Asclera (also known as Polidocanol) is a sclerotherapy injection solution intended to get rid of spider veins and varicose veins. It received FDA approval in 2010. Interestingly, it has been used in Europe for over 40 years.
Patients have expressed higher satisfaction with Asclera. Their experiences with the treatment is often characterized by
Once Asclera is injected into the blood vessel, it damages the interior cell lining called the endothelium. This damage causes blood platelets and debris to congregate at the site which causes the blood vessel to clot and seal off. This tissue is then regarded as waste and is carried away by the body’s own removal system.
Prior to the availability of Asclera, schlerotherapy was usually performed with Sodium Tetradecyl Sulfate. This is essentially a saline injection solution that also works by sclerosing (damaging) the endothelium on the inside of the blood vessel.
Asclera offers several benefits over sodium tetradecyl:
1) Less risk of unwanted effects such as:
2) More effective, according to and FDA study, than sodium tetradecyl by about 20%
3) Safer in the event that the solution is inadvertently injected outside the blood vessel
4) Less painful because Asclera is not made of saline, whereas sodium tetradecyl sulfate will often sting once it is injected.
5) Higher precision because Asclera can get rid of vessels as small as 1-3mm in diameter. These blood vessels used to be more difficult to address.
Asclera can be when the objective of the treatment is strictly cosmetic in nature. It can be quite effective for the following types of blood vessels:
1) Spider veins made of blood vessels less than 1mm
2) Reticular veins between 1-3mm
Vericose veins larger than 3mm can be treated with Asclera. But this should be confirmed through further examination. Many doctors recommend using ultra sound guidance to see if there are any attached accessory vessels that should be addressed, such as saphenous veins. Also, in some cases, surgery or laser treatment may be the best option.
Determining whether or not Asclera or other sclerotherapy techniques will be successful can be a complicated issue, especially with larger varicose veins.
It is important to understand that blood vessels branch and drive other blood vessels.
For example if you are trying to get rid of a varicose vein that is driven by high pressure vein within close proximity, relatively near the surface of the skin, then there is a good chance that sclerotherapy will be successful.
However, if the attached driving vessel (which feeds into the varicose vein that you want to get rid of) exists more deeply within your leg, sclerotherapy will be more challenging and may not even benefit from surgery.
Asclera is generally quite safe when smaller volumes are used. However allergic reactions can entail when quantities larger than 3ml are used frequently.
Anaphylaxis may be a risk with this high level type of usage. This is a serious type of allergic reaction where the onset is very rapid and can cause death.
In order to test for allergic reactions to Asclera, the doctor should use a small initial dosage. After a week, if there are no indications of adverse side effects, then both the patient and physician can proceed with a formal treatment.
Asclera should not be considered for sclerotherapy if:
1) you are allergic to Polidocanol
2) you have any type of blood clotting disorder (i.e. thromboembolic disease)
3) you are pregnant or nursing
Asclera, Sodium Tetradecyl Sulfate and other sclerosants have the following side effects:
2) hemosidering staining
3) hyperpigmentation (post-inflammatory)
4) blistering (occurrence is somewhat rare)
5) ulcers (occurrence is somewhat rare)
6) scars (occurrence is somewhat rare)
To help maximize your safety as a patient, be sure to thoroughly disclose all medications you are taking with your doctor. This includes:
The length of each treatment will vary on a case by case basis depending on the complexity of the removal process. Usually sessions can last anywhere between 15-45 minutes
No, there is no downtime with Asclera. Patients can get back to work and resume most of their normal activities right after their procedure.
However, three days following the treatment most doctors will recommend that patients avoid the following:
1) Sunbathing and prolonged sun exposure
2) Heavy exercise
3) Long airline flights
4) Saunas and hot baths
Asclera treatments can cost anywhere from $250-$500
It may take a few weeks to about a month to see the full results of an Asclera treatment. Several treatments may be needed for larger sized veins.
The reason it takes time to see results is that Asclera only triggers the process for getting rid of unwanted blood vessels. Once it starts the clotting process, it requires time for the tissue to be broken down and carried away by the body.
Los Angeles has Asclera procedures available at Fine Touch Dermatology, to serve people in the Southern California area who wish to get rid of leg veins.