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Foam Sclerotherapy

Ultrasound-guided foam sclerotherapy is the gold-standard treatment option for varicose veins when EVLA is not required, as recommended by the National Institute of Health and Care Excellence (NICE).

It’s worth noting, though, that the vast majority of patients with varicose veins do require EVLA.

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Foam Sclerotherapy
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What is foam sclerotherapy?

Foam sclerotherapy treats both the symptoms and the causes of varicose veins and thread veins. It’s most commonly used as a secondary treatment following EVLA, specifically to treat the residual and smaller varicose veins. Sometimes, it’s the necessary primary treatment required to treat the underlying vein condition.

Click here to watch Dr Suzie Anthony explain what foam sclerotherapy is.

Foam sclerotherapy is a procedure where a diluted drug is injected directly into varicose veins. The drug’s mixed with foam and air. The foam displaces the blood in the veins and the drug destroys the cells in the vein lining. After the procedure, treated veins shrivel up and your body breaks down and absorbs the dead tissue naturally. 

Foam sclerotherapy is carried out on an outpatient basis. It usually only takes around 30-45 minutes, depending on how many veins need treating. 

There’s little to no recovery time required after the procedure, so chances are you’ll be able to resume normal activities straight away. Better still, our patients do not usually find the treatment painful.

A detailed description of sclerotherapy treatment


At your initial consultation, you’ll have an ultrasound scan to identify which veins require which treatment. A consultant will then give you a full explanation of the treatment options, including potential complications and success rates. When you arrive for your foam sclerotherapy treatment appointment, your consultant and assisting nurse will welcome you into the treatment room. We encourage you to ask any further questions before you sign the consent form required for us to proceed. 

You can listen to your choice of music during your treatment, while your nurse will be at your side throughout your appointment.


The Procedure

At the start of the procedure, the veins that require treatment are identified. A small needle (butterfly) will be inserted into these veins so we can inject the foam solution. 

The foam displaces the blood in the vein and attacks the lining of the vein wall, causing the vein to shrivel up. The foam ensures good contact with the cells in the lining of your veins, producing the most effective results. The shrunken veins are then broken down and absorbed gradually by your body. As with EVLA, once the veins have been destroyed, the blood is naturally rerouted to healthy veins, improving your circulation.

If we’re treating large varicose veins, we’ll use ultrasound guidance during your procedure. This isn’t usually necessary for smaller veins that are close to the surface, as visual guidance is sufficient.

Due to the series of tiny injections involved in the foam sclerotherapy procedure, some patients find them uncomfortable or mildly painful. The sclerosant used can sting slightly. 

The procedure usually takes around 30-45 minutes. 



Following your treatment, your nurse will help you put on a compression stocking, which you need to wear for 7 days after your procedure. You’ll wear two of these if you have both legs treated. Your nurse will explain how to wear these and bathe in them. They’ll also provide you with aftercare advice, including any post-treatment symptoms to be aware of. 

You’re encouraged to go for a walk for at least 10 minutes prior to returning home.

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    Foam Sclerotherapy Aftercare

    After foam sclerotherapy treatment, you are to wear a class II compression stocking constantly for 7 days. This shouldn’t affect your movement, but we discourage you from going swimming with it on. 

    You can drive on the same day as foam sclerotherapy treatment. 

    We advise you to go for a 20-minute walk every day, and we urge you to resume your normal activities. 

    We do, however, advise you listen to how your body feels. Your body does a lot of the work absorbing the treated veins in the weeks after treatment, so don’t push it too far. Your consultant will advise you if there’s anything else you need to avoid following your procedure. 

    The sclerosant used can cause some bruising of the skin. The extent of this depends on the size of the area treated and the number of veins in that area.

    Click here to watch Dr Previn Diwakar explain how long it takes for foam sclerotherapy to work.


    Foam Sclerotherapy Follow-Up

    Following a primary sclerotherapy session, you may or may not need to return to see us. 

    You can assess whether you need to return yourself, based on how your leg looks and feels. The desired result is all down to you as the patient, so if you’re happy with the result, there;s no need to pay for a follow-up appointment. 

    If, however, you would like reassurance, or if you feel that you would benefit from further treatment, you can book either a reassessment follow-up or a further treatment appointment. We advise you to wait at least 4 weeks between appointments, to ensure you get the most benefit from each treatment session. 

    There’s no pressure to attend for a further treatment session straight away. You can wait up to 2 years before booking another session without needing to have a new consultation and scan prior to treatment. 

    Foam Sclerotherapy vs. EVLA

    If an underlying valve problem is found during your consultation, your treatment pathway is likely to involve the EVLA stages outlined within the Varicose Vein Treatment Pathway, rather than foam sclerotherapy alone. 

    Although some doctors treat large veins with foam sclerotherapy, the results aren’t as effective or as durable as EVLA. We want to ensure that your treatment has long-lasting results and sorts the root of the problem. As such, we do not recommend foam sclerotherapy as a primary treatment for the majority of patients. 

    We do use foam sclerotherapy for any residual varicosities we may find at a follow-up appointment after EVLA. Some patients who have a recurrence of varicose veins after EVLA may just need some foam sclerotherapy.

    Click here to watch Dr Suzie Anthony explain why we normally use foam sclerotherapy in combination with EVLA.


    Treatment Risks

    With all medical treatments, it’s important to weigh up the benefits versus the risks. With that in mind, we have provided you with a full outline of the known vein treatment risks. Or click here to watch Dr Suzie Anthony explain treatment risks.

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