Thread veins on the leg and the face – also commonly referred to as ‘spider veins’, ‘broken veins’, ‘surface veins’ or ‘venous flares’ – are small blood vessels in the most superficial layer of the skin (the dermis) which have become dilated and visible. Thread veins are very common, affecting around 80% of adults (evenly split across both sexes) at some point in life, and they are usually associated with underlying vein problems.
Key to our approach is, first, to find out what is going on beneath the skin with a scan. And as specialists in venous problems, we look for treatments beyond simply addressing the veins on the surface (which does not usually give good results in the long term, with thread veins coming back after treatment) or risking skin scarring from utilizing the wrong treatment methods.
The visible symptoms of thread veins appear as many different sorts of marks and depths of colour on the legs, depending on the size and distribution of the thread veins. The colour of the thread vein depends on the size of the vein itself, whether the blood within is flowing or stationary, and its depth relative to the surface of the outermost ‘dermis’ layer of the skin.
In some thread veins, especially those nearing 1mm in diameter, a layer of blood can clot and stick onto the thread vein wall. This layer of clotted blood (or ‘thrombus’ as it is known) causes the thread vein to look much darker still – usually dark purple or dark blue if near the surface.
once we have treated any underlying vein problems that may be present, we almost exclusively recommend the technique of ‘microsclerotherapy’ for the treatment of thread veins on the legs. This involves injecting a very dilute ‘sclerosant’ solution into the tiny veins to narrow the dilated blood vessels. This is achieved using an exceptionally small needle under very high magnification.
Each microsclerotherapy session is performed using a strictly controlled maximum dose of the sclerotherapy solution. If the thread veins being treated are extensive, it may be that a second procedure needs to be scheduled for the following day. It is perfectly safe to perform these two procedures in quick succession without any risk of overdose.
The area where the Microsclerotherapy has been performed will initially look worse than it did prior to the treatment, and improvement will only start to be seen between 6 and 12 weeks later. For this reason,its better not to repeat Microsclerotherapy in an area within three months, as it is impossible to tell whether the visible thread veins are veins that have already treated and are in the process of disappearing. Should any thread veins remain obvious in a treated area after three months, it may then be appropriate to repeat the procedure.
After care
As noted above, for the very best results, the patient needs to wear graduated compression stockings for a full 14 days and nights after microsclerotherapy. Although many patients are tempted to remove the stockings for showers or for baths, this will undoubtedly compromise the final cosmetic result. The patients who enjoy the very best treatment results are the ones who religiously keep their stockings on without interruption for the full fortnight.
Whilst most of our patients experience an excellent clearance of their thread veins, other patients are less fortunate, simply due either to their own individual biology, to specific life events such as pregnancy or even to prolonged use of the oral contraceptive pill.