What are thread veins and how are they best treated?
Thread veins, also called spider veins, are tiny prominent veins just below the skin surface.
They tend to branch and give a spidery sort of pattern hence their common name. Spider veins can occur anywhere on the body but most often on the legs and face.
Leg Thread Veins
Although usually just a cosmetic problem thread veins on the legs can cause symptoms like burning pain and itching. The best treatment for thread veins is microsclerotherapy (injections with a tiny needle; see video below) but this must be done properly. It is important, even with asymptomatic thread veins, to assess patients with Duplex Ultrasound Scan to rule out the presence of valve failure in larger deeper veins. If valve failure is present and left untreated the thread veins will recur or not respond to treatment. It is also important to check, with either high resolution ultrasound scanning or devices like Veinlite® (see video below), that there is not a reticular vein (a blue larger feeder vein) leading to the thread vein clump. If a reticular feeder is discovered it is important to close this off first by foam sclerotherapy.
The best chemicals to inject are prescription only and can only be prescribed by a doctor and administered under his supervision. Beauty parlours often offer thread vein injections but normally these will be using less effective chemicals that beauticians are alloweed to use and do not require a doctors precription.
Techniques like laser, IPL and Veinwave™ do not work well on thread veins of the legs although are effective in managing thread veins on the face.
With meticulous planning and technique it is possible to get really good results with the vast majority of patients but in general thread veins take longer to get rid of than large varicose veins do. You may need several treatment sessions.
Although as you can see, in the microsclerotherapy video below, that the instant results from injecting thread veins are very impressive these soon fill up again with blood and it can take a few days or even weeks for the thread veins to disappear again permanently. During this time you will probably find that they look worse for a while. You may get a tiny "blood blister" look to the treated veins or some brown marks. These will settle eventually. You may also get a mild allergic reaction like a nettle sting.
Serious reactions are very rare but a few patients (less than 1%) develop tiny ulcers. These will heal but can leave tiny whitish scars.
Facial Thread Veins
Thread veins on the face are a different matter to those on the legs. They do not require scanning and are best treated by thermocoagulation (aka Veinwave™).
Thermocoagulation uses a really small needle to just penetrate the skin over the thread vein and administer heat to close it off. You will feel a slight pricking sensation as the needle goes in and as the energy is delivered. Several treatment sessions may be required. After each the treated veins disappear instantly and you can go back to normal activities without restrictions.
Microsclerotherapy should not be used.
You can see a demonstration of thermocoagulation (Veinwave™) in action in the video below. Please note, the Veinlite video is a means of visualising the tiny veins whilst injecting them with Microsclerotherapy. It is not a treatment in itself.