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Varicose veins are a common problem, affecting up to 1 in 3 adults in their lifetime. They are usually a sign of an underlying venous insufficiency.
Thread veins can appear anywhere on the body but are mostly evidenced on the legs and face. They are more common than varicose veins, affecting up to 80% of adults.
Leg ulcers appear as broken skin in the lower leg or feet. We have been successfully treating venous leg ulcers for over 20 years.
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Microsclerotherapy is used to treat thread veins, and is by far the most common and most effective form of treatment.
Some clinics will offer treatment of thread veins using laser or IPL. Although this can be quite effective with thread veins on the face, it is usually both painful and ineffective with thread veins on the legs.
Microsclerotherapy involves the injection of a diluted drug, called a sclerosant, directly into the visible thread veins.
With meticulous planning and technique, it is possible to get superb results for the vast majority of patients. In general, however, thread veins are surprisingly more difficult to treat than larger varicose veins and can take longer to get rid.
What Is the Drug Used in Sclerotherapy?
The best drugs to use are prescription only; they can only be prescribed by a doctor and can only be administered under a doctor’s supervision.
Many beauty parlours often offer thread vein injections, but these will normally be using less-effective chemicals that beauticians are allowed to use and do not require a doctor’s prescription.
We use sodium tetradecyl sulphate (STS) as a sclerosant, in a liquid form. STS is a licensed drug and is extremely safe when used as a sclerosant. As with all drugs, however, there is a limit to the dose that can be administered in any one session. All of our microsclerotherapy sessions conform to the strict guidelines of maximum doses allowable of the sclerosant.
Can Microsclerotherapy Be Used to Treat Facial Veins?
Microsclerotherapy should not be used to treat facial thread veins. For treatment of thread veins of the face, we would recommend thermocoagulation.
The procedure takes place in a treatment room with your consultant and nurse.
At your initial consultation and scan, we will have explained the treatment options to you (including potential complications and success rates). Before proceeding with the microsclerotherapy treatment, we will ensure that you fully understand all of the information provided to you. You will then be asked to sign the required documentation.
We can play music of your choice if you like, and the nurse will be at your side throughout the procedure.
Diagnosis – What Is the Role of Duplex Ultrasound in Planning Treatment?
It is important, even with thread veins, to discover if there is an underlying cause for them, and this will need to be established prior to the microsclerotherapy being undertaken. The only way to determine if there is an underlying cause is by having a duplex ultrasound scan of your legs.
It is unlikely that patients suffering only with thread veins have an underlying problem; however, if there is an underlying problem, we generally strongly recommend this is treated before tackling the visible veins. If we treat the visible veins without first fixing an underlying cause, the veins are highly likely to recur.
If an underlying cause is identified, this will usually be a small reticular vein feeding a clump of thread veins. We would recommend treating the reticular vein using foam sclerotherapy. This can usually be performed at the same time as the microsclerotherapy for the thread veins, provided that the total dose of the sclerosant used is not exceeded.
We want to ensure that we provide patients with the most effective treatment that lasts.
If an underlying valve problem is found, please note that your treatment pathway is likely to involve the stages within the Varicose Vein Treatment Pathway.
What Is the Difference between Microsclerotherapy and Foam Sclerotherapy?
The drug used in microsclerotherapy is the same as used in foam sclerotherapy. The difference is that foam sclerotherapy is mixed with air to create a foam, and is used to treat larger veins.
The procedure involves injecting a diluted drug, in the form of a sclerosant, into the veins. The sclerosant causes localised damage to the inner lining (endothelium) of the vein. This subsequently causes the thread vein to collapse. The inner lining of the vein becomes thickened, sealing off the vein so that blood can no longer flow through it. The blood is redirected to deeper veins.
During the treatment, the thread veins initially disappear instantly as the sclerosant is injected into the vein. However, the veins rapidly become more red and more visible again immediately after treatment due to inflammation. The veins can often look worse immediately after treatment. It is common to develop localised redness, similar to a nettle sting. It usually takes several days or even weeks for the inflammation to settle, and for the veins to disappear.
As microsclerotherapy involves a series of tiny injections, some patients find this uncomfortable or mildly painful. The sclerosant used may also sting slightly.
The procedure usually takes around 30-45 minutes.
What Is a Session?
Most patients require between 2 and 4 sessions of microsclerotherapy, so it is important to note that it might take some time to fully resolve all of your thread veins. Occasionally, only 1 session is required. At the other extreme, we have had one patient – with extremely extensive thread veins covering almost every square inch of her legs – who required more than 30 sessions; but she was still delighted with the final results.
Ideally, the session would last until we have treated all the affected veins, but we must stop the treatment once we have reached the safety limit. The number of sessions required depends entirely on how many veins you present with and how well your veins respond to treatment (some veins may need treating more than once).
At your consultation, we will give you a good idea of how many sessions you’re likely to require based on our past patients’ experiences. In addition, prior to committing to a consultation, you’re welcome to send us some images of your legs and we can send these on to a consultant to review.
Once the procedure has finished, the nurse will help you put on a compression stocking (or two if you’ve had both legs treated). You are strongly advised to wear these for a full week post-treatment, and the nurse will talk you through how to wear them. The nurse will also provide you with aftercare advice, including any post-treatment symptoms to be aware of.
We will ask you to take at least a 10-minute walk following the appointment, prior to making your way home.
Following microsclerotherapy treatment, you are to wear a surgical compression stocking for a week. This will prevent you from swimming but should not restrict your movement.
The sclerosant used may result in some bruising. The extent of the bruising will depend on the size of the area treated and the number of veins in the area.
You can drive on the same day as microsclerotherapy treatment.
You can resume your normal activities following microsclerotherapy. We strongly encourage you to go on at least a 20-minute walk each day. If there is anything else that you should avoid for a period of time post-treatment, we will advise you on that.
Following a session of microsclerotherapy, you can book in for a reassessment follow-up with your consultant, or you can book straight in for a further session.
It is not mandatory to attend and pay for a follow-up appointment after a microsclerotherapy session unless you feel that you would benefit from further treatment. Patients normally self-assess their treatment progress and decide whether they are satisfied with the results to date or would like to attend for a further session.
There is no rush to attend for further sessions. You can wait up to 2 years before seeking another session without the need to attend for a new consultation and scan prior to treatment.
With all medical treatments it’s important to weigh up the benefits versus the risks. With that in mind, we have provided you with a full outline of the known vein treatment risks.