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He notes that while radiofrequency (RF) and laser ablation are effective for many varicosities, their associated catheters cannot access tortuous veins. In such scenarios, foam-based therapies, like polidocanol endovenous microfoam (Varithena), are well-suited for treatment. Dr. Wellons expresses concerns about physician-compounded foam (PCF), highlighting that PCF is not prepared in a controlled setting, leading to variability in bubble size and stability. This variability may increase the risk of complications. In contrast, polidocanol endovenous microfoam consists of small, uniform bubbles, offering a more stable and standardized therapy. Dr. Wellons concludes that polidocanol endovenous microfoam is safer and more likely to produce successful, durable results than PCF.