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Sclerotherapy of Telangiectasias: A Painless Two‐Step Technique

BACKGROUND Sclerotherapy of telangiectasias and reticular leg veins can be unpleasant and painful for some patients. OBJECTIVE To determine pain level with two different sclerotherapy techniques in a prospective randomized trial. METHODS Patients with symmetrical telangiectasias and reticular veins on both legs (C1A or SEPASPN1) were randomized to the standard (successive injections of chromated glycerin mixed with one‐third lidocaine‐epinephrine 1%) or two‐step technique (first treating only reticular veins with a single injection at the base of each cluster of telangiectasias and then successively injecting all remaining telangiectasias a few minutes later. Pain was assessed using a 100‐point visual analogue scale (0 = no pain, 100 = maximum pain). RESULTS Data from 53 consecutive patients could be evaluated. The two‐step technique was significantly less painful (28.2) than the standard technique (40.6, p < .001). CONCLUSION The two‐step technique with chromated glycerin mixed with one‐third lidocaine‐epinephrine 1% significantly reduces sclerotherapy pain. This may be a useful technique for patients who are particularly sensitive or afraid of sclerotherapy.