The Use of Proteolytic
Enzymes in Sclerotherapy

The American Vein and Lymphatic Society
Lomax, John E. M.D.


The purpose is to evaluate the potential efficacy of oral proteolytic enzyme supplements in the reduction of post-sclerotherapy morbidity. Thirty patients were placed in a double-blind study using a placebo and a specific oral enzyme preparation. The post-sclerotherapy symptoms examined were ecchymosis, edema, and pain. All patients underwent sclerotherapy for lower extremity telangiectasias and varicose veins up to 6mm in diameter. Following sclerotherapy with either sodium morrhuate or tetradecyl sodium, the patients were placed in com­pression garments. They were evaluated on Day 3, Day 10, and Day 20. Those patients receiving the oral enzyme supplement demonstrated a significant reduction in the duration and severity of post-sclerotherapy morbidity. This study would indicate a benefit to patients who receive oral proteolytic enzymes in the post-sclerotherapy period. This benefit did not appear to be age, sex, or vessel-size related. The benefits received are not dose or skill related but determined by patient’s response to the therapy.