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What is ultrasound guided foam sclerotherapy?

Foam Sclerotherapy

Images courtesy of
Steven E. Zimmet, MD

Foam sclerotherapy is a form of varicose vein treatment that involves injecting a foam solution directly into the varicose veins. Varicose veins are veins with valves that aren’t working well. The blood in these veins doesn’t flow efficiently, but rather pools in one particular area. The injected foam causes the treated veins to seal off, which eventually causes those veins to disappear. After foam sclerotherapy, blood that normally flows through that vessel will naturally redirect to other veins that are working properly.

Unlike the liquid medications used during traditional sclerotherapy, the foam material used in foam sclerotherapy material will show up on an ultrasound medical imaging device. Because of this, the foam can be detected and tracked during the injection procedure to enable more precise treatment of the varicose vein. Because of its thicker consistency, the foam maintains more prolonged contact with the wall of the blood vessel without being diluted by blood in the vein. Thus, foam sclerotherapy is more effective than liquid sclerotherapy in treating larger varicose veins that contain significant amounts of blood. Foam sclerotherapy is typically not needed to treat small veins such as spider veins. In fact, if used to treat spider veins foam sclerotherapy may be more likely than its liquid counterpart to cause overtreatment reactions such as discoloration. To learn more about ultrasound-guided foam sclerotherapy, refer to our vein procedures directory.

Foam sclerotherapy is done in-office. It generally takes about 15-30 minutes to complete, depending on the number of veins being treated. When treating veins below the skin’s surface, an ultrasound machine will be used to guide needle placement for the foam sclerotherapy. A local anesthetic may be used for these deeper injections. Most patients do not find the procedure very painful as the needles used are typically of small caliber.

After undergoing foam sclerotherapy, patients should be able to resume normal daily activities and should not have to miss work.  It is common for the physician to prescribe compression stockings for a week or two after foam sclerotherapy. Other common instructions are to do some walking each day as well as to avoid heavy weight-lifting and long travel for a one-week period following the foam sclerotherapy procedure. Follow-up treatments may be necessary to obtain the best results.

While foam sclerotherapy is usually very well tolerated, all procedures have potential complications. Refer to our medical directory to find a doctor who specializes in treatment of varicose veins with foam sclerotherapy in order to discuss treatment options, benefits and risks.


Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology

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