Copyright 2022 - Custom text here

What are spider veins? Thread veins are tiny blood vessels which run close to the surface of the skin and look like fine red, or sometimes purple, wiggly lines. They're also sometimes called 'spider veins' or 'broken veins', although the veins aren't infact broken but only slightly enlarged. The medical term for them is telangiectasia.


What causes them? Usually there's no obvious cause. Thread veins tend to develop as we age and our skin and blood vessels become less elastic. Hormonal changes associated with pregnancy and the menopause are thought to provoke their development - the reason why women are more prone to them than men.

You can also inherit a family tendency to the problem. Other causes include too much sunbathing, exposure to wind or extreme temperatures, cortico-steroid medicines and radiotherapy. Jobs that involve prolonged standing may aggravate the condition, but they don't actually cause it. Although you may not like the look of them, thread veins aren't dangerous, but they tend to become larger and increase in number over time.

Who gets them? Nearly all of us as we age, apparently. Around one in five women in their 20s have thread veins, a figure that rises to around half by the age of forty and continues to increase. By the age of 70 over 70 per cent of women have some thread veins.

Dr Zulkafperi a medical Director of Laser Hairfaceclinic advises treatment sooner rather than later. 'Smaller thread veins are easy to treat. Later on they can be more difficult. Younger women could save themselves a great deal of time, trouble and expense if they opted for early treatment.'

How are they treated? There are several options, lasertherapy, sclerotherapy or a mixture of both. Electrolysis is also used but this is far less popular now that laser treatment is widely available. Lasertherapy uses brief pulses of laser light to destroy smaller blood vessels. Several types of laser are used. A pulsed dye laser is best for thin red veins which are close to the skin's surface. Deeper blue or purple veins need a laser with a longer wavelength (YAG laser) to reach them.

Veins bigger than 4mm require sclerotherapy. This treatment uses a tiny needle (smaller than a sewing needle) to inject a solution (scelerosant) that causes microscopic damage to the cells lining the vein. The vein gradually shrinks and disappears over a period of about eight weeks. At an initial consultation your veins will be assessed and you'll be advised which form of treatment is most appropriate for you. Normally a test patch will be done at the same time.

Is the treatment painful? It shouldn't be. Although laser destroys tissue by heat you won't feel any burning or pain. Each pulse is less than a thousandth of a second and the laser only works on the unwanted vein leaving other skin untouched. The sensation of a laser is often described as similar to a rubber band pinging against your skin. A local anaesthetic cream can be used if you wish.

With sclerotherapy you'll notice the pricking sensation of the needle. Normally a local anaesthetic is injected into the vein with the sclerosant solution so the pain is minimal. Treatments normally last for around 20 to 30 minutes.

Are there any after effects? With sclerotherapy the veins may appear worse immediately after treatment and the site of the injections can look rather like insect bites. There may also be some bruising and sometimes the treated area may itch a bit. After a week or so the veins should begin to fade and they'll continue to do so for up to eight weeks, or even longer for bigger veins.

How many treatments are needed? On average three, but more may be necessary, depending on the number of veins and their size and location. The normal procedure is to tackle the larger veins first with sclerotherapy and then clear up the smaller ones with laser treatment. Treatments are spaced about eight weeks apart, so it may take more than six months to achieve the final result. Start now if you want better looking legs this summer.

How successful is it? You need to have realistic expectations. 'Some thread veins can be quite difficult to treat because they don't always run obligingly parallel to the skin surface,' says Dr Cotterill. 'Some are like big dippers they go up and down and a laser light doesn't always reach deeply enough to destroy them.' Veins in the lower part of the leg, particularly the ankle area, are more difficult to treat than those on the thighs. It's not normally possible to get rid of all the veins, but around 90 per cent clearance is common.

Are there any risks or side effects? Complications are unusual, but occasionally a skin ulcer can develop after sclerotherapy and some patients experience a brown discolouration of the skin which may take several months to fade away.

Around 10 per cent of people treated get 'matting' after sclerotherapy - a cluster of tiny red vessels around the treated area. However these can normally be cleared by laser treatment later. A very rare complication is the development of a blood clot in the vein (deep vein thrombosis).

Are thread veins related to varicose veins? They are part of the same spectrum of problems caused by blood pressure in the superficial veins of the legs being too high (see box below). If you have varicose veins you are more likely to have thread veins too, but the reverse isn't true, having thread veins doesn't predispose you to varicose veins. 'In women with big varicose veins there's no point treating thread veins until the varicose veins have been sorted out,' says

Dr Cotterill. 'They need doing first otherwise the treatment for thread veins won't work.'

What about treatment for broken veins on the face? Laser can treat the very fine veins that can appear on the nose, cheeks and chin and it's usually very successful. Often thread veins on the face are part of a condition called rosacea and additionally medication may be needed to control the problem.

Where is the treatment available? There are scores of clinics offering laser treatment around the country. The drawback is that anyone who can afford to buy a laser and pass a local authority hygiene inspection can operate most types of laser. They don't need to be medically qualified, so beware! 'You need to check that the person who is actually going to treat you is medically qualified, and is preferably a dermatologist or plastic surgeon, ' says Doreen Trust, of the

Disfigurement Guidance Centre.

The charity publishes The Skin Laser Directory which lists reputable UK clinics, both private and NHS, with details of their medically qualified staff. 'Even if you are paying privately my advice is to ask your GP for a referral,' says Mrs Trust, 'because he or she acts as a safeguard. If you've been referred the clinic will write to your GP after treatment with details of what's been done and the outcome, so you have a record, should there be any later problems.'

What does it cost? Costs vary widely. The largest group of 12 clinics, Lasercare, which operate both privately, and in the NHS charge £230 for a consultation and first treatment, then £185 per session afterwards. 'It's a good idea to select three or four clinics and call them,' says Doreen Trust. 'Describe your condition and ask how many treatments roughly will be needed what the approximate total cost of the treatment will be. It can vary widely so it's worth checking a few out.'

Is the treatment available on the NHS? Cosmetic surgery is normally only NHS funded if your appearance is having a detrimental effect on your mental health, for example if it's causing you to be depressed, or affecting your career or family relationships.

Treating varicose veins: Varicose veins are very common and affect around one third of women. The problem is part and parcel of the same circulatory disorder as thread veins, but at the more severe end of the scale. Varicose veins can become very painful and lead to complications such as bleeding, swelling and ulceration. They develop when the walls of the veins and the valves inside them sag under the pressure of the blood they carry. The veins dilate and the valves, which should help move the blood upwards, together with the action of the calf muscles, no longer work efficiently.

Treatment for varicose veins isn't always very successful. Around 100,000 NHS operations are performed each year and about 20 per cent of these are repeat surgery for recurrence. Small varicose veins are sometimes treated with sclerotherapy, in the same way as thread veins. However veins treated in this way are most likely to recur, and normally surgery is the preferred option.

There are two main methods. Either the varicose vein is disconnected and 'tied off' so that the blood is diverted through healthier veins. Alternatively, if the vein is very large and distended, it may be removed altogether through an incision in the groin, a process known as 'stripping'. Although it sounds alarming, the surgery is normally done as an outpatient and recovery takes only a matter of days.

A new procedure called VNUS closure has also recently been introduced here. A catheter is threaded into the vein, to introduce heat, which collapses and seals it. The treated vein becomes scar tissue and is eventually re-absorbed.

The procedure costs around £2,500 a leg and involves an incision made into the knee or ankle rather than the groin. Because the procedure is so new it's not yet known how effective it might be at preventing recurrence long term, for example over five years.