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Sclerotherapy in Aesthetic Medicine: Myths and Realities

BACKGROUND Sclerotherapy is commonly performed for elimination of reticular and telangiectatic leg veins. There are several variations in practice, from the preparation to post-therapy directives. OBJECTIVE To critically examine the misconceptions of sclerotherapy for aesthetic indications. MATERIALS AND METHODS This review assesses evidence for and against each of the most common myths regarding sclerotherapy for aesthetic indications. RESULTS Sclerotherapy can be safely used to treat veins in areas other than the lower extremities, with the exception of the face. Laser therapy is not superior to sclerotherapy for the treatment of small telangiectatic veins on the lower extremities. The type of syringe used to produce foam sclerotherapy is an important procedural consideration. After sclerotherapy, graduated compression stocking usage is a vital part of the procedure. Detergent sclerotherapy agents are similar, but not equivalent. Touch-up treatments after sclerotherapy should not be performed for 2 months post-treatment. Foam sclerotherapy does not have a high risk for air emboli. It is not advisable to treat the leg veins in “sections.” Finally, one cannot reliably treat the telangiectatic veins without treating the feeding reticular veins for a satisfactory result. CONCLUSION Many aspects of sclerotherapy have existing evidence to dictate best clinical practice.