Is Sclerotherapy Safe? | Side Effects and Complications of Sclerotherapy

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Sclerotherapy has been described as the “Swiss Army Knife” of vein treatments. What do I mean by this? Well nearly any vein can be treated by sclerotherapy. Any leg vein - varicose veins, spider veins, blue veins and veins which have come back after stripping, hand veins, veins on the chest, veins on the face. In fact, of all the methods for treating abnormal veins, laser, radiofrequency, medical glue - you name it anything that is called the GOLD STANDARD - sclerotherapy is without doubt the most versatile treatment option.

The evidence is that sclerotherapy is very safe. Many years ago a large French registry of over 12,000 procedures confirmed a very low rate of complications and side effects. This was confirmed by another study in the United Kingdom more recently. Sclerotherapy has an excellent safety record which compares favourably with other treatment options.

However, like all effective medical treatments sclerotherapy, does have side effects and complications which can be classified as either major or minor.

These are the major complications: anaphylaxis, venous thromboembolism, tissue necrosis (small scabs and small ulcers), nerve injury and swelling. The minor complications include matting which is a very annoying outcome - the formation of small new blood vessels after sclerotherapy which look like a bruise, pigmentation (sometimes called staining), and disappointment.

My team and I looked back at our records over a 15 year period involving over 5000 episodes of sclerotherapy. Over this period, we had no serious complications. We did have some minor complications: 3 people with persistent brown marks (more than 2-years) but all of these eventually resolved. We had 17 patients with matting, 39 patients with temporary visual disturbance, 28 patients with wheezing and cough, one patient with tingling and numbness of the face and hand and one patient was unable to drive home because of a headache. All of these minor complications were temporary and all resolved with the passage of time. Visual disturbance, headache and tingling are a form of migraine reaction.

So based on careful research of the medical literature and my own experience, I can confirm that Sclerotherapy is very safe. However all of us who treat patients with sclerotherapy are aware that patients might have allergic reactions and we must be prepared to deal with these. We are also aware of the contraindications by which I mean those people and those conditions for whom sclerotherapy should be avoided. We are also aware that people who suffer with migraines may have an attack of migraine triggered by sclerotherapy. That is why in general, I don't think it is appropriate for patients to drive themselves home after their first sclerotherapy session. My team and I are very careful to explain to patients what they can expect after sclerotherapy. In particular we tell them that sclerotherapy starts a healing process during which the veins may become lumpy and tender and that there may be discoloration over the successfully treated veins. For many years now, I have taken routine clinical photographs of our patients treatment areas before, during and after their treatment sessions. Clinical photography helps our patients see the improvement and leads to better satisfaction.

Successful Sclerotherapy relies on a team approach which ensures a good outcome while avoiding side effects and complications. Important among these are a Medicines Management policy to avoid medication errors and a policy of preparedness for any serious complications however rare they may be.

So in summary, yes sclerotherapy is safe provided the team that is administering sclerotherapy is skilled and experienced.