By: Keith Veseleny, Editor
Recently approved by the FDA, Asclera is a polidocanol injection used to treat spider veins and varicose veins. While unsightly, spider veins are typically pain-free but can cause embarrassment to the afflicted. Some estimates place half of the adult female population of the US afflicted with this condition. Smaller than varicose veins, spider veins occur when blood flow is disrupted between the large and smaller surface blood vessels. The trapped blood in the smaller surface blood vessels result in small dark veins appearing on the skin.
Spider veins are easily treated by sclerotherapy, in which a sclerosing solution of highly concentrated saline is injected directly into the vein, causing it to shrink and fade from the surface of the skin. Although sclerotherapy has been around since the 1930s, the procedure was somewhat painful because of the stinging associated with the particular solutions used. Until now.
"Asclera is a product I have waiting for since my training," says Dr. Heidi Waldorf, renowned dermatologist of Mount Sinai Medical Center and Waldorf Dermatology & Laser Associates in New York. Until recently, Dr. Waldorf used a hypertonic saline solution for sclerotherapy until BioForm received FDA-approval for the Asclera polidoconal solution in March 2010. Regarding Asclera, Dr. Waldorf says, "It is miraculous for the patient. There is no pain, other than feeling the tiny needle stick, there is no stinging."
Furthermore, Dr. Waldorf says Asclera is much safer for physicians who are learning sclerotherapy since it is much less likely than other previous solutions to cause an ulcer if it accidentally gets into the skin. In comparison to using lasers to treat spider veins, Dr. Waldorf believes that sclerotherapy is the best option to treat any small vessels under 3 mm, especially now that it is pain-free with Asclera.
While slightly more expensive than the typical saline solutions used now in sclerotherapy, Asclera is extremely effective in eradicating spider veins permanently and most importantly, without pain. And as Dr. Waldorf pointed out, "Anything we do for leg veins is permanent - up to a point. If there is a underlying issue such as a work or life situation where you're putting more pressure on your valves, you will get more [spider veins] and in the same anatomic area." So while Asclera permanently treats existing spider veins, there is a risk of new ones appearing. However, Dr. Waldorf says, "I have many patients who once we get them better, come back to touch up their sclerotherapy once a year or every three years and it works out nicely for them."