Varithena
A manufactured foam Polidocanol mixed into a fine, even foam in a canister. The bubbles push blood out of the way so the drug touches the vein wall directly.
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Dermapedia / CompareProcedures
Varithena vs Sclerotherapy
Varithena is a ready-made foam for large varicose veins, including the trunk vein under the skin. It is injected with ultrasound guiding it, usually in one visit. Plain sclerotherapy is better for spider veins and small surface veins. It is a course of injections spaced weeks apart. Both use the same kind of drug, so the real question is vein size, not brand.
At a glance
| The difference | Varithena | Sclerotherapy |
|---|---|---|
| What it is | A manufactured foam | A liquid, or a hand-mixed foam |
| What it feels like | Pressure, then an aching leg | Stinging, then a brief cramp |
| Downtime | Walk out, easy for a day or two | None, and walking is encouraged |
| Cost and insurance | One larger fee, often covered | Priced per session, and it is a course |
Sclerotherapy
Side by side
The differences that matter
What it is
Varithena
A manufactured foam
Polidocanol mixed into a fine, even foam in a canister. The bubbles push blood out of the way so the drug touches the vein wall directly.
Sclerotherapy
A liquid, or a hand-mixed foam
The same family of drug in liquid form. For medium veins many doctors whip their own foam at the bedside with a syringe.
How it works, illustrated
Sclerotherapy
Which veins it is for
Varithena
Large veins, including the trunk vein
Twisted trunk veins and big branches, usually found on ultrasound rather than by eye.
Sclerotherapy
Spider veins and small varicose veins
The fine red and purple lines, and small ropey veins you can see near the surface.
How it is done
Varithena
Needle or catheter, plus ultrasound
The leg is scanned while the foam is injected, so the doctor can watch it fill the vein and spasm it shut. No heat, and no numbing fluid along the vein.
Sclerotherapy
Freehand injections into what you see
Several small injections per visit, sometimes with a light or vein finder to spot feeding veins.
What it feels like
Varithena
Pressure, then an aching leg
The injection itself is quick. Legs often feel tight or achy for a few days afterwards.
Sclerotherapy
Stinging, then a brief cramp
Each injection stings for a second. Some solutions cause a short cramping ache.
How many visits
Varithena
Often one, sometimes two
A follow-up scan checks the vein stayed closed. Surface veins are usually mopped up separately.
Sclerotherapy
Usually two to four
Spaced a few weeks apart. Large clusters take more.
Downtime
Varithena
Walk out, easy for a day or two
Compression stockings for about a week. Walking daily is part of the instructions.
Sclerotherapy
None, and walking is encouraged
Stockings for a week or two. Skip the gym and long standing for a day.
The main downside
Varithena
Aching, lumps and staining along the vein
A treated trunk vein can feel firm and sore for a few weeks. The rare serious problem is a clot spreading into a deep vein, which is why walking matters.
Sclerotherapy
Brown staining and new tiny veins
A brown line along the treated vein can last months. A blush of new tiny vessels can appear nearby. Both usually fade.
Cost and insurance
Varithena
One larger fee, often covered
Treating varicose veins that ache, swell or bleed is often covered by insurance.
Sclerotherapy
Priced per session, and it is a course
The at-home or drugstore version
Varithena
There is no home version
Nothing sold to the public produces a controlled foam or puts it into a vein under ultrasound.
Sclerotherapy
Stockings and vein creams
Compression stockings ease aching and swelling but remove nothing. Creams cannot reach a vein. Handheld "vein removal" pens act only on the skin surface and can leave marks.
Who each suits
Varithena
- Best for — A leaking trunk vein, especially a twisted one a catheter cannot pass.
- The mindset — You want the source dealt with in one appointment, without heat.
Sclerotherapy
- Best for — Visible spider veins and small surface veins.
- The mindset — You are treating the look of your legs across a few visits.
Before you book
More photographs
Sclerotherapy
Common questions
Questions Patients Ask
Is Varithena the same thing as sclerotherapy?
It is a form of it. Varithena is a ready-made foam version of a sclerotherapy drug, aimed at large veins under the skin. Ordinary sclerotherapy uses a liquid on smaller veins you can see.
Can Varithena treat spider veins?
It is not used for that. Spider veins are treated with a much weaker liquid injected into the vein you can see.
Is Varithena better than laser or radiofrequency ablation?
Pooled comparisons have not shown a clear winner for keeping the vein closed. Foam avoids the line of numbing injections that heat treatments need, and reaches twisted veins a catheter cannot pass.
How many Varithena treatments will I need?
Often one per leg, sometimes two. A follow-up ultrasound checks the vein stayed shut. Surface veins usually need separate sessions afterwards.
Does insurance cover Varithena?
Often, when the varicose veins cause aching, swelling, itching or bleeding. Insurers commonly want an ultrasound and several weeks of compression stockings first. Spider vein injections are usually treated as cosmetic and not covered.
What are the side effects?
Aching, bruising, firm lumps and brown staining along the treated vein are common and settle over weeks. The rare serious problem is a clot spreading into a deep vein, which is why daily walking is part of the aftercare.