Thread or spider veins
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What are thread and spider veins?
These are very small veins that lie just beneath the skin. There are many names used to describe them. Generally, the smaller finer red veins are called spider or thread veins, whilst the slightly thicker, purple ones get called reticular veins. Many people find the appearance of these clusters of purple or red veins very unappealing. Some patients alter their lifestyles to avoid exposing their legs because of them.
What problems and symptoms can they cause?
Occasionally, the larger clusters of veins can ache after prolonged standing. More pronounced veins may bleed if traumatised. Generally though, patients main concern is naturally the effect on the appearance of their legs.
Do I need any other tests before treatment of these veins?
Around a quarter of patients with these surface veins can have underlying trouble with the main veins in their legs - the ones responsible for varicose veins. Unless problems with these are looked at first and treated appropriately, the chances of the surface veins recurring after treatment is increased. For this reason, it is important to see a Specialist who can treat all the problems that your veins may have, not just the surface veins. If the Specialist is concerned that you may have deeper, underlying problems they may recommend an ultrasound scan.
Injections or laser treatment?
The available evidence indicates that the use of micro-injections is more effective than laser treatment for these surface veins, especially the larger reticular veins. Studies show that injections removed more of the veins and speeded up the course of treatment. When the techniques are compared more patients preferred the injection treatment.
We therefore recommend the injection treatment for surface veins and reserve the laser for the small group of veins that don't respond well to injections.
What does the injection treatment involve?
Depending on the extent of your veins you may require between 2 and 6 treatments. Each session lasts around 30 minutes. No anaesthetic is needed due to the tiny size of the needle used for injections. You will simply be asked to lie on a couch and the Specialist will usually begin by treating the veins of most concern to you. The veins are injected with a solution that causes them to block up and then fade away over a period of months. You may notice a slight stinging sensation with the injections but most patients find them almost painless. Once the injection session is over your legs will be bandaged for 48 hours and then you will be asked to wear some compression stockings for a week day and night.
Here we can see the needle just before it is guided into the vein. The small size of the needle is apparent when compared to the doctor's finger.
How good are the results?
- No treatment is able to remove all of the surface veins in your legs.
- The patients who are most pleased with their treatments are those who are well informed by their Specailist and set out with realistic expectations of the final result.
- Nearly everyone will need at least 2 sessions.
- The veins will be worse for 6 weeks or so and will then gradually begin to fade away.
- Patients often develop new sets of surface veins in the years following treatment and may require further treatment.
- Around 10% of patients develop very fine veins around the site of their injections that can be difficult to treat.
- A realistic expection would be that your legs would be 70-80% better by the time your Specialist has finshed your course of treatment.
These before and after images demonstrate some of the improvements that are possible with this technique.
Potential complications
- As with all interventions there are potential complications.
- Nearly all patients experience some bruising and itching after treatment but these resolve quite quickly.
- Around 1 in 10 patients will notice some light brown discolouration around the injection sites which almost always resolves over a month or two.
- Around 10% of patients may experience no benefit or some worsening of their veins.
- One in a hundred people can develop a small ulcer at the site of the injection if the solution leaks out of the vein. These will nearly always heal but can be unpleasant whilst they are doing so.
- The risk of serious allergic reations to the injection is very unlikely but our facilities are fully equipped in the event of this most uncommon event.
