A liquid medicine is mixed with air into a fine foam and injected into the vein under ultrasound guidance. The foam displaces the blood, touches the whole vein wall, and makes the vein close down and scar away.
Ultrasound guided foam sclerotherapy injects a foamed sclerosant into a varicose vein, causing the wall to react, close and eventually be absorbed. It needs no anaesthetic and no cuts, takes fifteen to thirty minutes, and is particularly useful for veins that are too twisted for a laser fibre, for veins that have come back after earlier surgery, and for veins feeding an ulcer. More than one session is often needed.
Surgery removes a vein. Laser seals it with heat. Foam closes it chemically. All three end in the same place, which is a vein that no longer carries blood the wrong way, and each suits a different situation.
Foam's advantage is that it flows. A laser fibre needs a reasonably straight path, and a stripper needs a vein that will come out in one piece. Foam simply follows the vein wherever it goes, which makes it well suited to twisted branch veins, to veins that have recurred in scar tissue after earlier surgery, and to the network of veins around a venous ulcer where cutting is best avoided.
Its disadvantage is that it is less durable than heat or surgery for a large main trunk. Veins treated with foam reopen more often than veins treated with laser, and repeat sessions are common. That is a reasonable trade for the right vein and a poor trade for the wrong one.
Foam is a good tool used in the right place. Used as a shortcut on a large refluxing trunk it tends to disappoint.
The veins to be treated are identified on ultrasound and marked while you stand.
The liquid sclerosant is mixed with air through a fine tap into a stable foam immediately before use.
A fine needle is placed into the vein and the foam injected while it is watched on the screen, so its spread is controlled rather than guessed.
The vein is seen to fill and go into spasm. Injection stops when the target segment is filled.
The leg is bandaged or a stocking is fitted immediately, and you walk for around fifteen minutes before leaving.
You walk immediately and go home. Normal activity the same day. No anaesthetic to recover from.
Treated veins feel firm and tender. Compression is worn as instructed. Mild bruising and staining appear along the vein.
Tenderness settles. Staining is at its most obvious. Further sessions, if planned, are usually spaced from here.
Treated veins soften and flatten. Brown staining fades in most people over this period.
Treated veins harden, darken and gradually fade over several months. Brown staining along the line of the vein is common and usually settles within six to twelve months, though it can occasionally persist. Most patients need more than one session, and larger trunks reopen more often than they do after laser or surgery. Foam is very effective at clearing the twisted branch veins that other methods reach awkwardly.
Foam travels, which is the source of both its usefulness and its particular risks.
Compression immediately afterwards is what keeps the vein walls together while they seal.
For twisted branch veins, recurrent veins and veins around an ulcer, foam often works better than anything else. Its weakness is durability on a large main trunk, not effectiveness in general.
More than one session is common, particularly where there are many veins. That is planned for from the start rather than discovered later.
Staining is common and usually fades over six to twelve months. In a minority it persists, which is worth knowing before treating veins that are only a cosmetic concern.
Foam is offered where it genuinely is the better tool, most often for recurrent veins and around ulcers, rather than as an easier substitute for treating the trunk properly.
Priced per session, and more than one session is commonly required, so the estimate covers the expected course rather than a single visit. Treatment for symptomatic varicose veins is commonly covered by health insurance and government schemes. Treatment for appearance alone is not.
What people ask about injections rather than an operation.
Ask your question →Often two or three, sometimes more where there are many veins. You are given an expected number after the scan, and it is reviewed as treatment progresses rather than fixed rigidly.
Iron pigment from blood trapped in the treated vein leaks into the skin. It is common, and it fades in most people over six to twelve months. Occasionally it persists, which matters most if the veins were being treated for appearance.
Brief visual disturbance or a migraine-like headache happens in a small number of people shortly after foam injection and settles on its own. Tell us if it occurs, because it influences whether and how we use foam again.
Not for a large main trunk, where laser and surgery are more durable. For twisted branches, recurrent veins and veins around an ulcer, foam is frequently the better option.
Usually yes. There is no anaesthetic and no wound. You will be wearing compression and should walk regularly.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
