Patients often come to Vein Doctors Group claiming sclerotherapy does not work for them. What they need to understand when they make that statement is that there is an enormous variation in the skills of the doctors performing sclerotherapy. In some cases the doctors have been (at most) to a weekend course and have had little or no ongoing education. This situation contrasts with those doctors who have gained the highest award possible – Fellowship of The Australasian College of Phlebology. Invariably when patients complain that sclerotherapy has not worked for them, they have not had treatment by an ACP accredited doctor.
The difference in treatment technique is that with the former group of doctors they invariably do not treat the reticular veins. In this case sclerotherapy will either not work or last only a short period of time. The reticular veins are the larger blue / green veins that feed into the spider veins (telangiectasia) and if they are not treated first it is like trying to block a tributary of a river without first blocking the river. The inevitable consequence of this approach is that the spider veins will only go temporarily (if they go at all) and often there is the almost immediate appearance of “bruising” in the area. This bruising is a collection of smaller veins that unfortunately does not improve with time. This is called “matting”. Another cause of why sclerotherapy may not work is if there is an underlying vein that does not work properly (incompetent) and the pressure from this vein is feeding into the surface veins. This situation is only identified by a Duplex ultrasound scan performed before treatment to thoroughly evaluate the condition of the deeper veins.
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