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Perth's Leading Specialist in the Treatment of Varicose Veins

Dr Luke Matar | MBBS, FRANZCR, FACP

Cosmetic Microsclerotherapy

Cosmetic Microsclerotherapy

Sclerotherapy Injections for Veins

Injections of sclerosing agents (substances that cause the vein walls to collapse and scar together) are the most common injection treatment for veins offered at The Vein Clinic. Liquid sclerotherapy is used for treating smaller varicose veins and spider veins and is typically done as a cosmetic only treatment.

Foam sclerotherapy is a modification of this technique whereby air or physiological gases (oxygen/carbon dioxide) are mixed with the sclerosant agent to form a “foam”. Foam sclerotherapy has been proven to be more effective over liquid in treating larger incompetent veins. Foam sclerotherapy injections for larger veins are usually guided by ultrasound, to ensure accurate placement within the target vein, maximising efficacy and minimising the risk of complications.

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The first step is a consultation.

Head to our booking page to find out what to expect during your consultation and what you need to bring.

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How Cosmetic Microsclerotherapy For Veins Works

Microsclerotherapy involves meticulous injection (often with the aid of magnification, transillumination, or augmented reality) of a sclerosant solution using very fine needles. A transient burning discomfort from sclerosant entering larger veins may occur, but this usually lasts less than a minute. Sclerosants cause irreversible damage to the inner wall of the vein, resulting in a scarring reaction called ‘sclerosis’. This leads to permanent closure of the vein. The sclerosed vein undergoes a slow transition over time to become a fibrous cord and eventually disappears completely as the redundant scar tissue is removed by a process called ‘apoptosis’. The sclerosants are used at The Vein Clinic are sodium tetradecyl sulphate (STS) and polidocanol.

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The procedure

1

Stages of Vein Treatment

Stage 1

Treatment of large malfunctioning veins (trunk)
  • Endovenous Laser Treatment (EVLA) to great, small, and/or anterior accessory saphenous veins. 60 minutes

Stage 2

Treatment of large varicose veins (branches)
  • Phlebectomy removal of larger bulging varicose veins 90-120 minutescombined with

  • Ultrasound-Guided Foam Sclerotherapy (UGFS) on smaller veins. 30 minutes

Stage 2

Treatment of small varicose veins (branches) if required
  • Extra sessions of UGFS to close smaller veins if identified as required at post-treatment follow-up scan 30 minutes

  • You may not require this stage.

Stage 3

Optional treatment surface veins (leaves)
  • Usually done by Microsclerotherapy 30 minutes

  • Most patients require multiple treatment sessions to remove spider veins.

Stage 4

Stage 4
Follow up and maintenance to ensure best results
Learn more about treatment stages
What To Expect?

What To Expect?

Discomfort: Microsclerotherapy injections for spider veins involves a finer needle and the experience is much like a mosquito bite. The number of injections required is usually far more than that for varicose veins and may be between 10-100 per treatment session. Many patients are surprised to learn that spider vein treatments are generally more difficult and painful than the larger varicose vein treatments.

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Potential Complications of Microsclerotherapy

Staining

Staining

Pre-treatment and 6 months post

Staining or pigmentation can occur in up to 20% of patients and is due to the breakdown of red blood cells depositing iron containing the pigment haemosiderin. Melanin is also associated with post-sclerotic pigmentation and is more common in patients with darker complexions. Trapped blood predisposes patients to more pigmentation, as does incomplete treatment of underlying reticular veins. Most pigmentation usually disappears within 3-6 months. A small percentage of patients will have pigmentation persisting for up to 12 months. It may be permanent in about 1% of patients.

Matting

Matting

Pre-treatment and 5 months post

Matting is the development of new, very fine red networks of spider veins. Mostly seen around the lateral thighs and medial knee areas, they differ in appearance to the original spider veins that prompted the treatment. They can arise a few months after treatment, with a reported incidence of 7-10%. There is an increased risk of developing this complication if the primary treatment of sclerosing regional reticular veins in the dependent area has been inadequate. Fortunately, matting often disappears over time without the need for further treatment.

Skin Ulceration

Skin Ulceration

Ulceration of the skin is a rare complication and arises if the arterial circulation of the skin has been compromised. Occasionally the sclerosant triggers arterial spasm from an effect on the venous side of the circulation. Extensive ulceration of the skin due to direct injection of sclerosant into an arterial vessel is a very rare but serious complication.

Word of Caution

It is not uncommon that patients presenting to The Vein Clinic may have had less than pleasing long-term results from previous sclerotherapy treatment. The usual reason is that they have only had the visible surface veins treated. In many cases, underlying “feeder” veins that may only be visible on ultrasound have not been treated. This can result in the body producing even more abnormal veins once the surface veins have been treated.

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About The Vein Clinic

The Vein Clinic is a specialist medical clinic dedicated to excellence in the treatment of superficial venous disease. We are NOT a cosmetic clinic so we do things very differently from such clinics that treat veins according to what they see on the surface. We look deeper to get to the underlying source of your surface vein problems and will not treat you based just on what is seen to the naked eye. We DO NOT use surface laser to treat surface veins as this does not treat the underlying abnormality and may result in poor cosmetic results such as matting.

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Take the First Step Towards Healthy Veins

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Frequently Asked Questions

Get In Touch

Please send us an email and we’ll be in contact very soon or alternatively, call us on (08) 9200 3450.

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