Hyperpigmentation After Sclerotherapy Management

Abstract

Introduction: Varicose tributaries and spider veins are a widespread problem, especially in female patients. Yet this pathology doesn't influence the functionality of the extremity, it decreases life quality. Many women feel embarrassed with the bluish legs, thus trying to hide the 'imperfection' with special clothes or avoiding public places. Sclerotherapy is a cost-effective and relatively simple procedure that provides an excellent cosmetic effect in short time. No hospitalization is needed, no special regime is prescribed, the patient can get back to everyday activity in a half-hour after the procedure. In some cases, it is the only option for treatment. Time-effectiveness is also the key in a modern rapidly moving world. Methods: A prospective study was made in AngioLife vascular center. One hundred twenty-six patients after sclerotherapy were analyzed from April 2018 to January 2019. 87% female, 13% male, predominantly Caucasians (98%). Spider veins in 70% of cases and varicose tributaries in 30%. We used Aethoxysclerol as a sclerosant agent in all cases. We usually use a 3ml syringe with a 31G needle for spider veins. 10ml syringe and 25G needle for veins bigger than 2mm and 27G needle in smaller veins. No more than 8ml of sclerosant agent in total per session. The concentration was as recommended by the manufacturer. Sulodexide orally 25mg per day and Diosmine 600mg daily were prescribed to 60 patients. Diosmin 600mg orally alone was prescribed to 66 patients of the control group. Results: Photographic control was made the day after sclerotherapy, in 7 days, one month and three months after the procedure. The incidence of hyperpigmentation was 10% in patients with spider veins and 25% in patients with varicose veins in one-month follow-up in all groups. Three months' follow-up showed a significant decrease of skin discoloration rate in Sulodexide group: 2% of patients with spider veins and 10% of patients with varicose veins had brownish signs visa 8% and 20% respectively in the control group. Almost 5% of patients had signs of matting on sclerotherapy site in both groups. No adverse events, such as bleeding were observed in the Sulodexide group. Conclusion:-The use of Sulodexide seems to be effective in management and prophylactic of post-sclerotherapy hyperpigmentation-Further research is needed to evaluate effectiveness and safety of Sulodexide Disclosure: Nothing to disclose