Cosmetic applications of sclerotherapy.

The aim of this study was to broaden practitioner perspectives regarding the scope, safety, and efficacy of sclerotherapy for cosmetically unattractive veins and other conditions involving a variety of anatomical sites. The author wrote a review of results obtained following cosmetic sclerotherapy for both veins and in other applications is presented. This study involves hundreds of patients treated in a private phlebology practice spanning 33 years along with a brief review of pertinent literature. Since treatment of dilated veins involving the dorsa of the hands and face are rarely discussed, and widely performed, their treatment will be emphasized. The largely historical usefulness of sclerotherapy for other applications is also reviewed. As with lower extremity veins there was a great deal of both regional and patient-to-patient variability in terms of sensitivity to sclerosants and response to treatment. However, sclerotherapy carried out for cosmetic purposes has routinely produced satisfactory results for various applications and in a multiplicity of locations. Potentially serious complications and treatment failures were rare in properly selected patients. Patient satisfaction with a few exceptions was uniformly high. The addition of cosmetic sclerotherapy to an established phlebology practice can be a rewarding and highly satisfactory application of this versatile technique. Both treatment site, lesion type and the cosmetic nature of this therapy affects every aspect of treatment; legal, ethical, and procedural. Experience suggests that each area and type of lesion treated exhibits predictable patterns of response and risks. Vein treatment outcomes varying with anatomical site may reflect: 1) evolutionarily adaptive processes which have produced veins specialized for specific environments; 2) differences in patterns of cytokine recruitment and apoptotic processes. It should also be noted that potential complications reflect area specific patterns of venous anastomoses, nerves, vital structures, and the complexities of arterial architecture.