Sclerotherapy factsheet

Introduction

Sclerotherapy is a procedure used to treat vascular malformations, which are abnormal vessels in the body that become tangled or enlarged.

Depending on their location, they can cause: 

  • pain
  • swelling
  • bleeding.

Sclerotherapy is used to treat different types of vascular malformations, including:

  • lymphatic malformations – sponge-like fluid-filled pockets or cysts filled with lymph, a clear fluid like the liquid in a blister. They can appear anywhere, but are most common in the neck, armpits, and groin.
  • venous malformations – abnormal veins that grow too large and tangled. They can develop in the skin, muscles, soft tissues, or internal organs.
  • some arteriovenous malformations – abnormal connections between arteries and veins.
  • a combination of the above.

In sclerotherapy, a medicine called a sclerosant is injected into the abnormal vessels. This irritates the vessel, shrinking the malformation and which eventually disappears. 

Your child’s doctor may suggest sclerotherapy if:

  • the malformation could affect their eyes or airways
  • there is a risk of infection, bleeding, or blood clots
  • it affects their ability to move, such as walking, running, playing sports, or using their hands
  • they experience pain or discomfort
  • there are concerns about how it affects their appearance
  • treatment is needed to prevent future problems, such as blood clots.
     

 Preparing for treatment

Scans and tests

Before treatment, your child may need:

  • ultrasound and MRI scans – to get clear images of the malformation and help plan the treatment
  • blood tests – to check for any clotting problems that may need to be managed before the procedure.

Compression Garments

Some children may need to wear a compression garment after treatment. These tight-fitting pieces of clothing help reduce swelling and lower the risk of side effects like blood clots.

Compression garments are custom-made, so your child will need to be measured and fitted at least three weeks before treatment.

Fasting

Your child will be given a general anaesthetic during the procedure. This means they will be asleep and won’t feel pain.

Before anaesthesia, your child must stop eating and drinking for a certain period. This is called fasting nil by mouth. It stops food or fluids from entering their airways while asleep.

Your child’s treatment team will give specific instructions on when to start fasting nil by mouth before the procedure.

During treatment

Sclerotherapy is usually a day procedure, meaning your child can go home the same day. Some children may need to stay overnight for monitoring, especially if they have larger malformations or ones in the head and neck.

Before the procedure, the doctor will check the malformation using an ultrasound and sometimes X-rays. 

In some cases, they may decide not to go ahead if there is a high risk of the medicine spreading to nearby areas.

Sclerotherapy for Different Malformations

Venous malformations – The radiologist injects the sclerosant into the abnormal veins, causing irritation that makes them shrink or close.

Lymphatic malformations – The radiologist first removes fluid from the cysts before injecting the sclerosant. This helps the cysts harden and shrink over time.
 

 After treatment

After the treatment, pressure dressings will be applied to help with healing. If your child has a compression garment, it will be applied while they are asleep during treatment.

Your child can go home once the doctors and nurses are happy with their recovery.

Your child can eat and drink normally when they feel ready. 

They may experience mild side effects from the anaesthesia, like:

  • nausea
  • headache
  • sore throat
  • dizziness.

These should pass quickly.

There may be some swelling after treatment. This should improve after a few days and go away within two to three weeks.

Your child may also have some mild pain and bruising for a few days. This can be managed with over-the-counter pain relief, like paracetamol or ibuprofen.

 Management

Spacing of treatments

Your child may need three or four sclerotherapy treatments, spaced four to six weeks apart. These can be booked in advance or scheduled one at a time.

Some children need more or fewer treatments, depending on how they respond. The treatment plan will be reviewed and adjusted as needed.

Returning to school and sport

Most children can return to school or childcare a few days after treatment. 

They can start playing sports again after three weeks, as long as they feel comfortable.

When to see your doctor

All medical procedures, including sclerotherapy, carry some risks. Possible complications include:

  • swelling
  • infection
  • blood clots.

See your local doctor as soon as possible, or go to the nearest emergency department if your child has:

  • redness, warmth, or tenderness around the treated area
  • pus or fluid leaking from the area
  • red streaks spreading away from the treated area
  • fever
  • severe pain
  • sudden swelling
  • pain, throbbing, or cramping
  • unusual sensitivity in the treated area.

Speak to your child’s doctor if you have any concerns after the procedure.