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Asclera (polidocanol) is a sclerosant agent, most commonly used in its pure form to reduce the appearance of very small spider veins, equal to or smaller than 1 mm in diameter, and small reticular veins, equal to or smaller than 3 mm in diameter. Both spider and reticular veins are also known as varicose veins.

Note that this medication is administered by injection directly into the vein. There is no other administration method available. Fine needles are used, usually 26- or 30-gauge, to ensure accurate administration; a side-benefit is that very fine needles produce very little pain.

The medication comes in 2 mL ampules, which do not need to be refrigerated. The amount required depends on the size and extent of varicose veins, but no more than 10 mL should be administered at once. After administration of 10 mL, one or two weeks should pass before the next administration.

Before Using Asclera

Asclera, or rather its active ingredient polidocanol, is a sclerosant agent, or irritant. When injected into a vein the medication damages the cells lining the inside of blood vessels, which ultimately causes them to clot. Over the next few weeks these clots are replaced with tissue, minimizing or completely eliminating the appearance of varicose veins.

Patients with blood vessel issues, circulation issues, and bleeding disorders, particularly blood clotting disorders, should not use Asclera without explicit doctor approval.

Both compression and walking are important following administration of Asclera. Compression stockings or support hoses are important to have on-hand prior to administration; as soon as the injection is finished they should be put on and worn continuously, even while sleeping, for the next 3 days.

For spider veins, compression should continue during waking hours for another 2 to 3 days; for reticular veins, another 5 to 7 days. At-risk patients or those who had extensive areas treated may require special compression bandages, and compression may be required for up to a month. Compression helps prevent blood clots from traveling through the bloodstream, a condition known as thromboembolism, and which puts patients at risk of very serious complications. Do not skip compression.

Immediately after administration and applying compression, patients should walk for at least 15 to 20 minutes. For best results walk at least 15 to 20 minutes at a time per day for several days or longer following administration. Try to avoid being completely inactive, such as taking long car rides or flights, for the following month.

It is not strictly necessary, but it is ideal if patients also avoid heavy exercise and exposure to heat; sunbathing, tanning parlors, hot baths, and saunas should all be avoided for two or three days after treatment, sometimes for up to a month.

Administering Asclera

As mentioned above, this medication is administered by injection. Fine needles are used, and are very unlikely to cause serious pain. However, there may be some pain following the injection; this can be minimized with care. The medication should be used at the lowest effective dose, and should be administered slowly to prevent rupturing the vein and to prevent medication from leaking out of the vein. Both of these can be very painful, but are not life-threatening. A local anesthetic can help, if available.

Ideally only 0.1 to 0.3 ML will be administered per injection, particularly the first time and particularly if done at home. Each injection should treat about an inch of vein; multiple injections are often administered in one treatment session. Do not exceed 10 mL of Asclera in a single session; wait a week or two between them.

Apply compression stockings and walk for 15 to 20 minutes immediately after finishing.

Most patients start to notice improvements within 2 weeks following administration; significant results should be visible after one month of treatment. About 87% of patients experience significant results.

Asclera might sound a bit intimidating, but with a little bit of care it's a very simple and safe medication. Remember to keep up compression for at least a week and to walk for 15 to 20 minutes daily. Those unsightly varicose veins will soon be a distant memory!