The medicinal herb St. John's wort is a highly effective treatment for mild to moderate depression. According to the National Institutes of Health, St. John's wort rivals the efficacy of conventional antidepressant drugs and may have fewer side effects. Despite its overall reputation for safety, this herb may not be appropriate for people who intend to undergo surgery. Even mild surgeries such as sclerotherapy-- an outpatient treatment for varicose veins--may be risky for people taking St. John's wort. Tell your health care provider about any alternative treatments you use.
Bleeding Risk
St. John's wort is a mild anticoagulant, according to the National Institutes of Health. The NIH warns that St. John's wort may rarely increase the risk of side effects if it is combined with blood-thinning drugs such as coumarin. If you take St. John's wort alongside any blood-thinning drug, it can increase the risk of bleeding during your sclerotherapy procedure. However, this risk is entirely theoretical; no case reports exist linking St. John's wort to bleeding during sclerotherapy.
Drug Interaction
The NIH warns that St. John's wort may interfere with the metabolism of many medications that are metabolized by the liver. Although none of these drugs is generally administered to people receiving sclerotherapy, a physician may prescribe them before or after the procedure to mitigate potential complications. If a physician prescribes any drug for pain or bleeding after sclerotherapy, mention that you use St. Johns' wort. If the drug is metabolized by the liver's "cytochrome P450" enzyme system, it is not safe to use after sclerotherapy.
Unknown Factors
While no health care organization has directly linked St. John's wort to sclerotherapy complications, most physicians advise caution when using any medicinal herb. Few long-term studies have evaluated the interactions between St. John's wort and other drugs, and no reputable institution has studied the relationship between St. John's wort and cosmetic surgery procedures. Additionally, the U.S. Food and Drug Administration does not strictly regulate the production of herbal supplements, and no governing body can guarantee the purity or potency of these over-the-counter remedies. As a precaution, it is prudent to consult a physician before using St. John's wort or any other medicinal herb.
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