Effectiveness of liquid versus foam sclerotherapy with or without herbal gel in treating telangiectasia and reticular veins: A randomized controlled trial.

Abstract

BackgroundTelangiectasia and reticular veins are usually not a medical problem. More often, people are concerned with the aesthetic issues they cause. Reticular veins, unlike telangiectasia, are often annoying or painful. The more reticular veins you have in an area, the more annoying they will become. Sclerotherapy is an accepted treatment modality for reticular varicose veins and telangiectasia, in this study we compare between liquid and foam sclerotherapy and the effect of herbal gel application post procedural to reach the optimum results.MethodsThis single-centre, prospective randomized controlled trial enrolled a total of 574 patients who were initially assessed for eligibility. Thirty-nine patients did not meet the inclusion criteria ultimately after exclusion, 508 patients were randomized, with approximately 127 patients allocated to each group. Seventeen patients did not complete follow-up. Patients were randomized into four equal groups: group A: Liquid sclerotherapy without herbal gel, group B: Liquid sclerotherapy with herbal gel, group C: Foam sclerotherapy without herbal gel and group D: Foam sclerotherapy with herbal gel. The primary outcomes were clinical or photographic resolution or improvement of telangiectasias and reticular veins and patient satisfaction. Secondary outcomes included adverse events (hyperpigmentation, bruising, anaphylaxis, pain at injection site (during and after procedure) and time to resolution.ResultsResolution differed significantly among groups (p = 0.021). Foam sclerotherapy (Groups C and D) demonstrated faster improvement and higher VAS satisfaction scores compared to liquid sclerotherapy, with Group D achieving the highest satisfaction (p < 0.001). Time to improvement was significantly shorter in Groups C and D (p < 0.001). Adverse events did not significantly differ between groups and were transient and self-limiting.ConclusionFoam sclerotherapy demonstrated superior efficacy, faster clinical improvement, and higher patient satisfaction compared to liquid sclerotherapy, particularly when combined with post-procedural herbal gel application, which further enhanced resolution rates and overall patient outcomes.