Sclerotherapy

Sodium tetradecyl sulfate · Tromboject, Omega Laboratories

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How it works

A solution injected into the vein, which is then pressed closed

Subcutaneous fatVeinNeedle, into the vein

Sodium tetradecyl sulfateThe vein’s lining irritated; a thrombus forms; compression closes the vein

Layers, top to bottom: epidermis, dermis, subcutaneous fat, muscle; the vein runs in the fat.

Tromboject

compression

The solution in the vein, irritating its lining; a thrombus forms.

Pressed closed; the vein occluded by fibrosis.

EpidermisDermisSubcutaneous fatMuscleVeinNeedle, into the vein

Sodium tetradecyl sulfateThe vein’s lining irritated; a thrombus forms; compression closes the vein

Tromboject

compression

The solution in the vein, irritating its lining; a thrombus forms.

Pressed closed; the vein occluded by fibrosis.

0.5 to 2 mL an injection, 5 cm apart; compression closes the vein. Sodium tetradecyl sulfate “causes a direct irritation of the intima and formation of a thrombus, while compression promotes the occlusion of the vein by fibrosis”, the monograph states: the 1% solution for small veins, 3% for medium or large, at most 10 mL a session. Licensed for varicose veins of the legs. Illustrations are schematic.

What it costs

Treating the legs costs $150 – $600 a session on clinic pages

The legs, the one area the licence names

AreaA session
by injection count on three pages$150 – $600a session
Eleven clinic pages, five with a price. Three price the visit by injection count, 30 to 150 injections a session; one states a starting price, one a range. The pages sell a series, and none prices the legs by area. Canadian dollars before tax, as the clinic pages state them.

Results & duration

Improvement at twelve weeks in a placebo-controlled trial

One trial, EASI, and it was polidocanol’s. Nine in ten improved at 12 weeks, rated blind, in the one placebo-controlled trial read here; two in three satisfied. 338 people with spider or reticular leg veins, 105 on sodium tetradecyl sulfate 1%, 53 on saline, up to three injection visits; the numbers are the sodium tetradecyl sulfate arm’s, as the FDA’s Asclera label reports them. Tromboject’s monograph cites no trial of its own.

Panel-rated improvement, photographs

Good or complete at 12 weeks

92%Sodium tetradecyl sulfate 1% · of 105 people

8%Saline · of 53 people

A rating of good improvement or complete success on the panel’s five-point scale, the raters blind to treatment; 91% at 26 weeks. Spider and reticular veins of the legs, the small veins the monograph doses at 1%; the Canadian licence names varicose veins of the legs without a size.

FDA Asclera label 2025 §14, Table 3, the EASI trial

Patient-rated

Satisfied or very satisfied at 12 weeks

64%Sodium tetradecyl sulfate 1% · of 105 people

14%Saline · of 53 people

Shown their own before-and-after photographs and asked; 63% at 26 weeks. The polidocanol arm rated higher on this scale than the sodium tetradecyl sulfate arm, and the trial was polidocanol’s.

FDA Asclera label 2025 §14, Table 4, the EASI trial

How long does sclerotherapy last?

Measured to 26 weeks. In the trial, 91% of the sodium tetradecyl sulfate arm were still rated good or complete at 26 weeks after the last injection and 63% were satisfied, the last visit, not the end of the effect. The monograph puts 5 to 7 days between treatments and sets no course length; clinic pages describe a series of sessions and maintenance visits, their word.

