Have you observed small, twisted spider veins—red, blue, or purple—on your skin or possibly enlarged superficial ‘varicose’ veins on your legs? Regardless, these veins can be displeasing and even painful. Asclera offers an effective solution for these common issues. Understanding all aspects of this injection can transform the appearance of your skin.
What Is Asclera Treatment?
Asclera treatment is a type of sclerotherapy in which a chemical irritant is injected to ‘sclerose’ or harden the blood vessels to treat vascular and lymphatic malformations. Asclera helps treat two types of veins, i.e., tiny spider veins and smaller varicose or reticular veins, by causing inflammation, promoting blood coagulation, and facilitating the narrowing of blood vessels. It offers excellent anesthetic benefits with minimal post-operative maintenance, which makes it highly popular among people with unsightly veins. The treatment also helps in treating other related concerns like hemorrhoids and hydroceles.
An Overview Of Asclera Injection
Asclera injection is a sterile and non-pyrogenic prescription medication. It has been an FDA-approved, nearly painless intravenous solution throughout Europe for the last 40 years with very high success rates. Following are a few details about Asclera (1):
- Active Ingredient: Polidocanol (a non-ionic detergent comprising dodecyl alcohol and polyethylene oxide)
- Other Ingredients: 5% (v/v) ethanol and water for injection
- Structural Formula: C12H25(OCH2CH2)nOH Polyethylene glycol mono-dodecyl ether
- Generic Name: Polidocanol
- Class: Sclerosing agent
- Color: Colorless to slightly greenish-yellow
- Availability: In the form of 2 ml. preservative-free, glass ampules
- Strength: 0.5% (5 mg. polidocanol per ml.) and 1% (10 mg. polidocanol per ml.)
- Stability: Up to 3 years for an unopened ampule
How Does Asclera Work?
The medication’s mechanism of action is rooted in the procedure of ‘sclerotherapy,’ which has evolved significantly over the past few years with the introduction of newer agents. The sclerosing agent present in Asclera is polidocanol. When injected into the target vein, it induces ‘local endothelial damage’ by negatively impacting the endothelium (the cells in the inner lining) of blood vessels. This creates cellular debris at the site of damage, aggregates the platelets there, and forces them to form a clot by getting attached to the venous wall. As a result, the vein becomes constricted and closed by a dense network of cellular debris, platelets, and fibrin. The body absorbs this occluded vein, and connective fibrous tissue replaces it over time. The entire procedure diminishes the discoloration, bulging, swelling, and discomfort associated with the problematic veins and causes them to disappear eventually (2).
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Uses Of Asclera
Asclera is indicated to treat uncomplicated spider veins (≤ 1 mm.) as well as uncomplicated reticular veins (1-3 mm.), primarily visible in the lower extremity of the body. Its effects on varicose veins, which are more than 3 mm. in diameter, are yet to be studied. The injection is supplied in single-use ampules for immediate use only in a single patient.
Dosage Of Asclera
The strength of the Asclera solution and the injection volume depends solely on the size of the veins and the extent of malformation. Typically, 0.5% of Asclera is used for spider veins and 1% for reticular veins. However, you may need to undergo multiple Asclera treatment sessions if there are extensive varicosities. For this, 0.1 ml. to 0.3 ml. of the medication can be injected into each vein. But ensure the collective dose does not exceed 10 ml. per session.
Ideal Candidates
The Asclera treatment is proper for you unless you are pregnant, lactating, or allergic to polidocanol. You should also not have any vein disease or the problem of acute blood clotting. Do not forget to discuss your medical history, existing health issues, and running drugs with your physician to determine your candidature.
Administration Of Asclera
Asclera is for intravenous use only and should not be administered by anyone else but a dermatologist or healthcare provider. Here are the steps involved in the administration of the injection (3):
- At first, a glass or plastic syringe with a fine needle (26- or 30-gauge) is chosen for administering the medication.
- Next, it is carefully inserted into the target vein in a tangential direction.
- Then, the solution is injected into the vein slowly and gently while keeping the needle inside.
- After that, the needle is taken out of the vein, and the site of injection is covered.
- Finally, compression is applied to the area with the help of a bandage or gradient stocking to prevent deep vein thrombosis.
If you have extensive varicosities, your physician may recommend a more considerable post-procedural compression treatment. This can be performed by using compression bandages or a gradient compression stocking.
Time Required
Each Asclera session can last 15 to 45 minutes, depending on the extent of treatment. If your spider and varicose veins need more than 10 ml. of the intravenous solution, you must undergo repeat sessions at least 1 to 2 weeks apart.
Aftercare To Follow
Following the procedure, your doctor will instruct you to walk for 15-20 minutes. You’ll be monitored for any potential anaphylactic or allergic reactions. Post-treatment, a crucial practice is wearing thigh- or knee-high compression stockings continuously for up to 3 days for spider veins and a week for reticular veins. After this period, wear them during the daytime for 2-3 weeks. Additionally, engage in daily walks lasting 15 to 20 minutes for at least a few weeks.
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Recovery And Downtime
The Asclera treatment comes with minimal downtime and quick recovery. Just ensure you do not indulge in sunbathing, hot baths, saunas, heavy workouts, long flights, etc., for 2-3 days.
Risks And Complications
Some of the most common side effects of Asclera include bleeding, scarring, bruising, irritation, discoloration, pain, hypersensitivity, allergic reactions, infections, hematoma, pruritus, venous thrombosis, etc. A few rare yet severe complications reported are tissue damage, anaphylaxis, acute thromboembolic disease, neovascularization, etc. (4)
Lasting Time
Choosing Asclera can make your spider and reticular veins disappear permanently. But you may need another treatment if new veins grow there again.
Cost Of Asclera
Each session of Asclera treatment can cost you nearly $500, which is a little more expensive than traditional sclerotherapy treatments. However, it can vary widely based on the severity of your problem and the number of sessions required.
Summary
Asclera treatment, a form of sclerotherapy, effectively addresses unsightly spider veins and smaller varicose or reticular veins by injecting a chemical irritant to harden blood vessels. With its active ingredient, polidocanol, Asclera induces local endothelial damage, causing vein closure and subsequent absorption by the body. Ideal candidates, excluding pregnant or lactating individuals or those allergic to polidocanol, can expect minimal downtime and quick recovery. The treatment is FDA-approved for veins up to 3 mm in diameter, with costs averaging around $500 per session.
References:
- “Asclera,” RxList
- “Asclera“, American Health & Beauty
- “Polidocanol (Rx)“, Medscape