Sclerotherapie

Sclerotherapie, or sclerotherapy, is a medical procedure in which a sclerosant solution is injected directly into a vein or vascular malformation to irritate the endothelium and provoke inflammation, fibrosis, and eventual occlusion of the treated vessel. The aim is to collapse the abnormal vein and redirect blood flow through healthier pathways.

It is commonly used to treat varicose veins, reticular veins, and spider veins in the legs, as well as certain venous malformations. In cosmetic practice, it is favored for small-diameter veins, while larger varicose veins may require adjunctive or alternative treatments. Foam sclerosants, created by mixing gas with liquid sclerosant, are increasingly used because the foam can cover a larger surface area and remain in contact with the endothelium longer. The most widely used sclerosants are polidocanol and sodium tetradecyl sulfate; hypertonic saline and other agents may be employed in specific situations.

The procedure is usually performed on an outpatient basis, often with ultrasound guidance for deeper or larger veins. The volume injected depends on vein size and location. Local anesthesia is typically not required, though local anesthesia or topical anesthesia may be used for patient comfort. Post-procedure compression stockings or bandages are commonly advised to support vein closure and reduce swelling.

Complications are generally mild and transient, including tenderness, bruising, swelling, and hyperpigmentation; persistent thread-like veins or “matting” may occur. More serious but rare risks include deep vein thrombosis, pulmonary embolism, allergic reactions, tissue necrosis from sclerosant extravasation, and infection. Contraindications include active infection at the injection site, known allergy to the sclerosant, pregnancy (in cosmetic use), and certain thrombotic or vascular conditions. Multiple sessions are often needed for optimal results.