The US Food and Drug Administration (FDA) has approved polidocanol injectable foam (Varithena, BTG) for the treatment of incompetent veins and visible varicosities of the great saphenous vein (GSV) system, British pharmaceutical company BTG announced today.
Varithena (formerly known as Varisolve) is a pharmaceutical-grade, low-nitrogen, polidocanol foam dispensed from a proprietary canister device. It is a “minimally invasive, non-surgical procedure that requires neither tumescent anesthesia nor sedation,” the company said in a news release.
In a pair of phase 3 placebo-controlled studies known as VANISH-1 and VANISH-2, polidocanol injectable foam led to clinically meaningful improvement in the symptoms of superficial venous incompetence and the appearance of visible varicosities and addressed the underlying venous incompetence in the majority of patients treated, the company said.
It is estimated that more than 30 million adults in the United States have varicose veins, with women twice as likely as men to develop varicosities. Varicose veins may require treatment for symptoms including leg pain, aching, heaviness, restless legs, cramps, throbbing, fatigue, itchiness, tingling, and edema. Current treatments for varicose veins include thermal ablation and surgery.
Polidocanol injectable foam “provides US physicians with the only approved comprehensive therapy to improve symptoms and appearance for a wide range of varicose veins, including incompetent GSV, accessory saphenous veins and visible varicosities of the GSV system both above and below the knee,” BTG said.
According to the release, the company plans to launch the product in the second quarter of 2014.

This News is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake

What are Varicose Veins?

Varicose veins are large blue, dark purple veins. They protrude from the skin and many times they have a cord-like appearance and may twist or bulge. Varicose veins are found most frequently on the legs.

What are Spider Veins?

Spider veins are very small and very fine red or blue veins. They are closer to the surface of the skin than varicose veins. They can look like a thin red line, tree branches or spider webs. Spider veins can be found on the legs and face and may cover a small or large area.

What are Reticular Veins?

Reticular veins can also be known as feeder veins. They are the blue and green veins beneath the surface of the skin. Reticular veins enlarge because of increased pressure in the vein. They can be caused by heredity. You may have reticular veins alone but you may also have spider veins at the same time.

What Causes Spider and Reticular Veins?

Spider and reticular veins can be caused by many factors.

  • Heredity. Having a family member with prominent veins may increase the risk of you developing them. Approximately half of the people who get varicose veins have a family history of them.
  • Age. The normal wear and tear of aging may cause valves in the veins to weaken and not work as well.
  • Gender. Women are two to three times more likely to develop varicose veins than men. Up to half of American women have varicose veins. Changes in hormones due to puberty, pregnancy, menopause, or taking birth control pills may increase a woman’s risk of developing varicose veins.
  • Pregnancy. During pregnancy, the growth of the fetus increases the pressure on the veins in the legs. Varicose veins that occur during pregnancy usually improve within 3 to 12 months following delivery.
  • Overweight and obesity. Having extra weight on the body can put additional pressure on the veins.
  • Prolonged standing or sitting. This is particularly true with legs bent or crossed. When standing or sitting with legs bent or crossed, the veins have to work harder to pump the blood up to the heart.
Other possible causes for varicose veins are race, posture, occupation, hormones such as estrogen and progesterone, primary valvular incompetence, and incompetent perforating veins.

What is Sclerotherapy?

Sclerotherapy is a minimally invasive procedure that uses chemical agents injected into the veins that cause them to collapse or obliterate. This is a non-painful procedure that is very well tolerated without anesthesia at all. The sclerosing agent that Dr. Bishara utilizes is Asclera, the only FDA approved POL available in the United States. It is safe and effective having minimal reported complications as per today. Patients undertake their injections in a friendly and relaxed environment without pain at all. The procedure is completed in 30-45 minute sessions.
Who are good candidates for Sclerotherapy?
Anybody who has visible unwanted veins is a good candidate.
Before and after Sclerotherapy treatment:

Vein Treatment from Dr. Mark Bishara

While spider and varicose veins have been successfully treated for years through conventional methods such as stripping and ligation, these procedures often cause pain and other unwanted symptoms during and after treatment. Laser procedures offer patients more precise results through a minimally invasive setting. Laser vein treatment offers patients:

  • Fewer side effects
  • Less pain and trauma
  • Shorter treatment and recovery time
  • Minimal downtime

If you suffer from unsightly spider veins, Dr. Bishara can help. With two options for treatment, there is a solution for you. Ascelera injections are quick easy and relatively painless. Our IPL Laser treatments are perfect for smaller vessels. To see what treatment options are best for you, call and set up a complimentary consultation with Dr. Bishara today at 817-473-2120.


Today I want to talk about the benefits antioxidants can have on your skin. Antioxidants are chemicals designed to protect your body’s cells by neutralizing internal and external forces that produce free radicals. Free radicals are what causes our skin to age and cause skin damage. When free radicals attack healthy skin cells, they cause the cell to decay. While it is hard to avoid free radicals all together, there are things we can do to protect ourselves by making some changes to our lifestyle.

Some lifestyle changes you can make to avoid free radicals are things like avoiding sun exposure, cigarette smoke, more than moderate drinking, getting adequate rest, and having a diet high in antioxidants. When choosing a diet rich in antioxidants you are not only helping your skin, but you are doing a service to your body. Foods that are high in antioxidants are fruits, vegetables, whole grains, fish and omega 3 fatty acids.

Measures you can take to protect your skin include using topical antioxidants. Some ingredients to look for in your creams and lotions are vitamins A, C (ascorbic acid), E, green tea, idebenone, coffee berry, and coenzyme Q10. Using these lotions regularly is highly recommended to protect your skin from free radical damage.

Serums are another great way to get antioxidants deep into the skin. For example, Obagi™ makes an amazing Professional-C Serum™. Professional-C Serum 20% is proven to deliver better absorption and stability than the leading 20% vitamin C serum to give you a maximum antioxidant protection. Along with these lotions and serums, SPF of 30 is extremely important in protecting your skin from the sun’s harmful UV rays. If you want to go a step farther, getting facials, peels and microdermabrasions will help to shed the dead skin cells so that antioxidant rich products will be able to penetrate the skin further protect new skin cells.

Topical antioxidants can provide some protection from the environment and may be effective in slowing down the aging process. Maintaining your skin’s youthfulness requires integration into your everyday routine. Your skin is the first thing people see when they look at you so protect it and give it the nourishment that it needs.

Dr. Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

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