone replacement therapy) is usually stopped before the procedure.

Other minor side effects may include:

• Hair growth at injection sites (localised and temporary).
• Migraine sufferers may experience headache or visual disturbance following injection sclerotherapy. Simple analgesics like Panadol, Nurofen or other anti-migraine therapies will relieve symptoms.
• Numbness of the skin is temporary and quite uncommon, due to irritation of the nerves close to the injected vein. At times this may take up to 3 months for recovery.
• Intra-arterial injection is an extremely rare (1-in-10000) complication resulting in significant skin and muscle damage. This now rarely occurs as ultrasound guided injections and constant monitoring of solution during treatment have increased the safety profile.

By comparison, for surgical removal of veins the side effects are those for any surgery performed under general anaesthesia. These include nausea, vomiting, wound infection and deep vein thromboses.

Veins treated adequately by sclerotherapy will not recur. However, sclerotherapy does not correct the underlying weakness in your vein walls, therefore new vessels may appear with time. It is important to maintain normal body weight, exercise regularly and avoid wearing high-heeled shoes to minimise the development of dilated veins. An annual check-up is recommended to detect the development of new veins which can then be treated easily.

Lasers are occasionally used to vaporise small superficial spider veins and small blue veins called venules. Unfortunately when treating leg veins lasers can cause scars on the skin as well as pigment changes. The pain with laser treatment is greater than injections and the results are not very satisfactory. The gold standard for superficial veins remains injection sclerotherapy.

Lasers ARE effective on barely visible blood vessels under 0.2mm in size. Lasers are especially effective in treating prominent facial blood vessels. Dr. Dhillon uses a Gemini (dual wavelength 532nm and 1064nm) laser for facial veins and occasionally on leg veins in highly selective cases, and in certain others where sclerotherapy is contraindicated due to medical reasons. Ultrasound guided sclerotherapy (UGS) and endovenous laser treatment (EVLT) is for large, bulgy varicose veins.

Ambulatory phlebectomy is done as an office procedure under local anaesthesia. The varicose vein is marked and prepared, tiny incisions are made on the skin and the vein is pulled out with special hooks. Stitches are generally not required, though bandaging is. Scarring is usually minimal.

Surgically tying veins off (ligation) and pulling them out (stripping) are additional procedures that are slowly becoming less popular because of the need for general anaesthetics and hospitalisation, long downtime and high recurrence rate.

1. Read this information sheet again.
2. Do not apply moisturiser to your legs on the day of your appointment.
3. You may prefer to wear pants to your appointment, as they will conceal the stocking and underlying compression pads.
4. Always bring your compression stocking for each appointment; its use is vitally important to achieving best results.

1. Follow your doctor’s instructions for the best results.
2. Walk immediately following the treatment for 45 minutes, and additionally every day while undergoing treatment.
3. Avoid standing for long periods of time.
4. The time needed for compression stockings depends on the type of treatment you undergo. Your doctor will explain to you accordingly and you will be given written instructions to follow.
5. Leg waxing can be performed only after a period of two weeks from your last treatment.