There are three groups of sclerosing agents:
- Detergents include Sodium Tetradecyl Sulphate and Polidocanol.
- Irritants include Glycerine, Sodium Iodide, tetracycline and absolute alcohol.
- Osmotic agents. Specifically Hypertonic saline.
The detergent sclerosants Sodium Tetradecyl Sulphate (STS) and Polidocanol (POL) are the most important agents now in use today. They are very similar in their mode of action in that they remove the endothelial cells. Because STS and POL are surfactants the molecules dissolve into the membrane of the endothelial walls causing the cells to rupture which leads to the cell being simply washed away. When this happens the raw underlying surface of the vein wall is exposed triggering off a reaction which actives the formation of collagen forming inside the vein and sealing off the flow of blood in the vein. Eventually formation of scar tissue replaces the vein deserve special attention as they are now the most prolific agents used because of their long history of very safe use going back to the 1940s. (Trade name: “Fibrovein”) and (Trade name: “Aethoxysclerol” & “Laureth - 9”)