As with any therapeutic technique, sclerotherapeutic procedures may cause complications. The over-all risk associated with these procedures compares very favourably with surgery. It is important to remember that with a sclerotherapeutic procedure, no anaesthetic, no hospitalisation, and no time off work or physical activities is required.
Nevertheless, this is where you can read about the risks and complications associated with sclerotherapy.
1. Common occurences
- May persist for up to 4 to 5 weeks.
- Resolves spontaneously and is reduced by using anti-bruising creams such as Hirudoid™.
- Approximately 1 in 3 patients develop small localised areas of trapped blood.
- Trapped blood presents as tender, bruised lumps with yellow discolouration.
- Trapped blood is more likely if compression stockings are not worn.
- Readily treated during a 2 to 4 week follow-up visit by needle drainage.
Brown discolouration of skin (hyperpigmentation)
- Approximately 1 in 3 patients develop small patchy areas of pigmentation overlying the injected veins.
- Hyperpigmentation is caused by an inflammatory process.
- Hyperpigmentation is more likely if:
- Skin colour is olive or dark.
- Drugs, such as minocycline (antibiotic) or iron supplements, are used concurrently.
- Truncal venous disease is not treated first.
- Trapped blood is left untreated.
- Hyperpigmentation may be reduced by using skin bleaching agents (hydroquinone cream).
- Pigmentation usually lasts for 4 – 6 months but almost always resolves within 12 months spontaneously.
Pink discolouration of skin/small fine vessels (matting)
- Approximately 1 in 10 patients develop small patches of skin with new very fine blood vessels.
- May appear as patchy areas of ‘pigmentation’ but on close inspection the vessels become more obvious.
- Caused by the use of high concentrations of sclerosant or increased sensitivity of skin.
- May persist but can often be treated with additional micro-sclerotherapy.
2. Uncommon occurences
Painful leg (superficial phlebitis)
- Approximately 1 in 70 treatments result in superficial phlebitis.
- Caused by excessive inflammation in truncal veins in susceptible individuals.
- Responds quickly to ice, aspirin/ibuprofen, compression stockings and continuation of the daily walking schedule.
- Onset is usually 1-3 weeks after the treatment and may last 1-3 weeks.
- Your physician will need to exclude the possibility of DVT because up to 1 in 10 of these cases of thrombophlebitis can progress to deep venous thrombosis.
3. Very rare occurences
Small painful wound (dermal necrosis)
- Approximately 1 in 400 treatment sessions are associated with a small painful ulcer at or near one of the injection sites.
- These lesions are approximately 4mm in size and initially quite painful.
- Dermal necrosis is caused by sclerosant reaching the arterial vessel usually through abnormal connections with the venous system.
- Usually takes 4-8 weeks to heal completely but will leave a small scar.
Deep vein thrombosis (DVT)
- Approximately 1 in 500-1000 treatments are associated with an increased risk of developing DVT.
- This risk returns to normal 3-4 weeks after treatment.
Migraine headache / visual effects
- Approximately 1 in 800 treatments are associated with migraines or visual disturbance.
Systemic allergic reactions
- Approximately 1 in 1500 treatments result in a systemic allergic reaction.
Adjacent nerve damage
- Approximately 1 in 2500 treatments result in damage to nearby nerves.