A new way to treat varicose veins without surgery

Varicose veins are more than a cosmetic concern — they can cause pain, swelling and long-term complications. Fortunately, patients have access to polidocanol injectable foam, a minimally invasive, non-surgical treatment that provides effective relief with little to no downtime.

Varicose veins occur when faulty valves in the veins cause blood to pool, resulting in enlarged, twisted vessels. While some cases are mild, others can lead to skin changes, ulcers or blood clots.

Varicose veins affect about 15% of adults in the U.S.  Risk factors include aging, pregnancy, obesity, prolonged standing and family history. While lifestyle changes, like staying active and wearing compression stockings, can help, they often don’t address the underlying issue. If left untreated, varicose veins can worsen and lead to complications.

“Patients often think they have to live with leg pain, heaviness or visible veins,” said Dr. Zachary Pallister, Baylor Medicine vascular surgeon. “But with injectable foam, we’re able to treat the problem at its source without the need for surgery.”

What is injectable foam and how does it work?

Polidocanol injectable foam (Varithena) is an FDA-approved, non-surgical treatment for varicose veins that uses a prescription microfoam to close diseased veins and redirect blood flow to healthier ones. It is injected directly into the vein through a minimally invasive technique called sclerotherapy, requiring no incisions or stitches. The procedure is done in the office and usually takes less than 30 minutes. Most patients return to normal activities the same day with minimal discomfort or downtime.

While traditional sclerotherapy often is used to treat smaller, surface-level spider veins, this specialized injectable foam is designed for larger, deeper and more symptomatic varicose veins, particularly those in the leg’s largest superficial vein — which runs from the ankle to the groin — and its branches, areas that are often difficult to treat with other techniques.

The microfoam is injected directly into the vein, where it displaces blood, irritates the vein wall and causes the vein to collapse and seal shut. Over time, the treated vein is naturally absorbed by the body. Due to its foam consistency and ability to fill and treat twisted or hard-to-reach veins, this method provides a more targeted and efficient treatment option compared to older sclerotherapy methods.

“Patients are often surprised at how simple it is,” said Pallister, assistant professor of surgery in the Division of Vascular Surgery and Endovascular Therapy. “They’re up and walking right after the procedure and can return to normal activities the same day.”

Why choose injectable foam?

Studies show that most patients experience significant improvement in both appearance and symptoms, such as leg pain, heaviness and swelling. In clinical trials, more than 80% of patients reported an improved quality of life after treatment.

Compared to heat-based treatments like radiofrequency ablation, injectable foam may be a better option for patients with veins that are difficult to access or located close to the skin. It’s also an effective choice for people who have had previous vein treatments.

“Injectable foam allows us to treat a broader range of vein issues, including veins that are twisted or difficult to reach using other techniques,” Pallister said.

By Tiffany Harston, senior communications associate in the Michael E. DeBakey Department of Surgery