Asclera
Asclera® is Dr. Sherber’s preferred injectable sclerotherapy to treat spider veins (<1mm) and small varicose veins (1-3mm) in the legs. It gained FDA approval in the United States more recently, however its active ingredient (polidocanol) has been used extensively in Europe over the years as it is a much more comfortable and effective treatment than hypertonic saline, commonly used for sclerotherapy.
Dr. Sherber will not perform sclerotherapy on patients who have a history of a clotting disorder or acute vein diseases, those who are pregnant or breastfeeding, or people with a known allergy to polidocanol. In preparation for the appointment, Dr. Sherber asks patients to bring compression leggings or compression stockings (12-20 mmHg) to the appointment to be immediately worn post-treatment and for a week following treatment. An excellent selection of these compression leggings and stockings can be found here.
If there are evident deeper varicose veins, Dr. Sherber will often refer patients for ultrasound evaluation before treatment of superficial veins. Once the venous anatomy has been assessed, the areas to be treated with sclerotherapy will be defined. Asclera treatment is quite comfortable as very small needles are used with a slow and precise injection technique. The procedure should only take about 30-60 minutes to perform and an antihistamine may be recommended following treatment if the treated areas injected become itchy. Depending on the results of treatment with Asclera® and the number and size of the veins, multiple treatments may be needed for the desired result – using Asclera® to treat larger veins and Nd:YAG Laser to touch up smaller veins.