WHAT ARE THREAD VEINS AND WHAT ARE THE TREATMENTS?
What are they?
Thread veins are also called broken veins, spider veins or flares. All these descriptions show that they are the small veins of 1 or 2 millimetres in diameter which can discolour or throb in your leg. They arise from tiny veins just under the skin that have become weaker and wider. They can be blue or red and often appear in groups in a local area. As we get older changes occur in the skin, which becomes thinner and more fragile, and in the subcutaneous tissue, which also gets thinner, so that blood vessels under the skin become much more obvious. Thread veins do not signify any underlying medical problem, and are nothing to be concerned about, although many women do find them unsightly. They usually occur on the legs, although other parts of the body may be affected. Many women become so aware of them that they will not wear skirts or feel embarrassed to wear a swimsuit.
Many people have thread veins, and there are many factors involved in their development. They tend to run in families, commonly appear in pregnancy (thought to be due to high levels of oestrogen) and are more common with increasing age. Being overweight and smoking also seem to increase the likelihood of developing them.
Prevention
We are often asked how to prevent them and there is no simple way. Having a healthy life style and not smoking may help, but for many people it's simply the way they are made.
Treatment
The majority of thread veins are suitable for microsclerotherapy which involves an injection with a very fine needle. Depending on the size either a dilute solution of irritating solution called sclerosant is injected neat or alternatively mixed with air to make foam.
Most of the injections are relatively pain free but on occasion some of them can sting. When we are lucky one injection can run into many veins getting rid of them at one go. After the injection the vein becomes inflamed and you can get a wheal over the area which settles down over the next hour. The vein is then eaten up by the body, the vein can disappear or leave a thin brown stain after a few weeks. The injections are given in outpatients on a couch and we usually allow 30 minutes to ensure we get rid of as many as possible. You will be able to drive to and from the session but we will put stockings on you which we will ask you to wear for 24 hours. Most people will need more than one session but usually 2 or 3 sessions will see a considerable improvement.
The veins are eaten up by a process called inflammation and you will see reddened areas for up to 3 weeks. There will frequently then be a brown stain which fades over the next 6 to 12 weeks. These stains can take longer to fade and can continue to do so up to a year later. It is not a good idea to have them injected just before a holiday of that important wedding photo!
Results
Will you be happy that you had the injections?
If you have many veins we may not be able to get rid of all of them. What most people want to achieve is to be more confident with their legs, and go back to wearing clothes that reveal them. Interestingly thread veins can also ache and we improve symptoms very well.
80% of people feel that they have seen an significant improvement, so they can return to a more relaxed wardrobe.
15% feel that any improvement has not changed their appearance significantly.
5% develop complications; these can include a reaction to the sclerosant in the injection leading to a hard area, or in a smaller number of cases (2%) the skni can break down into a small ulcer usually 3 to 4 millimetres in diameter. This will heal but can leave a small scar.
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