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Asclera - Downtime? Pain? Results?

I'm Considering Asclera and I Heard It is an Amazing Procedure with No Downtime nor Pain. Feedback?

Doctor Answers (12)

Asclera - Downtime? Pain? Results?


Thank you for your question. Pain is subjective, there may be mild discomfort with Asclera or any sclersosing agent used for sclerotherapy treatment. Side effects may include can bruise especially, if taking any anti-inflammatory medications. It may take more than one treatment every 6-8 weeks to get better result. I hope this helps.

Bay Area Dermatologist
4.0 out of 5 stars 10 reviews

Asclera Results


Yes, many patients are very happy with the results of Asclera.

Prior to its availability, doctors used sodium tetradecyl sulfate which tends to sting. But one of the benefits of Asclera is that pain is less of an issue.

The FDA also compared the two drugs, and Asclera was found to perform better than the conventional saline injection.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 23 reviews

Question about Asclera Sclerotherapy


Asclera (generically known as Polidocanol)  is the newest FDA approved medication for treatment of spider veins. It is known as a vein sclerosant, which means that it is used to get rid of abnormal veins (typically of the legs).  The procedure of injecting Asclera into spider veins or varicose veins is known as "sclerotherapy".  Some of the advantages of asclera over other sclerotherapy medications is that is tends to be less painful.  The reason for this that Asclera medication has an "anesthetic" quality to it that actually causes the treated veins to become numb during injection.  Other sclerotherapy medications can often cause significant burning or stinging while they are being injected since they do not have any numbing characteristics.  Asclera is unique in this quality.

All sclerotherapy medications, though, will have a short period of downtime.  It is recommended that you wear compression stockings and avoid vigorous activity and sun exposure for at least a few days after treatment. Also, since the medication does require injections, there will always be some degree of discoloration and bruising of the skin after the treatment, and you have to wait for these skin changes to subside over time.

Joel Gotvald, MD, FACS
Austin General Surgeon
5.0 out of 5 stars 1 review

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Asclera is availabe at the Buffalo Niagara Vein Treatment Center

Asclera is trademark for Polidochanol. It is a sclerosant solution. It is not a procedure. It is used for sclerotherapy or foam sclerotherapy and the outcome depends on the expertise of the provider and whether or not you use stockings after the sclerotherapy and whether or not you develop pigmentation after the procedure.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.5 out of 5 stars 7 reviews

Asclera- Downtime?


In fact, there is a very high patient satisfaction rate with Asclera.  It is not a painful treatment and is highly effective for most patients.  While most patients do need multiple treatments (depends of the severity and number of the veins a patient has), they do see significant improvement with every treatment which makes it very satisfying.

There is no downtime, and patients go back to their normal acitivities right after the treatment.



Victoria Karlinsky, MD
Manhattan General Surgeon
4.5 out of 5 stars 12 reviews

Asclera works well


Asclera is an FDA approved scleroscant that works extremely well on small to medium sized varicose veins in the legs.  Unlike other commonly used scleroscants, such as saline, asclera is very well tolerated and virtually painless.  There is minimal to no downtime.  A series of treatments about 3-4 weeks apart will achieve the best results.  Compression stocking worn a few days after treatments helps ensure better results as well. 

Donna Bilu Martin, MD
Aventura Dermatologist

Asclera treatment for leg veins (sclerotherapy)


The FDA approved Asclera for the treatment of small to medium sized leg veins in the past year; however, similar products have been available for many years in Europe so we have good knowledge about this product's safety and efficacy.  There is very little pain associated with the actual injections, just an occasional sting.  The treatment may take anywhere from 15 minutes to an hour depending on how many veins are treated.  There should not be pain after the treatment - that may be a sign of a complication and should be reported back to your treating physician.  Many people have temporary redness, swelling, and bruising but this will not keep you from going to work and doing your everyday activities.  The treated areas may be bruised or discolored for a few weeks or even a few months.  Wearing compression stockings and protecting the treated areas from the sun will help to minimize the risk and shorten the duration of discoloration.  Some people need to have 2 or 3 treatments about 6-8 weeks apart  to achieve maximal results; this usually depends on the number and size of the veins you started with. 

