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

Doctor Answers 15

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.

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 85 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 35 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

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
4.9 out of 5 stars 25 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.