Impact of previous skin hydration on postsclerotherapy hyperpigmentation: a prospective, randomized, comparative study (SKINCARE Study).

Mariana Borges Firmo, Samantha Neves, Maria F Portugal, Viviane Santana DA Silva, Emanuel Firmo, Isabela Leal, Taina Ribeiro DE Azevedo, Fabricio Rodrigues Santiago, Walkiria Hueb Bernardi, Roberto A Caffaro, Eduardo Ramacciotti

Journal: International angiology : a journal of the International Union of Angiology 2026;45(4):244-249

PMID: 42803197

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Abstract

BACKGROUND

Postsclerotherapy hyperpigmentation (PSH) is a frequent and distressing complication. It is a cosmetic concern in aesthetic phlebology, with limited prospective efficacy/safety data. Skin hydration with moisturizer strengthens the skin barrier and may potentially prevent postsclerotherapy hyperpigmentation.

METHODS

This prospective, randomized, comparative study included 55 adult patients with reticular veins and telangiectasias. Patients were randomized to receive a daily moisturizer for 30 days before sclerotherapy or to no hydration. All participants underwent a single session of polidocanol 0.5% sclerotherapy. The primary efficacy outcome was moisturization's ability to prevent PSH, as evaluated by blinded evaluators using photos taken before and after procedures. Secondary outcomes included patient-reported outcomes assessed using the VEINES-QoL/Sym questionnaire.

RESULTS

Both groups experienced hyperpigmentation. PSH appeared in fewer patients who received hydration (44% vs. 57%, P=0.423), with no statistically significant difference. No skin alterations occurred at any time point. Nine patients (90%) rated the results as "very good" or "excellent".

CONCLUSIONS

In this randomized, double-arm, prospective, pilot study, the use of moisturizer 30 days before polidocanol 0.5% sclerotherapy did not reduce PSH.

Address: Faculty of Medicine (Famed), Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.; Faculty of Medical Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.; Faculty of Medical Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.; Albert Einstein Israelite Hospital, São Paulo, Brazil.; Science Valley Research Institute, Santo André, Brazil.; Faculty of Medicine (Famed), Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.; Federal University of Goiás, Goiânia, Brazil.; Faculty of Medical Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil - [email protected].; Science Valley Research Institute, Santo André, Brazil.; Hemostasis and Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA.

DOI: 10.23736/S0392-9590.26.05505-7

MeSH Terms: Humans, Female, Prospective Studies, Sclerotherapy, Hyperpigmentation, Polidocanol, Male, Middle Aged, Treatment Outcome, Telangiectasis, Sclerosing Solutions, Adult, Polyethylene Glycols, Aged, Emollients, Time Factors, Varicose Veins