An initial consultation to assess the suitability of microsclerotherapy for the patient may include an ultrasound examination to map out the vein structure and identify any underlying vein disease that may be feeding these superficial spider veins.
The harley street vascular
Microsclerotherapy
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Whatever your lifestyle, genetic predisposition or individual health aspirations – Your Circulation is your Lifeline.
The harley street vascular
What Is Microsclerotherapy?
Microsclerotherapy is a minimally invasive procedure designed to treat and eliminate small varicose and spider veins.
The technique involves the injection of a sclerosing solution directly into the affected veins, causing them to contract and eventually be reabsorbed by the body, leading to the disappearance of the vein from sight.
It is performed as an outpatient procedure, allowing patients to return to their daily activities with little to no downtime.
Indications for Microsclerotherapy
Microsclerotherapy is recommended for people seeking treatment for small to medium-sized spider veins and varicose veins in the following scenarios:
For Cosmetic Reasons
Spider Veins (Telangiectasias): These are small, thin veins that lie close to the skin’s surface and are usually red, purple, or blue. They are primarily a cosmetic concern without significant health implications.
Reticular Veins: Reticular veins are larger than spider veins and can serve as feeder veins for areas of telangiectasias. Their treatment can improve aesthetics and reduce the formation of new spider veins.
Microsclerotherapy in Singapore is primarily considered a cosmetic procedure. This means your insurance provider will most likely exclude it from coverage, as it’s not deemed medically necessary.
For Symptomatic Relief
Mild Varicose Veins: While microsclerotherapy is NOT the first-line treatment for large varicose veins, it is effective for smaller ones that may cause discomfort, itching, or swelling.
Contraindications and Considerations
Microsclerotherapy is not appropriate for every person. Specific contraindications should be carefully considered before proceeding with treatment:
- Allergic Reactions
People with a known allergy to the sclerosing agents used in microsclerotherapy should avoid the procedure. - Immobility
Patients who are immobile or unable to maintain an active lifestyle post-treatment may face increased risks, as activity is vital for recovery and preventing complications. - History of Deep Vein Thrombosis (DVT)
Those with a past occurrence of DVT or who are at high risk for thrombotic events need a thorough evaluation to assess the safety of undergoing microsclerotherapy.
The Microsclerotherapy Procedure
The microsclerotherapy process involves several key steps:
Pre-treatment Assessment
The Sclerosing Solution
The procedure involves preparing a sclerosant, which is a chemical solution that causes the veins to collapse and stick together. The specific type of sclerosant used and its concentration can vary depending on the size of the veins being treated.
For larger reticular veins, we use a process of creating micro foam – a mixture of air and sclerosant to create very fine microbubbles of the medication. A special system called the VARIXO system is used for this.
The Injection Process
The skin over the treatment area is cleaned, and the sclerosing solution (or microfoam solution) is injected directly into the affected veins using a very fine needle. Multiple injections are usually needed, depending on how many veins are treated.
Sometimes, we use Blue light to warm the veins and make the action of the sclerosant more effective. This is especially used in very fair skinned people who burn rather than tan on sun exposure, allowing us to use lower concentrations of the sclerosant medication.
Compression is applied to the treated area immediately after the injection to help close the veins and prevent blood from re-entering.
Patients might require multiple sessions to achieve desired results, especially for more extensive vein networks. The number of sessions varies based on the individual’s response to treatment and the extent of the vein condition, but 2 to 3 sessions are typically required.
Post-treatment Care
After undergoing microsclerotherapy, adhering to specific post-treatment care instructions is essential to maximise the effectiveness of the procedure.
Compression Garments
Patients are advised to wear compression stockings or bandages for a period ranging from several days to a few weeks after the procedure. These garments support proper healing by preventing blood from re-entering the treated veins.
Post-sclerotherapy creams
Microsclerotherapy can lead to faint brown pigmentation lines in the skin that typically fade over several weeks. We sometimes prescribe post-sclerotherapy hyperpigmentation (PoSH) and anti-bruising creams to speed up this process and prevent pigmentation after sclerotherapy, which must be used as advised.
Physical Activity
Engaging in regular, gentle walking immediately after the procedure is encouraged to promote blood circulation and prevent formation of clots. Strenuous activities should be avoided for a specified time to prevent pressure on the treated areas.
Sun Exposure
Direct sunlight on the treated areas should be avoided for at least a few weeks after treatment. Sun exposure can darken the treated veins, potentially affecting the cosmetic outcome.
Monitoring for Complications
While complications are rare, it’s important to monitor for signs of infection, severe pain, or changes in skin colour around the treated area.
Skincare
Gentle care of the treated areas is recommended. Patients should avoid hot baths, saunas, and swimming pools for a period after the procedure to prevent irritation and ensure optimal healing.
Potential Side Effects and Complications
Microsclerotherapy is a generally safe procedure with a high success rate. Like all medical treatments, it carries the potential for side effects and complications.
Common Side Effects
- Bruising and Discoloration: Patients may experience bruising, redness, or discolouration around the injection sites. These effects usually resolve within a few weeks.
- Pain and Discomfort: Some people may feel mild pain or discomfort at the injection sites, often described as a stinging or burning sensation.
- Swelling: Minor swelling in the treated area is common, especially if larger veins are addressed.
Less Common Complications
- Skin Ulceration: A small ulcer may form at the injection site, especially if the sclerosant leaks into the surrounding tissue. These ulcers can heal over time but may leave a scar.
- Allergic Reactions: Allergic reactions to the sclerosant used in microsclerotherapy can occur. Symptoms can range from mild, such as rashes, to severe, such as anaphylaxis.
- Thrombophlebitis: This is an inflammation of the vein that can occur after treatment, leading to tenderness and redness along the vein.
- Telangiectatic Matting: In some cases, new, fine, red blood vessels may develop near the site of treatment.
Rare Complications
- Deep Vein Thrombosis (DVT): A very rare but serious complication is the formation of a blood clot in a deeper vein, which can pose significant health risks if it travels to the lungs.
Frequently Asked Questions
How long does a microsclerotherapy session last?
A session usually lasts between 30 to 45 minutes, depending on the number and extent of the veins being treated.
Is microsclerotherapy painful?
Patients may experience mild discomfort or a stinging sensation during the injection, but the procedure is generally well-tolerated with minimal pain.
Is microsclerotherapy safe?
This treatment is safe; however, like all similar treatments, it does not come without some risk. Your vascular surgeon will discuss the treatment and its risks with you during your consultation.
Can the treated veins recur?
Spider veins are related to hormonal balance, age, genetic predisposition and sometimes occur at the site of a simple bruise after many years. Since not all these factors are controllable, spider veins can recur especially at sites away from the treated site.
Is microsclerotherapy reimbursed or covered by insurance?
Microsclerotherapy is considered a non-essential and cosmetic procedure by most insurers, and is usually NOT covered by insurance. You should confirm this with your insurance provider or agent.
you are covered
We are on the panel with most insurers in Singapore and with many international insurers; We also offer convenient options for self-paying patients.
