Why is sclerotherapy not recommended for obese people with varicose veins?

Misinformation. Sometimes, obese people need higher concentrations of the chemical that is injected into the vein (we call that the sclerosant). Sometimes obesity can cause a person to need more treatments thatn non-obese people would need, but obesity isn't a reason for nor treat people with sclerotherapy for their varicose veins.
Not necessarily. Sclerotherapy of varicose veins can be used on thin or obese patients. While there are indeed situations or medical conditions where sclerotherapy might not be advised, obesity alone does not exclude a patient from consideration for sclerotherapy.
Incorrect Advice. If you were told this, you were incorrectly informed. Obesity is not a reason to be excluded from varicose vein sclerotherapy. I hand performed hundreds of sclerotherapy session on obese individuals with excellent results. Although there can be certain contraindications for sclerotherapy, being obese or overweight is not one of the exclusion criteria. Get 2nd opinion from a vascular surgeon.
Use varies. In my practice, obesity in and of itself is not an absolute contraindication to sclerotherapy. Patients must be able to walk well and to wear compression stockings, as these are advised after treatment. They must be in reasonable health, without infection in the areas to be treated, and without any blood clots, or significant swelling.
Sclerotherapy can be. Used in obese patients, usually with good results. Compression after treatment is a critical part of sclerotherapy and it can sometimes be challenging to get adequate, consistent compression in obese patients, particularly if morbidly obese. This may mean more sessions or perhaps an increased risk for pigmentation and other complications. Consult with an experienced phlebologist.

Related Questions

How is sclerotherapy used to treat varicose veins?

Med destroys vein. Sclerotherapy consists of injecting a medication which is an irritant to the vessel. The medication burns the inside of the vein and your body then destroys the vein. There are two different medications currently approved for sclerotherapy. Both are effective. Discoloration over the area is common for 4-8 weeks.
Treat surface veins. Varicose veins are usually related to poorly functioning veins below the skin, detected by ultrasound. If present, the underlying veins should be treated before or at the same time as the surface veins. Sclerotherapy is the injection of medication into the unwanted surface veins in order to cause them to collapse and dissolve. Sclerotherapy is very technique dependent. See someone experienced.
Inflammation. A small amount of a chemical called a sclerosant is injected into the vein. There are different types of sclerosants but they all do the same thing. They cause the vein to become inflamed. The inflammation causes the vein to collapse on itself, to seal off and, as a result, it is absorbed by the body and disappears. Usually it is recommended that compression stockings be worn afterwards.
Foam sclerotherapy. Varicose veins have been treated by sclerotherapy for years. Sclerotherapy involves injecting the varicosites with a chemical that basically removes the inner lining of the vein causing it to spasm and clot off. Your body then gradually absorbs the treated vein. Often, ultrasound is used to guide the injection of the chemcial into the varicose veins.
Injury and healing. The agent causes a chemical injury/wound to the inner layer of the vein (endothelium) causing inflammation. Like any other would (thermal, stab, gun shot) body heals injury and forms a hard scar tissue that should shrink and close the veins. ("sclera" in greek is "hard") for varicose veins up to 17% recurrence rates first year have been reported. Not the best option!
Sclerotherapy. Sclerotherapy is used to treat varicose veins & spider veins. A small needle is inserted into the abnormal cluster of veins & then medication (sclerosant) is injected into the veins. It causes a local reaction inside the vein that destroys the vein wall. The vein dies & the body's immune system gradually absorbs the dead veins. Often procedure is performed with ultrasound to help guide therapy.

How effective is sclerotherapy for varicose veins?

Graeter than 90% Depends on the size of the varicies patient selection also a consideration.
Depends on vein size. Smaller vein respond much better to sclerotherapy than large ones. In the long term, larger veins probably only go away alittle better than 80% of the time. Smaller ones do better than that.
Better options. Varicose veins can be treated by sclerotherapy but they usually require multiple treatment sessions and, if they clot, from the treatment, they may become painful and require drainage. Sclerotherapy works well on small veins such as spiders and blue reticular veins. Varicose veins are best treated by micro incisions to remove them requiring local anesthesia and no sutures.
Very effective. Sclerotherapy is an effective treatment of varicose veins. It is the most versatile and often the best treatment for problem veins including varicose veins. It is best used on the surface veins after any underlying saphenous vein reflux has been treated. Saphenous reflux is best treated with thermal or laser ablation. Sclerotherapy is also an effective and versatile treatment for spider veins.

