Foam That Finishes the Job
What Is Varithena?
Varithena is an FDA-approved microfoam sclerotherapy used to treat the larger and more complex varicose veins that remain after the main diseased veins have been closed.
In a well-planned treatment sequence, the big axial veins are sealed first, typically with radiofrequency ablation or VenaSeal, and Varithena then takes care of the winding, deeper tributaries that a catheter-based treatment cannot follow. It is particularly effective for veins with tortuous anatomy and for veins that have not responded fully to other approaches. Its active ingredient is polidocanol, a well-established sclerosant that causes the vein wall to collapse and seal. Once sealed, the body gradually absorbs the closed vein and reroutes blood through healthy vessels.
A few practical facts make Varithena easy to plan around:
- Procedure time: approximately 15 minutes, in the Youngstown office
- Anesthesia: none required beyond the brief discomfort of a small needle
- Delivery: most sessions completed with a single, ultrasound-guided injection
- Driving and activity: patients drive themselves home and return to normal activity the same day
- Results: symptom improvement typically noticed within days to weeks
Varithena is rarely used as a starting point; it is most effective as the next step after the larger sources of reflux have already been addressed. That sequencing is part of what makes its results hold.
The Science Inside the Foam
How Varithena Works and What Recovery Looks Like
What separates Varithena from conventional liquid sclerotherapy is the foam itself, and the engineering behind it is worth understanding.
In larger veins, a liquid sclerosant gets diluted and swept away by blood flow before it can act evenly on the vessel wall. Varithena’s microfoam solves that problem: injected under ultrasound guidance, the foam physically displaces the blood inside the vein, so the polidocanol makes uniform, sustained contact with the full circumference of the wall. The microbubbles themselves are made of oxygen and carbon dioxide, gases that dissolve rapidly into the bloodstream, unlike the nitrogen-heavy room air used in foam mixed elsewhere. The result is a more consistent closure, achieved with a formulation built specifically to minimize risk.
Recovery follows the same compression protocol as RFA, since both treat larger veins: the dressing, wrap, and bolster stay in place for 48 hours, stockings are worn day and night for two weeks, and daytime compression continues for about six months for the best long-term result. Short, frequent walks are encouraged from the day of treatment. For four weeks, heat and direct sun on the treated area are avoided, and anti-inflammatory medications give way to acetaminophen for the same reason as after RFA. A follow-up ultrasound confirms each treated site before the plan moves to its next step, and full details live on the Compression & Post-Procedure Care page.
Every Vein in Its Turn
Dr. Schmetterer's Philosophy of Care
Varithena is rarely a standalone answer, and presenting it as one would be doing patients a disservice.
In Dr. Schmetterer’s hands it is part of a deliberate sequence: the duplex ultrasound maps the entire venous system first, the largest sources of reflux are closed, and Varithena then addresses what remains, each step confirmed by imaging before the next begins. That order matters, because treating tributaries while the vein feeding them is still open invites the problem back. It is the difference between a treatment plan and a series of procedures. After 34 years of vascular surgery, the planning is where his experience shows most.
The payoff for the patient is a result that holds: legs that stay comfortable through long days, evening walks, and everything else life in the Valley asks of them. Varithena is often the step that finishes that work.
FAQ
Frequently Asked Questions
How is Varithena different from regular sclerotherapy?
Both use polidocanol, but Varithena’s microfoam formulation is built for larger veins that liquid sclerotherapy cannot treat effectively. In bigger vessels, liquid is diluted and displaced by blood flow before it can work evenly, while the foam pushes the blood aside and keeps the medication in full contact with the vein wall. That mechanical difference is what makes Varithena far more effective for large and complex varicose veins.
Is Varithena painful?
No anesthesia is required, and most patients feel only the brief, mild discomfort of a small needle at the injection site. The procedure itself takes approximately 15 minutes and is very well tolerated. Patients drive themselves home and return to normal activities the same day.
Will I need more than one Varithena treatment?
Varithena is typically used as part of a staged sequence, after the larger axial veins have been closed with RFA or VenaSeal. The number of sessions depends on how many varicose tributaries remain and how extensive they are, which the initial ultrasound evaluation makes clear. Dr. Schmetterer outlines the complete plan from the start, so each patient knows exactly what their sequence involves.
