RT Book, Section A1 Chansky, Peter B. A1 Rieder, Evan A. A2 Baumann, Leslie S. A2 Rieder, Evan A. A2 Sun, Mary D. SR Print(0) ID 1190669593 T1 Sclerotherapy T2 Baumann’s Cosmetic Dermatology, 3e YR 2022 FD 2022 PB McGraw Hill LLC PP New York, NY SN 9780071794190 LK dermatology.mhmedical.com/content.aspx?aid=1190669593 RD 2024/03/28 AB SUMMARY POINTSWhat’s Important?Telangiectasias, venulectasias, dilated reticular veins, and torturous varicose veins are common age-related manifestations of chronic venous hypertension and valvular incompetence. A multifactorial pathogenesis is implicated in the development of lower extremity venous disease, including hereditary, hormonal, gravitational, thrombotic, and sedentary factors.Sclerosing agents produce their clinical effect through the permanent fibrosis and destruction of the vessel wall. Treatment guidelines include utilization of both the smallest quantity and lowest concentration of sclerosing agent to produce venous wall fibrosis and the treatment of larger, proximal veins before the treatment of smaller, distal veins.Common complications following sclerotherapy include hyperpigmentation, telangiectatic matting, and cutaneous ulceration and necrosis. Implementation of graduated compression for 2–3 weeks after sclerotherapy is essential to reduce the risk of complications and endovascular recanalization.Cosmetic treatment of superficial leg veins with sclerotherapy is an effective, safe, and satisfying treatment modality. Proper assessment, utilization of duplex ultrasonography, and knowledge of both sclerosing agents and injection techniques are critical to a successful outcome.What’s New?Sclerotherapy combined with laser treatment has demonstrated enhanced clinical outcomes.Duplex ultrasonography is a helpful resource to provide real-time guidance of sclerotherapy for the treatment of deep leg veins with a foamed sclerosant.What’s Coming?Novel endovenous ablation devices and sclerosants are potential future advancements in the treatment of medical and cosmetic venous disease.