Combination Foam and Liquid Sclerotherapy for Lower Extremity Reticular and Telangiectatic Veins: A Single-Center Retrospective Study

BACKGROUND Lower extremity reticular and telangiectatic veins are of common cosmetic concern. OBJECTIVE To retrospectively evaluate results of lower extremity sclerotherapy using a combination of foam and liquid sclerosing agents. METHODS A retrospective chart review of sclerotherapy patients at a dermatology practice (January 2014 to April 2023) was performed. RESULTS Eight hundred and nine patients (775 women and 34 men) with a mean age of 49.6 ± 12.2 (18–84) years underwent a mean 1.4 ± 0.7 (1–7) sessions. Multiple different sclerosing agents were used, with 0.2% sodium tetradecyl sulfate foam/liquid predominating, although 72% glycerin liquid and 0.25% to 0.5% polidocanol foam/liquid were also used. Coagula occurred in 61.0% of patients at 2 weeks and 6.4% at 3 months, whereas postsclerotherapy hyperpigmentation was seen in 5.0% and 19.1% of patients at the same time points. Both were more common after first-round treatment, each with a trend toward decreased frequency with increasing session number. Telangiectatic matting was found in 2.3% of 3-month follow-up patients. Edema, superficial venous thrombophlebitis, migraines, and ulceration were rarely seen. Significant clinical improvement was noted in 72.0% of treatments. CONCLUSION This retrospective chart review, the largest to date of its kind, confirms the safety and efficacy of cosmetic lower extremity sclerotherapy with a combination of foam and liquid sclerosing agents.