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

Doctor Answers 16

Asclera (polidocanol) treatment

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

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
4.9 out of 5 stars 13 reviews

Sclerotherapy and pain

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

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 94 reviews

Not normal

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 5 reviews


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 91 reviews

Asclera Injections

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

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


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

Payman Danielpour, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 38 reviews

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.

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
3.9 out of 5 stars 12 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.