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Polidocanol is a prescription sclerosing agent used to close selected unwanted or abnormal veins. A polidocanol injection must be given into the target vein by a trained healthcare professional after a vascular assessment.
Polidocanol is a non-ionic detergent sclerosant injected into a vein during sclerotherapy. It may be used as a liquid or professionally prepared foam. Authorised uses and concentrations vary by product and country.
During polidocanol sclerotherapy, the medicine damages the treated vein's inner lining. Platelets and fibrin collect at the site and close the vessel. The vein is gradually replaced with fibrous tissue while blood travels through other healthy veins.
Improvement is gradual, some veins need further sessions, and new veins may develop later.
Asclera polidocanol injection is a prescription product available in 0.5% and 1% concentrations in the United States. It is approved for uncomplicated spider veins up to 1 mm and uncomplicated reticular veins from 1 to 3 mm in the lower extremity. Under this approval, it has not been studied for veins larger than 3 mm.
A clinician chooses the concentration and volume for the vein being treated. Asclera is for intravenous use only and should be administered where severe allergic reactions and procedural complications can be treated.
Polidocanol may be used for selected spider and reticular veins. Specialists also use it in some vascular-malformation procedures, but these techniques may be off-label. A vascular examination determines whether treatment is appropriate.
The search “polidocanol vs ethanol sclerotherapy” usually concerns venous malformations, not ordinary spider veins. Ethanol is a potent sclerosant used by specialists for some malformations. Polidocanol is a detergent sclerosant that may be better tolerated in selected procedures.
Research suggests ethanol may produce a stronger response in some venous malformations but may cause more adverse reactions. Evidence is limited, and selection depends on the diagnosis, anatomy, treatment site, clinician experience and risk profile.
Common polidocanol side effects are usually local and may include:
Bruising, irritation, pain, warmth or itching
Temporary swelling or tenderness
Skin discolouration or hyperpigmentation
A small clot inside the treated vein
Fine new vessels around the treatment area
Some changes take weeks or months to settle. Ask the clinician when the area should be reviewed.
Rare but serious Asclera side effects include a severe allergic reaction, deep-vein thrombosis, pulmonary embolism and major tissue injury. Seek urgent help for difficulty breathing, facial or throat swelling, widespread hives, fainting, chest pain, coughing blood, sudden breathlessness, or pain and swelling in one leg.
Accidental injection into an artery or leakage outside the vein can cause ischaemia, ulceration or tissue death. Stroke, transient ischaemic attack and heart problems have also been reported close to polidocanol administration. New weakness, speech difficulty, severe visual disturbance or intense pain needs urgent assessment.
Polidocanol should not be used in someone with a known allergy to it or an acute thromboembolic disease. Tell the clinician about previous blood clots, reduced mobility, recent major surgery or hospitalisation, pregnancy, breastfeeding, heart or lung disease, and all medicines being used.
Use polidocanol only after examination and prescribing by a qualified professional.
Never inject it yourself or share an ampule.
Follow instructions for compression stockings or bandages.
Walk after treatment and during the following days as advised.
Avoid strenuous exercise, prolonged heat and long flights for the period specified.
Report increasing pain, skin breakdown, marked swelling or colour change promptly.
No. Correct needle placement, dosing, compression and observation are essential. Incorrect administration can cause severe tissue injury, a blood clot, embolism or anaphylaxis.