Thread Veins
Thread veins (telangiectasia varicose veins) appear as fine clusters of vessels in the skin, usually on the face or legs, and occur due to the weakening of valves in the blood vessels. Unlike varicose veins, thread veins do not bulge and are generally painless, though they can on occasion cause some discomfort.
Treatment Options
Microsclerotherapy
Microsclerotherapy is the gold-standard treatment for spider veins and reticular veins and uses a diluted version of the solution (sclerosant) used in sclerotherapy. It is injected using a fine needle into the problem veins and works by sealing the vessel and redirecting blood to the surrounding healthy vessels. The body will then absorb the vein over the following months. The procedure takes between 15 - 40 minutes to complete, depending on the size of the area to be treated, and causes minimal discomfort. Some bruising is likely to occur, along with the possibility of temporary brown discoloration of the skin; this occurs in about 25% of cases and fades over time. The veins are likely to look worse for around 6-8 weeks before beginning to disappear and larger reticular veins may temporarily feel hard, lumpy and tender before being absorbed by the body.
After the Procedure
A compression stocking is applied to the whole leg after treatment. This should be worn full-time for 48 hours. After this time, the stocking and the dressing can be removed, and the legs washed in the shower with lukewarm water. The compression stocking should be applied after that and must be worn during the day for 2 weeks and removed at night when in bed. It is important to walk regularly immediately and, in the days, following the procedure. Avoid standing still for prolonged periods, and avoid running, cycling, rowing, or any high-intensity leg exercise for 1 week following treatment. When not mobilising, you can rest with your legs up. It is safer not to drive home after treatment. You will be scheduled for a review appointment with Mr Oluwole 4 weeks after.
Travelling
You may travel short distances (under 4 hours) 1 week after the procedure. It is ideal to avoid flights/train/car travel over 4 hours duration for 3 weeks following the procedure. It is important to stay hydrated and walk around the cabin regularly whenever flying to minimise your risk of blood clots.
Side Effects
It is not unusual to experience the following during treatment- Headache: this occurs occasionally, particularly in people predisposed to migraine, and is usually treated with mild painkillers. Cough: this occurs with higher doses of sclerosant and usually resolves within 30 minutes. Feeling lightheaded: this is uncommon but can occur with higher doses of sclerosant or in patients with needle phobias.
Possible Issues Following Sclerotherapy
Discomfort/bruising/swelling: It is normal to experience some discomfort and bruising in the areas overlying the treated veins. It is expected that they will be tender when pushed on, and larger veins will feel hard and lumpy. Usually no pain relief is required, but paracetamol and topical anti-inflammatory cream can be used, and it is important to stay active during this time. Hyperpigmentation: Light-brown staining occurs in about 25% of cases along the course of treated veins. This is related to the iron component of blood being absorbed by the skin, and typically fades over time. Deep vein thrombosis (DVT): This is extremely rare less than 1% of cases, but if it occurs a course of oral anticoagulation drugs (anti-clotting) is prescribed with a follow-up ultrasound. Telangiectatic Matting: This is rare, but a small proportion of patients can develop a network of fine new veins around the injection site. The problem is difficult to treat; some cases will resolve on their own over several months, but if the problem persists, an additional session of sclerotherapy can be trialled to target underlying reticular veins, followed by another period of observation over several months. Recurrent veins: Recurrence rates for the larger varicose veins is up to 20% in the first 5 years following treatment. If this occurs, a repeat ultrasound scan can be performed to determine the nature of recurrence and best treatment option. Spider veins have a higher tendency to recur than varicose veins. Recurrent spider veins can be managed with top-up microsclerotherapy sessions.
Very rare complications ( less than 0.5% of cases)
- Allergic Reaction/Anaphylaxis
- Ulceration
- Infection
Returning to Normal
Most people will return to normal activities almost immediately and you can go back to work from the next day.
Follow Up
Mr Oluwole will see you for a follow up session in 4 weeks if needed.
