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Varicose & Thread Vein Care in Birmingham, Wolverhampton, the Black Country, South Staffordshire and surrounding areas

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Thread Vein Treatments

What are the principles of treatment of leg thread veins?

Research has shown that a significant proportion of people with thread veins have problems with deeper feeder veins. This is why I always recommend that an ultrasound scan is carried out prior to commencing treatment.

The general principle of treatment is that varicose veins or larger feeder veins need to be treated first prior to dealing with the thread veins themselves. Failure to address underlying problems leads to higher rates of complications, high recurrence rates and patient dissatisfaction. This is because the higher pressure in these feeding veins prevents successful closure of the thread veins and may even make them worse.

Thread Veins deeper feeder.jpg

Thread Veins best treatments
What is the best treatment for leg
thread veins?

There are a wide range of treatments that are offered for thread veins. Several websites advertise creams or dietary supplements to treat thread veins but there is no evidence that these are effective at all.

The most common procedures offered in cosmetic clinics are laser, short wave diathermy (Veinwave) and microsclerotherapy. Whilst laser and short wave diathermy are effective treatments for facial thread veins the results of these treatments for leg thread veins are disappointing. One of the reasons for this is that these treatments fail to treat the underlying feeder veins associated with leg thread veins. In addition, leg thread veins are often larger and deeper in the skin when compared to facial thread veins and therefore treatment of these with laser requires high power settings which significantly increase the risk of causing skin burns.

My preferred treatment for thread veins is microsclerotherapy. As well as being the most effective treatment for leg thread veins, microsclerotherapy has the advantage of being able to simultaneously treat the feeder veins leading to long lasting results.


What is microsclerotherapy?

Microsclerotherapy is the gold standard treatment for leg thread veins. It is a straightforward procedure that is performed in a treatment room and usually takes between 30-45 minutes.

A liquid called a sclerosant is injected directly into the thread veins using a very fine needle with minimal discomfort. The sclerosant damages the lining of the vein and causes the vein to become inflamed. This results in the vein blocking off and then over a period of time the vein is reabsorbed completely back into the body. After injecting the thread veins the leg is placed in a compression stocking. This is important as the compression keeps the veins emptied to prevent blood re-entering the treated veins and reduces the chance of complication such as skin staining.
Thread Veins Microsclerotherapy

Please download my microsclerotherapy information sheet for further information...

Thread Veins how long How soon will I see results?

The most important aspect to appreciate is that the improvements seen with microsclerotherapy often take several months to be achieved as it takes time for the treated veins to be completely reabsorbed. This is not a treatment that will get your legs looking good for your beach holiday at a weeks’ notice! Some forward planning is required.

Due to the inflammation it is quite common for the thread veins to look worse initially. I usually tell people that it will take 6-8 weeks for the appearance of the veins to start to improve. By 3 months it is quite clear which veins have been successfully treated and which ones require further treatment. It is because of this that I will wait for 3 months to pass before re-treating a leg. Whilst most veins look significantly better by 4-6 months improvements continue for up to 12-18 months after treatment. Most people require 2-3 treatment sessions to achieve results that they are happy with. Overall 8 out of 10 people are pleased or very pleased with the results of microsclerotherapy.

What are the complications of microsclerotherapy?

Microsclerotherapy is a very safe technique with little in the way of significant side effects. Some possible side effects are:

a. Skin Staining – If some blood tracks back into a treated vein this can become trapped and due to the iron pigment in the skin a rust coloured stain can appear over the vein. If these occur the skin stain (which looks like a bruise) will usually fade with time and resolve over 4-6 months. Occasionally the staining can be permanent. The trapped blood can be removed with a small needle after about 4 weeks and this will usually result in the area settling down a little quicker.

b. Telangiectatic matting – This is the formation of new very fine veins at the site of an injection. It occurs in about 5% of people treated and usually resolves by itself over a 12 month period. Matting is more likely to occur in people where an underlying feeder vein has been missed. If needed these new veins can be treated with a further microsclerotherapy or laser if the veins are very fine.
Thread Vein Complications

c. Small Skin Ulcer –This is an uncommon complication. If the sclerosant is injected into a very small skin artery a small ulcer (<1mm) may result. This is painful and will take about 8 weeks to heal leaving a small white scar.

d. Allergic Reaction – The sclerosant injected into the vein often causes local inflammation of the vein not to dissimilar to an insect bite but true allergic reactions are rare (1 in 4000)

e. Deep Vein Thrombosis (DVT) – Due to the dilute concentrations of sclerosants used in microsclerotherapy, this is an extremely uncommon complication with a reported incidence of around 1 in 3000.

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