Duration of therapy with compression stockings following Sclerotherapy for Spider Veins (telangiectasisas)

There are varying recommendations across the board by phlebologists for the use of compression therapy following sclerotherapy for telangiectasias (spider veins).  The recommendations vary from practice to practice, from country to country, and from one published scientific paper to another. There are no uniform guidelines for the use of compression therapy following sclerotherapy for telangiectasias.

Telangiectasias are intradermal dilatations of subpapillary venous plexus and measure less than 1 mm in diameter.  They are classified as CEAP C1 in the classification of venous disease.

Studies have been done and published which showed great diversity of methods used with most phlebologists recommending the use of 20 mm Hg to 40 mm Hg grade compression stockings.  Recommendations are to wear them for as little as 24 hours to three weeks and to three months.  Some authors have shown that compression was effective or is effective in telangiectasias that are larger than half millimeter in diameter. Others recommend the use of compression stockings for all telangiectasias that are treated with sclerotherapy.

In a study performed by Dr. Weiss which was published in Dermatologic Surgery 1999; volume 25, pages 105 - 108, the best effect was noted in patients who wore stockings for three weeks.  In another study performed by Philippe Kern, MD, Albert-Adrien Ramelet, MD, Robert Wütschert, MD, and Daniel Hayoz, MD which was published in the Journal of Vascular Surgery 2007; Volume 45, Issue 6, June 2007, Pages 1212–1216, wearing compression stockings (23 to 32 mmHg) for 3 weeks enhance the efficacy of sclerotherapy of leg telangiectasias by improving clinical vessel disappearance.  It also showed that a certain benefit of compression was already observed after 3 days and 1 week.

At Venasmart, we recommend compression stockings use for three months following injection sclerotherapy for telangiectasias.

The use of compression stockings following sclerotherapy is believed to enhance the effect of sclerosing solutions by:

1. Reducing the formation of post sclerotherapy thrombus
2. By reducing pigmentation.
3. By reducing telangiectatic matting
4. and by minimizing postsclerotherapy inflammation and angiogenesis.  Angiogenesis is neovascularization following hypoxic injury to tissue.

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