Thread veins, also called telangiectasia or spider veins, are small clusters of blue or red broken veins that can appear on any part of the body. Although harmless, they can cause distress as the sufferer often feels self-conscious, particularly if the veins are on areas such as the face and legs.
Sclerotherapy was developed in the 1920s for the treatment of varicose veins. This was refined for the treatment for thread veins, which is what we now call microsclerotherapy. Thread veins are smaller than varicose veins. They are usually very near the surface of the skin, red, blue, or purple in colour, and less than 1 to 2mm in diameter.
How does sclerotherapy work?
Sclerotherapy is a simple procedure performed by skilled medical practitioners which involves injecting a solution into the veins on the body using a very fine needle, thereby causing the vein to collapse and fade from view.
Who is suitable for treatment?
Sclerotherapy usually works best on those with small veins. You must be free from blood-clotting disorders, in overall good health, not pregnant or breastfeeding.
What results are expected from sclerotherapy?
Immediately after treatment, thread veins can look worse to begin with and large vessels may go black. Fading starts after three weeks and it will be three months before the main benefit is seen. Improvement continues for a year.
Most patients are pleased with the difference that sclerotherapy makes, usually seeing an overall improvement of 80% following a course of treatments.
It is important to realise however that this treatment does not prevent new veins from emerging in the future and, as time passes by, it may be necessary for touch-up treatments when new veins appear.
Does the procedure hurt?
Sclerotherapy treatment has been shown to be the most successful way to eliminate tiny blood vessels. It is almost painless and causes little discomfort.
Are there any risks associated with sclerotherapy?
No treatment is risk free, but sclerotherapy is very safe. Most patients experience no complications, but some minor side effects have been reported. These include slight blistering which occurs when small amounts of the solution seep into the surrounding skin areas. These blisters tend to heal rapidly. Occasionally, a small, dark area of pigmentation resembling a freckle may remain. These spots, however, do tend to disappear over time or respond to further treatment with bleaching creams.
Bruising around the treated area, which eventually disappears, can result if the veins are unusually weak. Sclerotherapy solutions are irritants and treated areas will resemble a nettle rash for a few hours afterwards and may be itchy, which is entirely normal.
Complications that may occur in rare cases are:
- Hyperpigmentation, which is usually transient and is less common in small vessels than in large ones. Compression garments decrease the incidence of hyperpigmentation.
- Allergic reactions including mild skin conditions such as urticaria (hives) and possible anaphylaxis, although this is incredibly rare.
- Telangiectatic matting (the appearance of new small vessels) due to injections that are administered too rapidly or in which the sclerosant concentration is too high. It usually resolves spontaneously over several months but may be permanent.
- Superficial thrombophlebitis (inflammation), which usually occurs in large vessels that are rarely treated with microsclerotherapy.
- Tissue necrosis, which presents as an ulcer, is a rare complication of sclerotherapy and is more common with hypertonic saline.