Egypt, J. Plast. Reconstr. Surg., Vol. 40, No. 1, January: 89-95, 2016 Comparative Study between Injection Sclerotherapy with Polidocanol 1% Versus Injection Sclerotherapy with Polidocanol 1% Followed by Intensive Pulsed Light in the Treatment of Lower Limb Minute Varicosities TALAL A. ABDEL RAHEEM, M.D.; WALEED S. ALDABAANY, M.D.*; SHREEN ADEL, M.D. and MAI ASHRAF, M.Sc. The Departments of Dermatology and Plastic Surgery*, Faculty of Medicine, Fayoum University, Fayoum, Egypt ABSTRACT Background: Varicose veins are veins that have become enlarged and tortuous. Sclerotherapy is a well-tolerated and highly efficacious treatment for varicose and telangiectatic leg veins. IPL is high-intensity light source, which emit polychromatic light with noncoherent broad wavelength spectrum of 515-1,200nm. The basic principle of IPL devices is a more or less selective thermal damage of the target. Patients and Methods: The present study included 30 female patients with bilateral primary varicosities. All patients subjected to general and local examination and venous duplex ultrasonography to exclude saphenofemoral, saphenopopliteal or any perforator incompetence. Then the patients were categorized in to 2 groups: Group (A) performed injection sclerotherapy with POL 1% only and group (B) performed injection sclerotherapy with POL 1% followed by 4 sessions of IPL on residual very small telangiectasias that couldn’t be injected. Results: Our study showed that there was no statistically significant difference between the two groups as regarding the overall patient and physician satisfaction (p-value >0.05). Conclusion: In conclusion we don’t advice to follow the injection sclerotherapy by intense pulsed light as it didn’t improve the satisfaction neither of the patients nor of the physician. Key Words: Sclerotherapy – Polidocanol – Varicosities. INTRODUCTION Varicose veins (VVS) are veins that have be- come enlarged and tortuous. This term commonly refers to the veins on the leg. Although VVs can occur elsewhere [1]. Varicose veins are more common in women than men, and are linked with heredity [2]. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury, and abdom- inal straining. Less commonly, but not exception- ally, VVS can be due to other causes, as post 89 phlebitic obstruction or incontinence, venous and arteriovenous malformations [3]. Sclerotherapy is highly effective treatment for telangiectatic leg veins. Sclerosing solutions act by inducing endothelial damage endosclerosis, which lead to endofibrosis of the treated vessels. Sclerosing solutions can be placed into three broad categories based on their mechanisms for producing endothelial injury: Detergent as sodium tetradecyl sulphate (STS) and polidocanol (POL), Osmotic as hypertonic saline, and chemical irritant solutions as chromate glycerin. Effective sclerotherapy results when the endothelial damage and associated vas- cular necrosis are sufficient to destroy the entire vessel wall [4]. After review of literatures, we found some studies that evaluated effect of intense pulsed light (IPL) on the leg telangiectsias treatment. Most studies report good result of smaller vessels. Goldman et al., demonstrated a 90% clearance rate of 159 patients with vessels of <0.2mm diam- eter and of 80% in vessels of 0.2-1mm in diameter [5]. Also, Schroeter et al., observed similar results and reported clearance rates of 92.1, 80, and 81% in vessels of <0.2, 0.2-0.5, and 0.5-1mm diameter in their multi-center study of 40 patients. Intense pulsed light seems to be most effective for superficial, red telangiectasias less than 1mm [6]. PATIENTS AND METHODS This study was conducted over 10 months from March 2014 to January 2015 on outpatient clinic