Sclerotherapy for superficial venules and telangiectasias of the lower extremities

Sclerotherapy remains the best single treatment for telangiectasias and superficial venules of the lower extremities. It has been used successfully for decades. It is, however, a somewhat tedious and time-consuming procedure and requires great patience on the part of the physician. With careful attention to the details of the procedure and with necessary practice and experience on the part of the physician, a good result will be obtained. To summarize: Use one of the safe, modern sclerosing solutions: hypertonic sodium chloride 18 to 25 per cent, Aethoxysklerol 0.25 to 1.0 per cent, or Sclerodex. Good illumination, liberal use of alcohol on the skin, and 2 to 3 X magnification will increase the visibility of the tiny vessels. Use 3-ml Luer-Lok syringes and 30-gauge needles and thread the needle carefully into the vessel while using slow and steady injection with light pressure. Always provide post-treatment compression with cotton balls, tape, and compression hosiery. Because the majority of patients are most gratified, serious risks are minimal, and most side effects are of a transitory nature, sclerotherapy is a most worthwhile technique to master and include in one's armamentarium of simple, office-based cosmetic dermatologic procedures.