It is estimated that over half of the population suffers from varicose veins or their smaller counterpart, spider veins. These pesky veins, while not dangerous, may be unsightly and can be embarrassing to the owner. There are a myriad of reasons why patients develop varicose or spider veins including genetics, prolonged standing, aging, menopause or obesity. Treatment for veins can range from surgery, lasers to sclerotherapy. While sclerotherapy has been available for a long time, a new sclerosing agent is available that may make the procedure pain free: Asclera.
Recently seen on The Dr. Oz Show, Asclera, which is manufactured by Merz Aesthetics, was FDA approved in March 2010 for the treatment of uncomplicated spider and reticular veins in the lower extremities. While the product has been available in the US for over a year, not many physicians offer it.
According to renowned dermatologist and Director of Laser and Cosmetic Dermatology at Mount Sinai Medical Center in New York, Dr. Heidi Waldorf, "One of the major reasons patients have not heard about Asclera is traditional sclerosing agents such as sotradecol (Sodium Tetradecyl) or saline are both relatively inexpensive and can be purchased in large multiple-use vials - so there is an added cost to physicians."
"Asclera is the only sclerosing agent that contains Polidocanol, which is the actual product itself generically," Dr. Waldorf continues, "Asclera is the only product containing Polidocanol that has been FDA approved and it only comes in single-use vials."
Much like other sclerosing solutions, Asclera works by damaging the lining of blood vessels which then causes the vessels to seal up and over time, disappear. The solution is directly injected into the vein and possible side effects with traditional sclerosing solutions such as saline or sotradecol is stinging and discomfort. However, patients who have undergone Asclera report a much more comfortable treatment with no pain.
"As an off label use, we can dilute the single vials of Asclera; we can take the 1% or the 0.5% and turn it into a 0.25% solution based on the size of the vessels to be treated," describes Dr. Waldorf, "A lighter solution may be better for smaller vessels. For example, I would use the 1% Asclera solution for verticular vessels (veins between 1 and 3 millimeters) and I would use the 0.5% concentration for the small telangliectasia or spider veins. If a patient had very small vessels, for example, telangliectatic matting I might decide to use 0.25% concentration for treatment."
Dr. Waldorf says another benefit to Asclera in comparison to traditional sclerosing solutions is should the fluid get outside of the blood vessels being treated, there is less risk of ulceration, pigmentation, or texture change.
Dr. Waldorf does point out that one potential side effect of Asclera that is not seen with saline scleorising solutions is a small risk of anaphylaxis, which is a severe but immediate allergic reaction. However, patients should only seek treatment with reputable and experienced physicians whose treatment rooms would be well stocked with injectable Benadryl and epinephrine, should it be needed.