The Art of Sclerotherapy

Why is sclerotherapy performed
Sclerotherapy and  laser treatments for spider veins  form the foundations of a phlebology practice.  Patients present for sclerotherapy to treat telangiectasias (spider veins on the legs), reticular veins, and varicose veins.  While patients may reports only cosmetic concerns, a comprehensive assessment will demonstrate only a  fraction having purely cosmetic veins. Most will have underlying venous insufficiency that will require correction prior to sclerotherapy for telangiectasias.

Who should perform sclerotherapy?

Sclerotherapy is routinely performed only by board-certified vein doctor near me, but this can vary state to state.  In many states, registered nurses are allowed to do sclerotherapy, while also physician assistants and nurse practitioners also can perform with proper training.  Certainly physicians should be skilled at sclerotherapy and understand the risks and benefits of treatment.
It is difficult to become adept at sclerotherapy without hands-on training.  While one can learn the theory, risks, benefits of sclerotherapy through the literature, the skills needed to perform the procedure are learned only with direct experience. 

What to use for sclerotherapy?
Commonly used liquid agents include hypertonic saline, sodium tetradecylsulfate, glycerin, and polidocanol.  Regardless of what agent is used, one should be thoroughly familiar with the appropriate concentrations and volumes of liquid to be used for safe and effective results.  There is a direct correlation with the pressure used to inject, volume of sclerosant and concentration used to obtain successful results. The liquid can be converted to foam sclerosant for increased potency using the Tessari method  This involves taking a small concentration of the liquid sclerosant and mixing it with air in a  3:1 to 4:1 ratio. Given the increased potency of foam, a smaller volume and concentration is needed for effect.

Where to perform sclerotherapy?
Sclerotherapy in NJ should be performed by a board-certified vein doctor.  The procedure is office-based, but can also be performed in procedure centers or hospitals depending on the physician preference.