Professional Sclerotherapy Training for Medical Doctors in South Africa


Used for the treatment of spider veins or telangiectasia and, less commonly, of varicose veins for more than 150 years, the practice that is now known as sclerotherapy was, in earlier times, undertaken by laypeople with no formal training. More recently, however, it has been recognised that in inexperienced hands, and because it involves the injection of a solution into a vein, the procedure carries a small but significant element of risk. It has therefore become subject to stricter regulations and today, for example, it may only be conducted by a trained, medical doctor in South Africa.


The underlying principle is a surprisingly simple one. The unwanted vessels, which may be lymphatic as well as venous, are injected with a special fluid known as a sclerosant with the result that they first begin to shrink and then, over the course of a few weeks, will gradually dissolve until absorbed naturally by the body with the aid of its immune system. Unlike vein stripping surgery, sclerotherapy is essentially a minimally-invasive procedure which, with the appropriate training, is now providing doctors and their patients throughout South Africa and worldwide with a faster, safer and markedly less costly alternative that only requires minimal downtime.


Widely regarded by medical aesthetics practitioners as the “gold standard” for the treatment of large spider veins and smaller varicosities, it offers a significant advantage over the use of lasers. This is because the sclerosant solution also acts to seal off the feeder vessels that originally gave rise to these malformations and this ensures that, once treated, these anomalies will be far less likely to reform later. This form of treatment therefore has the potential to offer patients a more permanent solution than is possible with the use of laser therapy.


Treatment techniques have continued to evolve and so, to be of value, professional training courses offered in South Africa are required to cover advances such as foam sclerotherapy. In this variation, the technique requires the use of multiple silicone-free syringes or pumps, and involves injecting a combination of sclerosant drugs, such as sodium tetradecyl sulphate and air or carbon dioxide into the affected vessels. The foaming effect that results serves to increase the surface area of the vessel that is in contact with the chemical sclerosant, thickening the vessel walls and sealing off feeders fare more effectively than the use of a liquid sclerosant alone.


In this augmented form, the procedure even becomes effective for the treatment of larger varicosities, such as those that commonly affect the great and small saphenous veins of the leg. An ultrasound scan is first used to map the varicose veins, and then to monitor the progress of the injected sclerosant in real time. In addition, an ultrasound scan may be used for follow-up checks to confirm the closures of feeder veins and to identify any residual areas that are likely to benefit from further sclerotherapy treatments.


Expert professional training in these procedures is available to medical doctors in South Africa from the Medskills Training Academy. In order to maximise on personal attention and ensure sufficient practice, classes are limited in size and all instructors are themselves qualified doctors with proven teaching abilities, and actively engaged in the various techniques that they cover.