Perth's Leading Specialist in the Treatment of Varicose Veins
Dr Luke Matar | MBBS, FRANZCR, FACP
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.
Read MoreHow 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.
Read MoreThe procedure
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
Follow up and maintenance to ensure best results
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.
Stockings: Following spider vein microsclerotherapy, compression stockings are usually worn continuously (day and night) for 21 days and following varicose vein foam sclerotherapy for 14 days. This compression is necessary to ensure the veins properly adhere and close. Interruption of this compression will drastically decrease the efficacy of your treatment.
Potential Complications of Microsclerotherapy
Staining
Pre-treatment and 7 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
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
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.
In many cases, patients presenting with spider veins are usually only seeing the “tip of the iceberg”. A high percentage of patients will have hidden varicose veins. If the underlying abnormal veins are not treated first, results from surface sclerotherapy will not be satisfactory. It is for this very reason that The Vein Clinic will not undertake microsclerotherapy without first investigating the status of your underlying veins using high frequency ultrasound evaluation.
Once all “feeder” veins have been eliminated and the medical stages of treatment are complete, we can move on to the cosmetic stage of treatment with surface microsclerotherapy. In order to improve the success of sclerotherapy, we use specialised magnifying and cross polarisation technology (Syris V600 ™) to literally see 1mm below the surface of the skin, improving the targeting of spider veins.
Read MoreAbout The Vein Clinic Perth
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.
Dr Luke Matar and The Vein Clinic specialise in minimally invasive and non-surgical treatments for varicose veins, spider veins and venous reflux. Vein experts around the world now recognise these treatments as the new standard of care for the removal of varicose veins. Unlike with vein surgery, your everyday life will not be affected by your treatment.
Read MorePatient Satisfaction
Meet Your Vein Specialist
Dr Luke Matar MBBS, FRANZCR, FACP
Dr Luke Matar is the only Australian doctor to have been personally trained by the inventor of laser perforator vein ablation, the world-renowned UK-based EVLA expert Professor Mark Whiteley. The advantage positions him as the clear choice to treat your varicose veins.
Meet Dr Luke Matar
Other Minimally Invasive
Varicose Veins Treatments
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.
If you are unsure of what vein condition you may have, assess your legs with our online tool.
If you are looking for cosmetic spider vein treatment only, please click here.