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Asclera (Polidocanol) for Varicose Veins?

Does Asclera, Polidocanol work on varicose veins?

Doctor Answers 13

Asclera for Sclerothrapy

Asclera (Polidochanol) is FDA approved. It has advantages because it is painless on injection, has low likelihood of skin necrosis and is effective.

It is commonly used for feeder veins, reticular veins and some individuals use it for varicose veins. Its concentration when used is 0.5% to 1 %.

Asclera is a wonderful product for cosmetic sclerotherapy.  

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Asclera for varicose veins.

Asclera (Polidocanol) is an FDA-approved sclerosant for treating small unsightly spider veins up to somewhat larger (but still relatively small) varicose veins. Varicose veins can be quite large and visibly disfiguring, and also symptomatic with bulging, itching, or pain and heaviness in the affected areas.

Large varicosities (> 3-4mm in diameter) may still be effictively treated with sclerotherapy, but as the abnormally dilated vessels get larger, the amount of sclerosant gets correspondingly larger as well as less effective, since the sclerosant works by irritating the lining of the vein, stimulating spasm and clotting within the vein. The larger the vein, the more blood that is present to dilute the sclerosant, making it less potentially effective. Asclera works great for small spider veins, but the smaller they are, the more technique-dependent effective sclerotherapy is dependent upon.

For large(r) varicosities, better options exist, including endovenous laser ablation all the way to old-style surgical vein stripping. A dedicated vein clinic or a specialist in vascular surgery would be the people to see. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 171 reviews

Asclera for Varicose Veins

If varicose veins are extensive and/or painful, I suggest you consult a board-certified VAscular Surgeon, as Sclerotherapy (leg vein injections) may not be as suitable for you as Endovenous Foam Ablation (perhaps using polidocanol foam), which is a newer more comprehensive treatment). 

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 5 reviews

Asclera and leg veins

Asclera is a fabulous injection to remove leg veins and superficial spider veins. The injections can be somewhat painful so I always recommend applying Emla to numb the skin before the injections. It usually takes several treatments spaced one month apart to treat these veins. The procedure works extremely well but takes multiple treatments. 

Asclera (Polidocanol) Sclerotherapy for Varicose Veins & Spider Veins of the Legs

Yes, Asclera (also known as Polidocanol) does work well for varicose veins, as long as any deeper venous problem is addressed at the same time.  Most patients with varicose veins also have a deeper circulation condition known as venous reflux disease.  This deeper disease results in the varicose veins forming at the surface.  If the underlying vein disease is not treated, the surface branches will not response properly or will occur.  Usually this disease affects the deeper saphenous veins of the legs and can usually be addressed by a laser treatment or radiofrequency treatment prior to or in conjuction with the sclerotherapy.  A good analogy is that the diseased saphenous vein is the trunk of a tree and the varicose veins at the surface are the branches of the tree.  If you only treat the branches, the trunk will just grow new branches (new varicose veins).  If the trunk problem (which is usually present) is successfully identified by ultrasound and treated, then the branches can often be treated with Polidocanol or Asclera sclerotherapy.  Very large surface branches are usually best treated with phlebectomy (they tend not to respond well to sclerotherapy), but small to moderate sized varicose veins or reticular veins tend to respond very well to sclerotherapy with Polidocanol.  Asclera / Polidocanol is an FDA approved medication for both small varicose veins as well as spider veins.

Since you should always have an ultrasound done to check for the deeper vein problem and since this deeper problem should always be addressed before treating the surface branches, I would suggest that you see a board-certified vein specialist for a detailed evaluation before you have any treatments on your varicose veins done.

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

Painless Vein Treatment

Ascelra is now FDA approved for the treatment of varicose veins. I have found it is most effective for spider and reticular veins, but can also be used for larger caliber vessels. For larger vessels ultrasound guidance often improves outcomes.

Jeffrey Fromowitz, MD, FAAD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Polidocanol is effective against larger veins

Yes!  Polidocanol can be used to successfully treat larger caliber veins including varicose veins.  Although these veins can be visualized easily and treated with sclerotherapy, ultrasound-guided sclerotherapy can be more effective in treating affected vessels, by identifying potential feeder vessels called accessory or perforating vessels.  If you have varicose veins, it would be wise to first obtain an ultrasound study of the legs--quick, easy, painless, and informative--to determine if upstream vessels such as the great saphenous veins require treatment first before proceeding with polidocanol sclerotherapy treatment.

Melanie D. Palm, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 15 reviews

Spider Vein therapy

It works best on spider veins and reticular veins. i have never used it on varicose veins and am happy with performing microphlebectomy are larger varicose veins if ablation of tributaries dont work to shut the varicose vein down. i have seen a number of complications from other physicians injecting a wide range of agents into larger veins including matting and skin staining with dark brown spots.

Polidocanol works!

Yes, Polidocanol (Asclera) does work and is now FDA approved in the US (March 2010).  We've been using it in our office for awhile now with excellent results.  Patients are who've previously were injected in Sotradecol find Asclera to be just as tolerable and effective.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Options for sclerotherapy

There are many options for sclerotherapy, including polidocanol and STS.  There is no universal medicine that is applicable for every situation.  I would advise you to go to a board certified phlebologist.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 57 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.