What is the difference between "Sodium tetradecyl sulfate" (Sotradecol) and Sodium Morrhuate (Scleromate)? Which of these sclerosants would you use, and why?
There are several choices for sclerosing agents but only two are FDA approved, Sotradecol and Asclera (Polidocanol). These two are classified as detergents. They are safe and effective with the least amount of side effects.
Published on Jul 11, 2012
There are various types of sclerosant solution that have different mechanisms of action. Sclerosing agents fall into three categories: 1. Hyperosmolar- eg hypertonic saline(23.4%); 2. Detergent- eg Sodium
Tetradecyl, Polidocanol (Asclera), Sodium Morrhuate; 3. Chemical (direct Irritant, such as Chromated Glycerin.
Sodium Morrhuate has a higher complication profile- pigmentation, skin necrosis, and risk for severe allergic reactions (anaphylaxis). Choice of solutions depends on the size of the vein, proximity to skin surface, and other factors, including user preference. I strongly prefer using Sodium Tetradecyl as it can be used as Foam (FDA approved), and is very versatile for veins of all sizes, by changing the concentration of the solution (dilution).
Published on Jul 11, 2012
Good question. Sotradecol (sodium Tetradecyl suphate) is FDA approved for treating spider veins. Although it has been used in it's compounded form for "off label" use, it is a very good product used in the most dilute concentration for effectiveness. Sodium Morrhuate is compounded and off label and therefore we do not use it. The only other FDA approved solution is Asclera, which is Polidochanol. This too was off label for many years but now comes in two strengths. We prefer the approved versions of both of these products because they are consistent and, therefore, our results are consistent. Asclera supposedly has slightly reduced problems with staining, which is residual pigmentation. However, we use lower strengths with excellent results in both Sotradecol and Asclera.
Published on Jul 11, 2012
I am not aware of scleromate. STS or polydocanol are the standards. I would recommend 1 percent polydocanol.
Published on Jul 11, 2012
These are different detergent chemical compounds. The latest and, in my opinion, best solution for sclerotherapy of most cosmetic veins is polidocanol (generic). The 1-1.5% solution without foaming is effective in treating most veins other than large reticular or varicose veins where the concentration might have to be a bit stronger (and CO2 foam may be helpful in obtaining circumferential coverage of the inside of the vein wall).
Published on Jul 11, 2012
Both of the mentioned sclerosants are acceptable options for sclerotherapy. They are classified as dilute detergents. I prefer Asclera (polidocanol) due to the minimal side effects and good clinical results.
Published on Jul 11, 2012
Both are in the detergent class of sclerosants. Sodium Morrhuate has caused many cases of anaphylaxis and causes extensive skin necrosis if extravasated. STS is safer but can still cause the same problems and can cause hyper pigmentation in up to 30 percent of patients. I do not use either of these products.
Published on Jul 11, 2012
There is not a big difference between these two drugs besides the differences in chemical make up, but they are in the same class of drug and are considered detergents. They both cause protein breakdown of the vein. Our facility does not use either. We use a drug called Polidocanol (Asclera), which is also a detergent. It is just as effective with less risk to the patient. Both the Sotradecol and Scleromate can cause tissue necrosis if used improperly, but with Polidocanol, there is very little risk of tissue damage.
Published on Jul 11, 2012
Both of these solutions are in the family of detergents because they can be mixed with air or C02 to form foam. A third solution, polidocanol (Asclera), can also be foamed and is also a detergent sclerosing solution. Tetradecyl sulfate and polidocanol are FDA approved and sodium morrhuate was grandfathered in by the FDA. All work well, but it is thought that morrhuate has more allergic reactions than the other two. Tetradecyl sulfate is also stronger than polidocanol, but also has more potential complications. I prefer polidocanol as my sclerosing solution of choice.
Published on Jul 11, 2012
Sotradecol and scleromate are both considered sclerosants. However, when talking about doing "sclerotherapy" involving the legs, sotradecol is the more commonly accepted drug of choice. There are a multitude of sclerosants out there, not all of which are appropriate for the legs. There are sclerosants for varicose veins in other areas of the body. Polidocanol is another viable option when doing sclerotherapy on the legs.
Published on Jul 11, 2012