Foam Treatment for Varicose Veins

Sclerotherapy (needle therapy) is a treatment method applied especially for fine and capillary varicose veins on the skin surface. The primary purpose of the treatment is to improve the aesthetic appearance. Sclerotherapy is the process of closing the vein by injecting a chemical substance or drug into the vein with the help of an injector with a thin needle tip. The closed thin varicose veins are absorbed and destroyed by the skin with time, and thus they become invisible or less noticeable.

Sclerotherapy can be done in two ways. The first one is that the injector is filled with the drug, which is then delivered into the vein in liquid form. In a second way, the drug is mixed with a certain amount of air to create a foam, which is then delivered into the vein. This application is called "foam sclerotherapy" or "foam treatment for varicose veins." Sclerotherapy is applied especially for red-colored thin capillary varicose veins, namely, 'telangiectasia,' and for medium-sized blue and green varicose veins, ‘reticular veins.’  The foam treatment is a more proper treatment for blue-green and relatively thicker varicose veins.

Drug Used in the Foam Treatment for Varicose Veins

In our country, there is only one drug available and used for sclerotherapy. ‘Polidocanol’ is the active ingredient of this drug. The same drug is used in both liquid and foam sclerotherapy procedures. In other words, a different drug is not used in the "foam treatment for varicose veins," but the same drug is used in a different form. For this purpose, foam is achieved by mixing a certain amount of medicine and air by using two injectors. Then, this foam is injected into the varicose vein using the appropriate needle tip.

During the foam treatment for varicose veins, a certain amount of air is delivered into the vein. Under normal conditions, there is no free air in our veins. Only a certain amount should be given during a sclerotherapy session so that the foam delivered does not cause some side effects. Otherwise, some side effects may develop, including coughing, chest tightness, migraine attack, and even temporary vision loss. Therefore, a gradual treatment plan must be used in the foam treatment for varicose veins. In many patients, it is not appropriate to treat all varicose veins in a single session, considering some reasons and patient health.

What to Do Before the Foam Treatment for Varicose Veins?

First of all, the patient must be given detailed information about the treatment in a face to face conversation. The estimated number of sessions the treatment will take, cost, and the expected recovery rate are discussed. Then, a written and signed consent form (medical consent) d from the patient. Standard medical photographs of all patients undergoing sclerotherapy should be taken. A separate written and signed permission form must be obtained before this photoshoot. This photoshoot documents details such as permanent marks, dark spots, or moles that exist on the legs before the treatment. Besides, it enables the objective comparison of the pre- and post-treatment situations. These photos are solely for medical documentation and are taken without revealing the identity of the patient. 

How to Apply the Foam Treatment for Varicose Veins?

The foam treatment for varicose veins is conducted in sessions. The number of sessions required for each patient varies from person to person, depending on the prevalence of varicose veins in the patient's legs. Sclerotherapy sessions are organized in an outpatient clinic setting. Each session takes approximately 45-60 minutes. The length of time required between sessions varies by the coexistence of medium-sized and thin capillary varicose veins in the treated region.

The foam treatment for varicose veins seems simple from an external perspective but it must be applied by a physician because improper applications can cause serious side effects, and skin necrosis and gangrene. Before the treatment, the patient should be examined by a cardiovascular surgeon, and the patient should have a venous ultrasonography scan. During foam sclerotherapy, a suitable dose of foam should be administered into the vein with the appropriate needle tip and at the appropriate pressure. When the drug is administered intravenously, a feeling of redness and a slight burning sensation occur in that region. However, since the application is performed with considerably fine needle tips, the patient feels a slight degree of pain, which is likely to be comparable to a mosquito bite.

What to Do After the Foam Treatment for Varicose Veins?

The patient is recommended to walk after the foam sclerotherapy session. Contact sports, aerobics, or weight lifting are inadvisable for a week after sclerotherapy. Also, you can go back to work one-two days after sclerotherapy, unless it involves intense physical activity. Compression stockings should be worn for two weeks after sclerotherapy because compression after sclerotherapy is important for the success of the treatment. The treated regions should not be exposed to direct sunlight for at least two weeks after sclerotherapy because sunlight can stimulate the melanin pigments and leads to dark marks. If you can protect your leg with foam sclerotherapy from sunlight with long trousers or skirts, sclerotherapy can be applied in summer. But of course, it will not be appropriate to have sclerotherapy at a time when you are planning a trip to the seaside.

However, it must be noted especially that the foam treatment for varicose veins is not a treatment method that provides you with definite results within a few days. When applied to an enduring patient with an experienced and correct technique, almost perfect results can be achieved. In this way, you can simply wear the clothes you want in the upcoming summer season, and you will not be disturbed by the appearance.

In conclusion, sclerotherapy is utilizable in a patient with normal venous ultrasonography results for a better appearance, that is, for cosmetic purposes. The vascular structure and diameter must also be appropriate, and the treatment, along with a correct technique, must be performed by an experienced physician. Before and after photos of the treatment should be taken. It takes months to get the expected results from the treatment. During this process, the patient should also be enduring and attend the required number of sessions. If you are uncomfortable with the appearance of your varicose veins, Assoc. Prof. Dr. İlker Kiriş can examine you and provide you with insight. Assoc. Prof. Dr. İlker Kiriş is a physician with plenty of experience in the foam treatment for varicose veins, and he specifically deals with this issue in his daily professional practices.