Earlier this year, the Food and Drug Administration approved a new drug for the treatment of spider veins. The medication is called Asclera and its active ingredient (polidocanol) is a detergent consisting of alcohol and polyethylene compounds. The solution works by irritating the veins into which it is injected. This causes the cell walls to become fibrous and closes off the blood vessel. This means blood can no longer pool in the damaged vein giving it a reddish, bluish, or purplish web-like appearance. Over time, the collapsed vein degrades and is replaced by other tissues.
The goal of this treatment is to cause spider veins and other small varicose veins to become less apparent. Asclera isn’t approved for treating large varicose veins for medical purposes. It is intended for cosmetic improvement of the blood vessels just under the skin. At this time, it is recommended for treatment of faulty veins in the legs – although some dermatologists may experiment with using it to address spider veins in other areas of the body.
In a clinical study published in June of 2010, Asclera performed favorably in comparison with sodium tetradecyl sulfate (STS) – a similar vein treating agent. Both performed much better than a placebo solution injected into control patients. At the 26 week mark after treatment, 84% of patients reported satisfaction with the treatment using Asclera versus 63% for STS and just 16% for the placebo.
Some patients did experience adverse reactions at the site of their injections. These were described as mild to moderate. According to the FDA, side effects of treatment commonly include bruising, pooling of blood, discomfort and discoloration. Rare but serious (even fatal) complications have been reported including extreme allergic reactions. Because of this, patients with a known allergy to polidocanol are not considered candidates for treatment with Asclera. All patients are monitored for a period immediately after treatment to verify that they will not have an unforeseen allergic reaction.
Errors on the part of the physician administering the injection can also cause problems. For example, if the drug is accidentally injected into an artery instead of a vein, this can cause tissue death. If the medication is inadvertently injected into the surrounding tissue, it can cause severe pain. This may be resolved with injection of a local anesthetic such as adrenaline. Patients should select a dermatologist or vascular specialist who has extensive experience with spider vein treatment protocols to avoid these mistakes.