FDA Asclera label 2025 §14, Tables 3 and 4 · Tromboject monograph §3 · clinic pages

Recovery & risks

Discoloration and bruising were common

EASI trial, sodium tetradecyl sulfate 1% · 105 people

  • Discoloration at the site74%
  • Irritation73%
  • Bruise65%
  • Pain31%
At the site
The reactions listed in the trial’s adverse-event table were at the injection site and most were mild, the label states; itching in 27%, warmth in 21%. The monograph names pain, phlebitis, hives and ulceration there.
Along the vein
“A temporary or permanent discoloration (hyperpigmentation) may remain along the path of the sclerosed vein segment”, the monograph states, the risk higher at the higher concentration. New fine vessels in 20% in the trial.
Weeks later
Deep vein thrombosis and pulmonary embolism have been reported after sclerotherapy, embolism as long as 4 weeks after injection, and compression may lower the risk of deep vein thrombosis, the monograph states. The trial’s ultrasound at one week and 12 weeks found no deep vein thrombosis; a clot at the injection site in 1%.
Next session
5 to 7 days between treatments, the monograph says, and at most 10 mL a session.

Side effects in the product monograph

Discoloration along the vein, ulceration, tissue necrosis after extravasation, anaphylaxis, deep vein thrombosis: reported in the monograph, no rate established.

Discoloration along the vein

Ulceration at the injection site

Deep vein thrombosis and embolism

Adverse reactions and warnings in Tromboject’s product monograph · Illustrations are schematic.

Read from the trial’s STS arm and the monograph. Discoloration at the site in 74%, a bruise in 65%, in the trial; most listed reactions mild. The FDA’s Asclera label lists adverse events at least three percentage points more frequent with Asclera or sodium tetradecyl sulfate than with saline; the listed reactions were at the injection site and most were mild. Downtime was not measured. The harms on the cards are the monograph’s, which gives no rate.

Frequently asked questions

Tromboject 1% and 3% (sodium tetradecyl sulfate) hold drug identification numbers 00511234 and 00511226, marketed by Omega Laboratories since 1987, Health Canada’s Drug Product Database records; the monograph states the use as “the treatment in adults of varicose veins of the legs by compression sclerotherapy”. Polidocanol, the sclerosant of the trial above and Asclera in the United States, has no marketed Canadian product: Varithena, a polidocanol foam, holds a DIN the database lists as dormant since February 2020. A drug identification number records Health Canada’s review of the product for the use filed; it does not establish every benefit, area or duration a clinic advertises.Health Canada · DPD, DIN 00511234, 00511226 and 02444267 · Tromboject monograph §1

GST or HST applies to taxable cosmetic treatments: 13% in Ontario, 5% where only GST is charged. The clinic prices here are before tax. A treatment for a medical or reconstructive purpose may be exempt when it meets the applicable health-care exemption’s conditions, including who supplies or performs the service; its purpose alone does not establish an exemption.Excise Tax Act · s. 165, Sch. V Pt. II ss. 1, 1.1, 1.2 and 5 to 7, Sch. VIII

A physician, a nurse practitioner, or a nurse working under one. The College of Nurses of Ontario’s guideline on aesthetic services (2026) names administering a substance by injection among the controlled acts, so an RN or RPN needs an order or directive from a nurse practitioner or physician, while nurse practitioners are autonomous. Tromboject’s monograph adds that it should only be administered by a healthcare professional experienced in venous anatomy and in the diagnosis and treatment of venous conditions. Other provinces set their own rules.CNO · Aesthetic services, practice guideline (2026) · RHPA s. 27(2), para 5 · Tromboject monograph §6

The one placebo-controlled trial this page reads, EASI, is the pivotal study in the FDA’s label for Asclera, Kreussler’s polidocanol, with sodium tetradecyl sulfate 1% as the comparator; its first author is at the University of Bonn. So the numbers above come from a rival product’s trial, not Omega’s. Tromboject’s monograph cites no trial; its supporting document is Sotradecol’s US label. No trial independent of both makers is cited here.FDA Asclera label 2025 §14 · Rabe 2010, PMID 20483861 · Tromboject monograph §10

Of the eleven pages read, one names the product, Sotradecol or Tromboject; the others name none, and two describe “a solution of sugar, salt and water”. Sodium tetradecyl sulfate is the sclerosant with a marketed Canadian drug identification number; the monograph’s 1% solution is for small veins, the 3% for medium or large.Health Canada · DPD · Tromboject monograph §3 · clinic pages, 1 naming a product

Sources

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