Am J Physiol Endocrinol Metab 282: E551–E556, 2002. First published October 30, 2001; 10.1152/ajpendo.00352.2001. Effect of ibuprofen and acetaminophen on postexercisemuscle protein synthesisT. A. TRAPPE,1 F. WHITE,1 C. P. LAMBERT,1 D. CESAR,2M. HELLERSTEIN,2 AND W. J. EVANS11 Nutrition, Metabolism, and Exercise Laboratory, Donald W. Reynolds Center on Aging,Departments of Geriatrics and
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Microsoft word - sclero instructions.4.09.final.doc
Sclerotherapy is an injection treatment used to eliminate small size varicose veins and “spider”
veins. Small varicose veins are 1 or 2 mm in diameter, about the width of the letter “n or m” on
this page. Spider veins are tiny blue or red veins commonly seen on the legs. Spider veins
usually appear spontaneously and become noticeable over time as they increase in size and
number. The small varicose veins and spider veins discussed here are cosmetic in nature and
almost never account for any pain felt in the leg, even at the site of the vein itself.
Sclerotherapy irritates the vein causing inflammation and eventually disappearance of the vein
over several weeks to months. This is achieved by introducing medicine into the vein with a very
small needle. There is minimal sensation involved from the small needle.
The plan for treatment varies from patient to patient depending on the type, size and quantity
of veins to be treated. Treatment sessions take approximately 20 to 30 minutes. After the
treatment we require the use of support hose with 20-30mm hg pressure to cover the treated area.
Results: It is important to realize that the best results require patience and time to achieve. It
takes time for your body to respond to the injections. Each area of spider veins may need to be
treated several times for the majority of the veins to go away. Sclerotherapy is similar to treating
acne with a topical medication – you have to apply it several times to see results.
Post treatment: wear support hose the day of the treatment and the following day. We
encourage you to walk as much as tolerated, but discontinue strenuous exercise for the day of the
treatment, overnight and the following day, resuming on the second day after treatment. You
may shower daily. It is best not to soak in bath tub or hot tub for at least 48 hours.
Possible Side Effects:
• Itching- you may experience itching around the area injected. If this occurs, it is usually
mild and lasts for one to two days. If itching is significant, Benadryl tablets, 25 mg (over the counter) may be used. • Pain- patients may have some tenderness at the injection site. Injection of the sclerosing
agent is rarely uncomfortable although there may be some sensation with the injection. This is usually well tolerated by most patients. Acetaminophen (Tylenol) can be used if needed, according to product directions. • Bruising- may occur at the injection site and generally resolves in a week or so.
Planning your sclerotherapy treatment schedule should account for bruising with regard to any social occasion which may have you exposing the treated area. • Skin Pigmentation may be noted months after injections. This pigmentation is
infrequently seen. Spider veins and varicose veins carry blood which can either be trapped inside the treated vein or leak outside the vein after sclerotherapy. Occasionally this blood is not immediately cleared away by your body resulting in the blood dwelling in the tissues for a period of time before it is naturally removed. The breakdown and absorption of this blood can result in a light brown discoloration in the skin over the treated veins. This discoloration fades over time and is rarely persistent. Disappearance occurs over about a year. • Darkened vein segments may be noted after sclerotherapy. This is a vein with blood
trapped inside during the healing process. This is normal and will resolve. We often use a small needle to empty the blood from the vein segment at the next appointment. You can easily feel the trapped blood with your fingertips. • Sun exposure after sclerotherapy requires use of sun block to prevent enhanced sun
exposure to the skin where the veins were injected.
Rare Side Effects:
• Ulceration at injection site- very rarely a small ulcer will occur at the site where the
vein is injected. An ulcer can take several weeks to completely heal. A small scar may result. • Allergic reaction- there is a very rare incidence of an allergic reaction to the solution
injected. Please inform us of any allergic history.
Sclerotherapy Pre-Treatment Instructions:
• Leg Preparation- do not use oil, lotion or powder on your legs the night before or the
• Clothing- bring a pair of loose, comfortable shorts to wear during your treatment. Dress
• Medications- you should avoid the use of aspirin and/or ibuprofen for a five days before
and after the treatment if possible. The use of these medications could increase the amount of bruising you may develop.
Sclerotherapy Post-Treatment Instructions:
• Compression Hose- these are required to be worn immediately after each treatment.
Hose can be purchased at our office. We recommend thigh high support hose or pantyhose with 20 to 30 mmHg compression. The hose should be worn the day of the treatment, overnight and the following day. Sometimes you will be instructed to wear the hose daily during the waking hours for several more days. We carry the necessary support hose for purchase in our office for your convenience. • Driving- you may drive immediately after your treatment. If your trip home is more than
an hour, we recommend that you stop hourly to stretch your legs. • Bathing- you may remove your compression hose and shower daily. Hot tubs and hot
baths should be avoided for 48 hours (or longer) after sclerotherapy. It is thought that the warm water will dilate the veins and may diminish the effect of treatment. • Activities- you may return to work and resume normal activity except exercise
immediately after treatment. Exercise will bring more blood into the leg and will dilate the veins which may diminish the effect of the treatment. Avoid high impact aerobics, jogging, running, leg weight lifting and sit-ups until the second day after treatment. Resume full speed day 2 • Follow-up- The doctor or nurse will advise you when you should return for subsequent
treatments. Generally your second treatment will be scheduled within 2-3 weeks after the initial treatment. Remember it is important to call our office if you have any questions or concerns before or after your sclerotherapy treatment. • The number of treatments you require will be estimated before your first treatment.
This is an estimate. Essentially, patients need enough treatments to the individual veins to fully injure the veins prior to giving the body several months healing time so that the majority of veins will disappear. • Follow up treatments- Spider veins which become noticeable months or years after
treatment are new spider veins, not the “old ones that are back.” One or two touch up treatments is usually all that is needed at that time. Many patients who have completed their sclerotherapy return every one to two years for a touch up treatment.
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