What can I expect from sclerotherapy for varicose veins?

Depends. There are many situations where sclerotherapy is the treatment of choice, but it depends on the size of the vein and what the underlying cause is. Some sclerotherapy is for cosmetic reasons only and as such is usually not reimbursed by 3rd party payors.
Vein Resolution. Sclerotherapy can be a great option for treatment of variocse veins in many situations. It works best for veins that are 1-3 mm in diameter. It can be done with regular sclerosant drugs or foam sclerosant. The veins will typically absorb & disappear within weeks to months after injection. You will have some mild tenderness & possible lumpiness of the veins while they absorb, but minimal pain.
Sclerotherapy of VV. Sclerotherapy of varicose veins is a process to eradicate the veins. The larger veins usually take much longer to heal than the spider veins. Once a varicose vein is injected it will usually get hard from the solution clotting the vein. This clot may take months to resolve and sometimes requires draining (evacuation) under local anesthesia. Several treatments may be necessary for large veins.

Who can have sclerotherapy done for spider or varicose veins?

Most patients. Most with spider & varicose veins can have sclerotherapy. Patients with varicose veins need an ultrasound to evaluate the underlying veins. Underlying veins are often treated with evlt or radiofrequency. Large surface varicose veins may be better treated with ambulatory phlebotomy. Contraindications to sclerotherapy include blood clots, allergy to the medication, serious illness, & unable to walk.
Nearly anyone. There are few absolute contraindications to having sclerotherapy done: having a current deep or superficial venous thrombosis, being allergic to the slcerosant that is being used, and pregnancy. Most won't treat nursing mothers and care needs to be taken with certain sclerosant preparations in patients who have a history of getting migraines with aura (usually funny visual changes before hand).
Most patients. Sclerotherapy of spider or varicose veins is widely used today and is very safe. However, there are certain medical conditions or situations where sclerotherapy would be ill-advised. A vein specialist/phlebologist can help you to see if you are a candidate for sclerotherapy or other treatment options.
Most people. Sclerotherapy is usually done for spider veins and not for varicose veins. Almost anyone can undergo sclerotherapy provided they are medically stable, have no allergies to the sclerosing solutions and can tolerate the needle treatments. Age by itself is not a contraindication and I have personally performed sclerotherapy on an 8 yo with a hemangioma and a 95 yo with bleeding from ankle spiders.
Most People. Almost anyone can undergo sclerotherapy for both spider or varicose veins provided they don't have a serious medical condition that might increase the risk of sclerotherapy and they have no allergies to the sclerosing solutions and can tolerate the needle treatments. Age by itself is not a contraindication although usually done on adults.
Most individuals OK. Sclerotherapy is common therapy used to remove spider or varicose veins of the legs, whether for cosmetic or medical reasons. Small needles are inserted into the vein clusters & a drug is injected into them which closes the veins. There are very few absolute contraindications for sclerotherapy treatments. Some patients with clotting or bleeding issues should avoid. See a vein specialist & discuss.

Can you give me more info on sclerotherapy done to their varicose veins?

Vein sclerotherapy. Leg vein sclerotherapy is injection of safe solutions to alter the structure of the cells lining the vein channel surface. Successful result is to destroy malfunctioning veins, sealing them closed so they are absorbed and disappear. Blood detours into the normal veins, improving symptoms, circulation and appearance.
Sclerotherapy. Sclerotherapy is common therapy used to remove spider or varicose veins of the legs, whether for cosmetic or medical reasons. Small needles are inserted into the vein clusters & a drug is injected into them which closes the veins. FDA approved sclerosant drugs are polidocanol & sotradecol. Non FDA approved drugs used worldwide include glycerine & hypertonic saline. Can work for all size veins.

Is sclerotherapy an efficient and long-lasting, problem-free solution for varicose veins?

Yes it is. Depending. Sclerotherapy of veins in the leg is a very simple, office based procedure that involves the injection of a solution that "scleroses" or irritates the inside lining of the vein causing it to collapse. Veins aren't visible but the blood in them is so if the vein is sclerosed and has no blood in it, then it isn't visible. The needle is tiny and it hardly hurts. See a vascular surgeon!
Nothing is permanent. Sclerotherapy will certainly make the veins that are treated go away. The chance that those same veins will come back is only about 2%. Although they don't regenerate, that doesn't mean that you'll never get another bad vein as long as you live. You get abnormal veins because of your heredity and that you can't change. Regardless, periodic touch up treatment is the way to go.
Yes effective. Yes, sclerotherapy is effective. If your varicose veins are related to reflux then rf ablation of the greater saphenous is a good option. Other options include stab phlebectomy.
Veins. This is for treatment of spider veins These are usually hormonal so it's likely new ones will develop in future However sclerotherapy is a great option.

