Pulsed-dye lasers may be helpful to reach those vessels that are too small to be injected. Allergic reactions cannot occur and it does not cause permanent staining of the skin at the injection sight. We also use Sotradecol which is a detergent type of sclerosing agent. Pressure over the larger vessels after sclerotherapy causes them to respond better to treatment. Larger vessels can also be treated, but may need surgery, and vascular studies prior to treatment.
Side effects are uncommon.
They include brown spots or small crusts or ulcerations at the injection sights. If a brown streak occurs along the course of the treated vessel, it will fade without treatment. Some vessels may require two to four treatments before responding completely. Ankles frequently swell for a few days after they are treated. Thrombophlebitis of the treated vessel occasionally occurs.