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I Had Asclera Injections Done Yesterday, It Was So Painful I Couldn't Finish. Is This Normal?

Doctor Answers 8


I usually place numbing cream in the areas of proposed injections for at least 45 minutes prior to injection.  The injections hurt and it is my only way to decrease the pain

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 15 reviews

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Painful Asclera Injections

Thank you for your question. Sclerotherapy agents such as Asclera may cause some discomfort, but are generally tolerable procedures. Make certain you do not feel continued pain, burning, or ulceration as these may be side effects. I would recommend perhaps pre-treating with ice to help numb the area. Be sure you are under the supervision of an experienced injector. I hope this helps.

Painful Sclerotherapy Not Typical

As a sclerotherapy expert who has performed over 30,000 sclerotherapy treatments over the past 30 years, I can say this is not a typical reaction. In fact, I have never had this problem in any of my patients. At most there may be some minor discomfort during the sclerotherapy procedure. There are a few reasons why sclerotherapy could be painful, but without further information it is not possible nor appropriate to say anything further. I recommend seeking treatment for your veins from a vein expert who has a long, successful track record of performing advanced vein procedures.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.5 out of 5 stars 7 reviews

Pain with Sclerotherapy Vein Injections if Legs

No, this is not typical or normal, especially with the newer sclerotherapy medications like Asclera (Polidocanol).  Some of the older sclerotherapy treatments, such as hypertonic saline, were often very uncomfortable.  But the newer medications are well tolerated in general.  Asclera has chemical properties that give it an anesthetic effect when injected, so it is usually is not painful to administer (except for the small needle pokes, which are similar to ant bites).  Most patients tolerate the procedure very well.  I have done thousands of sclerotherapy treatment sessions and have never had to quit a treatment due to the inability of the patient to tolerate the discomfort. 

One possibility is that some of the medication was escaping from the veins and going into the tissue around the veins, causing pain. 

Some of the things that can be done to minimize discomfort are:

1)apply numbing cream to the skin that is a topical anesthetic, such as Emla cream, just prior to your treatment

2)Have the vein doctor do cyro-sclerotherapy in which hyper-cooled air is administered to the skin during treatment

3)Have the vein doctor use a cooling-pack or ice-pack on the skin just prior to injections


I hope the information was helpful.

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

Alternative techniques for Asclera Injections

Sclerotherapy injections can be quite uncomfortable in certain cases. When the injections burn or cause more than a momentary sting, a more dilute solution should be used. Foam sclerotherapy is a technique that also causes less pain during the injections. Talk to your doctor about these and other methods to make sclerotherapy more tolerable.

Marilyn Pelias, MD
New Orleans General Surgeon
5.0 out of 5 stars 10 reviews

Asclera is not painful

I have done several thousand sclerotherapy sessions and I don't recall ever stopping because it was that uncomfortable for the patient. You must be very sensitive to needle sticks or to the Asclera. There is an element of 'burning sensation' which subsides with topical ice packs in minutes. Try another Board Certified Phlebologist or another sclerosing solution.

Asclera injections so painful...normal?

No not really, when done effectively. I put numbing cream on my patients before treatment and use a cryomachine which additionally blows intensely cold air on the area I am injecting. Both of these help keep any pain at bay and I've been doing my treatments this way for over ten years. I do at least one or more asclera (sclerotherapy) session a day to legs, face, etc. and I have never had to stop because a patient complains it's too painful. In the old days of using saline and nothing else the procedures were very painful, but today with good solutions and good technique, the procedure shouldn't be intolerable. Perhaps find another physician who uses more "pain free" technology like I prefer.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.5 out of 5 stars 9 reviews

ASCLERA is Normally Not Very Painful for Spider Veins (Capillaries)

Hypertonic saline injections for spider veins are painful.  ASCLERA (polidocanol) that unintentionally gets out of the vein can be painful.  Call your doctor for a recheck to make sure all is well.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 2 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.