Is sclerotherapy an efficient and long lasting - problem-free solution for varicose veins?

Not best for VV. Sclerotherapy is an excellent treatment for spider veins but it does require multiple treatment sessions and it is not permanent. Sclerotherapy will require periodic touch up treatments. Varicose veins are due to refluxing (leaking) valves of the saphenous system and the gold standard treatment for these veins is a duplex reflux ultrasound followed by valve closure and microphlebectomies.
Not a miracle cure. Sclerotherapy can be a very good options for varicose veins but is not the "miracle cure" people would like it to be. There can also be some potential "problems" from sclerotherapy, including risks of skin pigmentation, trapped blood, or allergic reactions. Recurrence of new veins is always a possibility, so not always "long lasting". You will need ultrasound first. Phlebectomy also good option.

When going in for sclerotherapy, how many veins can be done at one time? I have a large number of varicose veins on my legs. Can a person have sclerotherapy done on both legs at the same time and on a number of veins or will it require multiple appointmen

The. The answer to both of your questions is yes. We can and often do perform sclerotherapy on both legs at the same time. However, when the veins are extensive, multiple visits are usually required.
Varicose. Varicose veins are a complex problem and sclerotherapy is an excellent option but may not be the best single option. In many cases a combination (mutimodality) is useful and ultrasonic imaging is very useful. Furthermore, if you have extensive disease, expect that this is a lifelong condition that may require periodic treatment in order to maintain results. Sclerotherapy can be performed on a variety of differing sized veins. However, deeper veins may require ultrasound guidance. Other techniques such as endovenous laser or vein stripping and/or ligation may provide comparable or even superior results. Laser may be useful in treating the spider veins and "mattting" that is associated with varicose veins and not traditionally managed with the large vein techniques. However the quick answer to your questions are: yes both legs can be injected simultaneously and yes, multiple appointments will be required to reduce but not necessarily get rid of them. I don't want to disappoint you but it is important to have realistic expectations. Meet with an expert. I hope this helps!
All depends. If we assume you do not have large vein reflux then sclerotherapy may be appropriate. If you have extensive veins on both legs, my preference would be to treat one leg at a time. I tend to limit treatment sessions to 20 minutes, but certainly others may do more. Suspect you will require numerous treatment sessions.
Yes, yes, and yes. The answers to all of your questions is yes. However, as dr. Placik said (make sure you ready his answer, it is excellent), if you have a lot of varicose veins you need to make sure that you have an ultrasound evaluation of your veins before treatment. Sclerotherapy, alone, might not be the best choice. You might very well do better with a combination treatment approach.
Different Issues. If you have varicose veins then sclerotherapy is not the treatment of choice. The first step is a venous reflux exam to look for leaking valves in the saphenous system which is usually the source of the varicose veins. This can be treated by a laser and the vv's by micro incisions. Following this sclero can be done to the spiders. Both legs can be done at the same time and usually multiple rx.

When going in for sclerotherapy, how many veins can be done at one time? I have a large number of varicose veins on my legs. Can a person have sclerotherapy done on both legs at the same time and on a number of veins or will it require multiple appointmen

Although. Although both legs can be treated at the same visit, it is common to require sessions in the future.
Sclerotherapy. Commonly sclerotherapy is done in more than one session, especially if both legs need to be treated. If you have a large number of bulging veins in your legs it is important that your legs be evaluated properly before treatment. I would recommend that a venous ultrasound be done before any treatment is considered. A visit to a phlebologist (vein specialist) for an evaluation would be good.
Venous eval. First. Sclerotherapy can be done on both legs at one time. However, if you have extensive spiders, then you will most likely need multiple treatment sessions. I routinely do both legs at the same time unless each leg is extensive, then I do each separately. Also, if you have varicose veins with spiders, then you should have a venous reflux sonogram before treatment and see a vein specialist.
Depends. I firmly believe that a venous work up should be done in cases of varicose veins before treatment. Most often we find an underlying problem that is causing what you see on the skin. This should be addressed to limit recurrence and actually treat the real problem. See a vein specialist.