Sclerotherapy and aesthetic impairment

Venous malformations are errors of morphogenesis and consist of abnormal channels linked by normal endothelium and represent the most common congenital vascular anomalies. Injection sclerotherapy has been identified as an effective alternative to surgery and is considered nowadays as the less invasive option with good midterm results, especially with detergent sclerosing foam. Sclerotherapy acts as an irritant on the endothelius of dysplastic vessels triggering immediate thrombosis. As result of a sclerotherapy treatment a young woman experienced a scalp necrosis and a scalp scar as negative longterm outcome, associated with a depressed mood with anxious substrate. The less diluted sclerofoam, a slightly excessive total amount of foam (8cc) administered in a unique session in general anesthesia, had prolonged vessel wall contact with a more concentrated foam. The visible scalp scar is a non-facial scarring following a sclerotherapy and the anatomic location is in a usually visible area. The scar is patent in sitting position, half visible in the right lateral and occipital view, barely visible in the front view and not perceptible in the left lateral view. The alopecic scalp scar determines a functional damage, by decreasing the thickness of the scalp, associated with a significant aesthetic impairment. Size, location and surface of the scar can beside arouse unpleasantness or distaste in the observer, resulting in strong feeling of discomfort and mortification, with negative incidence on femininity and on the individual personal image. The presence of a scalp scar is not only an aesthetic impairment, with elements of gravity like gender, age and single status, but affects also the individual emotional-affective sphere in private, social and work context