Sclerotherapy in Aesthetic Medicine: Myths and Realities

Combination Foam and Liquid Sclerotherapy for Lower Extremity Reticular and Telangiectatic Veins: A Single-Center Retrospective Study

BACKGROUND

Lower extremity reticular and telangiectatic veins are of common cosmetic concern.

OBJECTIVE

To retrospectively evaluate results of lower extremity sclerotherapy using a combination of foam and liquid sclerosing agents.

METHODS

A retrospective chart review of sclerotherapy patients at a dermatology practice (January 2014 to April 2023) was performed.

RESULTS

Eight hundred and nine patients (775 women and 34 men) with a mean age of 49.6 ± 12.2 (18-84) years underwent a mean 1.4 ± 0.7 (1-7) sessions. Multiple different sclerosing agents were used, with 0.2% sodium tetradecyl sulfate foam/liquid predominating, although 72% glycerin liquid and 0.25% to 0.5% polidocanol foam/liquid were also used. Coagula occurred in 61.0% of patients at 2 weeks and 6.4% at 3 months, whereas postsclerotherapy hyperpigmentation was seen in 5.0% and 19.1% of patients at the same time points. Both were more common after first-round treatment, each with a trend toward decreased frequency with increasing session number. Telangiectatic matting was found in 2.3% of 3-month follow-up patients. Edema, superficial venous thrombophlebitis, migraines, and ulceration were rarely seen. Significant clinical improvement was noted in 72.0% of treatments.

CONCLUSION

This retrospective chart review, the largest to date of its kind, confirms the safety and efficacy of cosmetic lower extremity sclerotherapy with a combination of foam and liquid sclerosing agents.

Pycnogenol® prevents skin hyperpigmentation following sclerotherapy

BACKGROUND

The aim of this registry supplement study was to evaluate the effects of the oral supplement Pycnogenol® on possible skin discolorations or other minor skin changes after varicose vein sclerotherapy in comparison with a standard management (SM).

METHODS

One hundred sixty-one subjects completed the study. 84 took Pycnogenol® from the day before sclerotherapy for 12 weeks and followed SM. 77 followed SM only and served as controls. 420 injection sites were followed-up in the Pycnogenol® group and 431 in the control group. The number of injected veins (using only Aetoxysklerol) was on average 4-8 veins/patient. No side effects were observed for the SM or for supplementation. Pycnogenol® supplementation showed a good tolerability. The two management groups were comparable for age, sex and veins distribution at inclusion.

RESULTS

After 12 weeks, skin discoloration assessed by a skin staining score was generally significantly lower and less frequent (P<0.05) with Pycnogenol® with a score of 0.4±0.2 compared to controls (with a score of 2.1±0.4). In addition, the number of stains per treated vein was significantly lower in the Pycnogenol® group than the control group.

CONCLUSIONS

Varicose vein sclerotherapy is a minimally invasive procedure almost without complications. Pycnogenol® intake appears to improve healing and prevent skin discolorations after injection of the sclerosing agent. To verify this effect of Pycnogenol®, more studies for a longer period are needed.

Sclerotherapy off the Lower Extremities: A Single-Center Retrospective Study of Veins Treated on the Dorsal Hands and Chest

BACKGROUND

Few studies have evaluated the safety and efficacy of treatment of cosmetic dorsal hand and chest/breast veins.

OBJECTIVE

To retrospectively evaluate results of dorsal hand and chest vein foam sclerotherapy.

MATERIALS AND METHODS

A retrospective chart review of dorsal hand and chest vein sclerotherapy patients at a dermatology practice was performed between January 2014 and April 2023.

RESULTS

Fifty-five patients (54 female and 1 male patients) with a mean age of 55.8 ± 10.5 (31-83) years underwent treatment. Mean number of sessions for dorsal hand ( n = 41) and chest ( n = 14) patients were 1.5 ± 0.9 (1-5) and 1.6 ± 1.2 (1-5), respectively. Both groups were predominantly treated with 0.2% sodium tetradecyl sulfate or 0.5% polidocanol foam. Rate of coagulum formation across all sessions in the dorsal hands and chest was 15.2% and 3.0%, respectively. Vein induration, edema, postsclerotherapy hyperpigmentation, and persistent erythema were rarely seen. No patients experienced superficial venous thrombophlebitis, erosion/ulceration, telangiectatic matting, or neurologic side effects. Seventy-five percent and 63.2% of chest and hand patients, respectively, demonstrated significant clinical improvement at 3-month follow-up, although not systematically evaluated.

CONCLUSION

Foam sclerotherapy of dorsal hand and chest veins with detergent sclerosing agents is safe and effective with mild, self-limited adverse events.