Foam sclerotherapy: how does it work?

Written by: Mr David Greenstein
Edited by: Laura Burgess

Varicose veins can cause many problems: aching legs, unsightly veins, bleeding, skin damage, eczema, leg ulcers, blood clots, and heavy swollen and discoloured legs! We’ve asked leading vascular and venous surgeon Mr David Greenstein to explain how he uses foam sclerotherapy to treat the condition and its unsightly symptoms.

What are the causes of varicose veins?

Varicose veins are predominantly caused by the 41 directional valves in the vein. When the valve becomes faulty the blood moves in two directions instead of one and causes the vein to swell with increased pressure. This then develops into varicose veins. Risk factors of the condition include obesity, pregnancy, a history of deep vein thrombosis and it can occasionally run in the family.

What is foam sclerotherapy?

Foam sclerotherapy can be used for treating primary varicose veins, which are veins that have never been treated before, or recurrent varicose veins, where the condition reoccurs in individuals who have previously had treatment for them.

The treatment uses a foam solution of sclerosant (a chemical agent), which is injected into a vein to destroy it. The procedure takes around 45 minutes and is performed under local anaesthetic. It is a useful technique in treating varicose veins and the patient can leave hospital on the same day.

Varicose veins are very common as about one in three people in the UK have them throughout their lifetime. They are more common in the elderly than a younger age group although one in 15 people have signs of varicose veins meaning it can occur in young people too.

What conditions is foam sclerotherapy used to treat?

It is one of many different treatments for varicose veins and often the consultant will have a preferred treatment option. In my clinic, I only use sclerotherapy for recurrent varicose veins but it can be used for primary. It is not as effective as endovenous laser therapy or radiofrequency in treating primary varicose veins but it is very useful for recurrent varicose veins.

What are the side-effects of foam sclerotherapy?

Foam sclerotherapy is overall a very safe procedure. However, because of the chemical agent, there is a potential risk of blood clots. Sometimes veining of the skin can occur. Very rare complications include stroke. Your consultant will discuss the various treatment options with you so that a bespoke management plan is tailor-made. It is not a dangerous procedure but, as with any procedure, there is always a risk.


How long after foam sclerotherapy do you see results?

You can start to see results relatively immediately. Occasionally, more than one session is required, which is dependant on the severity of the veins and the clinical examination.


How long does recovery from foam sclerotherapy take?

It is immediate although there can sometimes be minor discomfort. Compression bandaging has to be worn for up to two weeks but is not required for endovenous treatment. Follow-up appointments depend on the severity of the vein, for some, it might be one and for others more than one consultation.

Can you walk or take a flight after the procedure?

Yes, you can walk immediately and it is very important to do so straightaway. You can start to exercise too if that’s part of your routine. If you have a trip and need to fly then short-haul is fine. For a long-haul flight, you would need a check-up with your doctor beforehand within a couple of weeks of having had the procedure.

How much does the procedure cost?

Foam sclerotherapy is done on a sessional basis and works out normally £8-900* a session, with some patients needing it done three times. Other options such as laser treatment would cost around £2-3,000 and take longer.

*Prices listed in May 2019 and may be subject to change.

Do not hesitate to book an appointment with Mr Greenstein if you would like to discuss having your varicose veins removed.

By Mr David Greenstein
Vascular surgery

Mr David Greenstein is a foremost consultant vein surgeon. Based at the British Varicose Vein Centre at the Hospital of St John and St Elizabeth, London, he is known for his friendly and approachable manner. He has an interest in the modern management of venous disease, deep vein thrombosis (DVT), and the swollen leg.

Mr Greenstein offers pioneering laser treatment for varicose veins, thread veins, and leg ulcers including VNUS treatment and ClariVein treatment, as well as venous superglue and infra-red assisted sclerotherapy, and has published numerous peer-reviewed articles on venous disease and varicose veins treatment. He also has an interest in pelvic venous congestion syndrome, and has recently been involved in pioneering new treatments and pathways in deep vein thrombosis (DVT) management using thrombolysis and intravenous stents, aimed at returning the leg to normal size and function.

He regularly organises workshops and is a member of the European Venous Forum Faculty. Mr Greenstein graduated at Leeds University in 1989, and has since trained in a number of major vascular units in Nottingham, Sheffield and Adelaide, Australia.

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