Sclerotherapy is the method for eliminating superficial telangiectasias (“spider veins”) and some varicosities by the injection of a solution, called “sclerosing agent, into the veins. The vast majority of patients who have sclerotherapy will have significant clearing of the veins with at least good improvement. There can be no guarantee, however, that it will be effective in every case. Less than 10% of patients undergoing sclerotherapy will have poor results, in which the veins do not improve despite multiple injections. It is extremely rare for anyone’s condition to worsen because of treatment.
It is important to realize that sclerotherapy does not prevent development of new spider veins and varicosities over the years. Many people will require treatments from time to time to keep their legs clear. Standing occupations, pregnancy, and estrogen increase this tendency.
It is difficult to predict the number of treatments needed to clear or improve the condition. Each leg area may need to be injected one to five or more times, over a period of several months. Improvement is usually seen over a period of months, not weeks. In each treatment session, multiple areas can be treated, thus reducing the total number of sessions required. The total number of treatment sessions needed depends on the amount and severity of the veins (the average is three to five), with severe cases requiring as many as ten or more.
Sclerotherapy is not covered by your insurance company. When the veins are small, the treatment is considered cosmetic and not covered. Each patient has the responsibility for payment at the time of service, whether or not the treatments are successful.
What Is Asclera® (pronounced a skler ah)?
Asclera® (polidocanol) Injection is a prescription medicine that is used in a procedure called sclerotherapy and is administered by a healthcare provider to treat two types of veins:
- Uncomplicated spider veins (very small varicose veins ≤ 1 mm in diameter)
- Uncomplicated small varicose veins (1 to 3 mm in diameter) known as reticular veins
How Does Asclera® Work?
Asclera® is a sclerosing agent that is injected into the vein. It works by damaging the endothelium, the cells lining the inside of blood vessels. This causes blood platelets to attach to the lining of the vessels; eventually, cellular debris and platelets cause the blood vessel to clot. Over time, the clotted vein will be replaced with tissue.
- On average, 86% of patients were satisfied or very satisfied with their Asclera® treatment
- Patients were significantly more satisfied with Asclera® than with either sodium tetradecyl sulfate (STS) or placebo (p<0.0001)
1 At 12 and 26 weeks after last injection patients received the digital images of their treatment area taken at baseline and were asked to rate their satisfaction with their treatment using a verbal rating scale, where 1 = very unsatisfied, 2 = somewhat unsatisfied, 3 = slightly satisfied, 4 = satisfied, and 5 = very satisfied.
What should I avoid after receiving an Asclera® Injection?
For two to three days following the treatment, avoid (if you are uncertain, please ask your healthcare provider):
- Heavy exercise
- Long plane flights
- Hot bath or sauna
Are there any possible side effects to Asclera® treatments?
Yes, they may include:
- Severe allergic reactions have been reported following polidocanol use, including anaphylactic reactions, some of them fatal. Severe reactions are most frequent with use of larger volumes (> 3 mL). The dose of polidocanol should therefore be minimized. A doctor should be prepared to treat anaphylaxis appropriately.
- In rare cases, formation of small “burns” or ulcers form, usually due to leakage of Asclera® into the skin. They heal in time, but may leave a scar.
- Inadvertent perivascular injection of Asclera® can cause pain. If pain is severe, a local anesthetic (without adrenaline) may be injected.
You should tell your doctor about all the medicines you are taking, including:
- Prescription and nonprescription medicines, vitamins and herbal products
You should not be treated with Asclera® if you:
- Have a known allergy to polidocanol
- Have an acute vein or blood clotting (thromboembolic) disease
- Are pregnant or nursing
How long is each Asclera® session?
A typical sclerotherapy session lasts 15 to 45 minutes. One injection is usually administered per inch with multiple injections per session. Following treatment compression stockings or support hose should be worn continuously for 2-3 days and for 2-3 weeks during the day time.