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

Doctor Answers 18

Pain from the needle or pain from the medication?

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The small pokes from the needle are irritating but we typically use among the smallest needles available, so the pain from these should be minor. If the pain was from the poke, you may simply be more sensitive than some other people to this stimulation. 

If your pain was from the actual injection of medication, that is unusual. Asclera should be essentially painless as it enters the vein. This contrasts with saline injections, which hurt substantially. 

Miami Beach Physician
5.0 out of 5 stars 8 reviews

Pain is subjective

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 This is usually a very well tolerated treatment and done without much pain or problems.  Pain is different for everyone.  I have had people fall asleep during treatments and have had people screaming.  Everyone is different and feels pain differently.  If they have pain, you can try topical anesthetic but these topical numbing medications also can shrink down the veins that are injected and make it harder to see to inject them. 

Susan Fox, DO
Hollywood Phlebologist
5.0 out of 5 stars 8 reviews

Asclera (polidocanol) treatment

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Pain tolerance is different for everyone, sclerotherapy
injections involve some level of pain due to the fact that during the
procedure Asclera (polidocanol) is injected into the spider vein using a
needle. I prefer a small needle to prevent discomfort for patients
usually 30 or 32 Gauge needles. Another consideration would be sedation
medication if otherwise treatment cannot be tolerated. 

All the best, 

Dr. Nguyen

Generally only mild discomfort

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Asclera (polidocanol) is one of the most well-tolerated sclerotherapy agents with respect to pain and has a very, very low rate of causing damage to skin. I much prefer using it over Sotradecol or concentrated saline. Glycerin with lidocaine is well-tolerated as well. I usually use a 32 gauge needle - very small - which minimizes discomfort even more. Sclerotherapy has a very good safety profile when administered properly and has good success percentages.

Derek Norcom, MD
Portland Physician

Sclerotherapy and pain

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Asclera, generic name Polidocanol sclerotherapy treatment may cause minimal discomfort depending on the area injected. A small needle is usually used and is well tolerated. Unusual pain associated with Asclera sclerotherapy may be related to the injection outside a vein. Asclera carries a mild analgesic property. MICROFOAM SCLEROTHERAPY is the most comfortable to administer.

Maraya Altuwaijri, MD, FACS
Laguna Hills Vascular Surgeon

Vein treatment in Los Angeles

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Foam sclerotherapy is very well tolerated by our patients for the treatment of spider veins and reticular veins. 


Dr. Karamanoukian

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Not normal

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There can be a little bit of discomfort with sclerotherapy but so much pain is unusual and likely meant that the asclera was outside of the vein.

Aaron Shiloh, MD
Philadelphia Physician
5.0 out of 5 stars 6 reviews


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This is very unusual in my practice.  I typically use a 31 gauge needle (tiny), perhaps ask your doctor if he/she is using the smallest possible needle.  Also, Tylenol or Tramadol (prescription) before treatment can help.  Best regards- Dr. C

Guy Cappuccino, MD
Mount Airy Plastic Surgeon
5.0 out of 5 stars 105 reviews

Asclera Injections

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Everybody's pain threshold is different.  Many people experience a little pinching from the needle and slight burning from the solution.  However, it is typically tolerated well.  I would suggest taking some Tylenol before your next Asclera treatment. Ice may be helpful too.  Thank you for your question. 

Janet M. Neigel, MD
Florham Park Oculoplastic Surgeon
4.6 out of 5 stars 21 reviews

Pain after sclerotherapy

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The injection sites after sclerotherapy can be painful for several days to weeks. Usually, the discomfort is resolved within 3 weeks of injection.

Ewa Timek, MD
Grand Rapids Plastic Surgeon

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.