Nancy Samolitis, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Asclera results not as good as saline in my experience


The two most common sclerosants for sclerotherapy are Asclera and hypertonic saline (salt water).

Asclera is less painful, however, I have found the results for spider veins to be less reliable.   Downtime is usually minimal to none and similar to saline.  Some redness or bruising may occur that last up to several weeks.  Hemosiderin (red-brown discoloration) staining can last several months or longer, but is less common.  Compression hose are recommended for 2-5 days thereafter, depending upon vessel size.

All sclerosants take about one month for maximum fading or clearance of the visible veins.

Most patients will require several treatments for best outcome.

Robert Strimling, MD
Las Vegas Dermatologist
4.5 out of 5 stars 7 reviews



using asclera works alot better than sotradecol or other meds. downtime is minimal as you should be able to return to work right after the treatment.

Timothy Mountcastle, MD
Ashburn General Surgeon
4.5 out of 5 stars 21 reviews

Asclera for spider veins IS amazing, but it is not magic!


I have been doing sclerotherapy for 31 years, and the best results (and fewest side effects) are achieved by leg elevation and elastic compression for 48 hours after injection. After that, compression is optional, and perhaps helpful, but not necessary. Bruising may be present for 2-4 weeks (or hemosiderin staining for several months), and suntanning or any kind of ultraviolet exposure is not recommended during this time to avoid permanent discoloration. Fall or winter treatments and pants or slacks avoid these problems. Touch-up sessions are scheduled no sooner than one month after the initial treatment. Most spider veins less than 3-4mm in size can be eliminated, permanently!

Polidocanol (Asclera--BioForm Medical, USA; Aethoxysclerol--Europe) is superior to all the other commonly-used sclerosants. It has been used with great success and excellent safety profile for many years in other countries, but until March 30, 2010, was not FDA-approved for any use in this country (USA). Though this drug has been around for many years, it was initially not approved by the FDA because it was developed as a new type of local anesthetic, but had the undesirable side effect of causing the tiny capillaries in the injection area to seal shut. Not so good for a local anesthetic, but EXACTLY what you are looking for to treat spider veins--something that is otherwise minimally toxic which causes undesired spider veins to seal shut, and does so without pain (except for the very tiny needle poke--not unlike a TB test)!

The previous FDA-approved sclerosants, sodium morrhuate and sodium tetradecyl sulfate, both cause severe or mild pain on injection, and have higher risk of other side effects compared to polidocanol. Doctors who used polidocanol prior to FDA approval purchased the pharmaceutical from manufacturers overseas, properly informed their patients, and have successfully used it for years.

As a side note, one of the most common sclerosants in the USA for years has been hypertonic saline, which is NOT FDA-approved for sclerotherapy either. This sclerosant had much more variability and potential for side effects since each physician who used it "off-label" used their own concentration, and some mixed it with other local anesthetics because hypertonic saline alone burned so painfully when injected into blood vessels.

Now that polidocanol is FDA-approved for the treatment of spider veins in the USA, you can expect that more physicians will be using it. There are still some side effects (bruising, hemosiderin staining, post-inflammatory hyperpigmentation, and occasional blister, ulceration, and/or scar) seen with ALL sclerosants (FDA-approved or not), but with skilled injector technique polidocanol is the GOLD STANDARD sclerotherapy agent.

So, you can see that sclerotherapy is indeed a wonderfully successful procedure in the hands of someone very good at cannulating tiny capillaries with tiny needles, making this a VERY operator-dependent procedure. Pain--hardly any (but NOT none); downtime--minimal (if you want great results), none (if you are OK charging for retreatment of those that are "allowed" to recur because of "no downtime" hype!)

So go for it, but make sure your injector is being honest about the treatments. NO pain and NO downtime is an exaggeration; what else is that person telling you?

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.