What concentration and when?
‘One of the most important concepts in sclerotherapy is that of achieving optimal destruction of the blood vessel wall with the minimum concentration of sclerosant necessary for a clinical result. Too high a concentration leads to adverse sequelae’.
Goldman & Bergan – Sclerotherapy. Treatment of varicose and telangiectatic leg veins 2001
Concentration guidelines
Below is a guide to the appropriate concentration of Fibrovein to use for a given size of vein. The guide is approximate since the effect will vary slightly from patient to patient and according to technique. Too high a concentration can lead to adverse effects such as pain, necrosis and pigmentation. Spider and thread veins are best treated with 0.2% Fibrovein.
| Vein diameter | Fibrovein concentration |
| <1.0mm | 0.2% liquid |
| 1-3mm | 0.5% liquid |
| 3-5mm | 1% foam |
| +5mm | 3% foam |
Adapted from the European Guidelines for Sclerotherapy (Rabe et al., 2014) and Bush and Bush (2017)
Comparison with polidocanol
Fibrovein is an anionic detergent whereas polidocanol is a non-ionic detergent; by and large the anionic detergents are the more powerful surface active agents. Fibrovein is more surface active than polidocanol and therefore should be used at lower concentration. Where practitioners have previously used polidocanol then caution should be exercised when they start to use Fibrovein. They should use Fibrovein at half to one third the strength of polidocanol for the same size vein. Using too high a concentration of Fibrovein can result in increased incidence of adverse sequelae such as pigmentation and necrosis.
| Vein diameter | Fibrovein concentration | Approx Polidocanol concentration |
| < 0.5mm | (0.1%) | 0.25% |
| 0.5-1.0mm | 0.2% | 0.5% |
| 1-3mm | 0.5% | 1% |
| 3-5mm | 1% | 2% |
| +5mm | 3% | 3% |
Kobayashi et al., (2006); Bush and Bush, (2017); Thibault, (1999)
Diluting Fibrovein
Diluting Fibrovein is not recommended but if all strengths are not registered in your country and dilution is unavoidable please contact us for details.