
Thread veins, or spider veins are very fine dilated veins situated just beneath the surface of the skin. As with larger varicose veins genetic and hereditary are influencing factor together with hormonal changes as at the onset of periods and during pregnancy. In some patients they are associated with varicose veins but in other people they occur without any problems associated with their deeper veins. It is essential that patients with thread veins undergo a venous assessment to make sure that there is no underlying condition causing them. Treating surface veins in the presence of varicose veins, even though they are not visible, results in them not disappearing or returning quickly giving an unsatisfactory result.
Mild to severe pain can be associated with spider veins as well as fatigue, aching and throbbing. This can quite often be cyclical in women and related to their periods. Such symptoms that present with larger varicose veins do not always disappear following surgery but do diminish with subsequent sclerotherapy treatment for thread veins. The best form of treatment for these small veins is needle sclerotherapy. Some doctors use lasers to treat thread veins on the legs, but scientific data find that these are not very effective on leg veins in comparison to injection treatment. Lasers are best suited to facial thread veins.
Advertisements promoting creams treating thread veins often appear in the press. Scientific evidence shows that these do not work at all!
Sclerotherapy is a technique used for the removal of thread veins and spider veins. It involves injections with a very fine needle of an agent which has an irritant effect on the lining of the veins causing the walls of the veins to stick together. Blood stops flowing through these small veins, which are then absorbed by the body’s natural defence mechanisms over a period of up to three months. The blood flow is then directed back to the deeper venous system.
Bruising can last anything from two weeks to three months depending on the size of the thread vein treated. Due to bruising following injections the treated areas can look worse before they improve and it is necessary to be patient to obtain a good result. Occasionally thicker bruises associated with larger veins, can remain for several months causing brown discolouration of the skin. This could take up to a year to fade. High compression stockings are worn for up to four days to help reduce the amount of bruising. It is usually advisable to leave a month between treatments on the same area to allow bruising to settle.
Half of the vessels treated at any one session usually disappear. At least 80% of all vessels treated during the course of sclerotherapy can be expected to go away.
A brisk walk of 20 minutes is beneficial and it is possible to drive afterwards. Normal exercise is encouraged the next day. It’s alright to fly afterwards, however it is advisable to drink plenty of water and to wear class 11 compression stockings on long journeys. As a general rule standing still should be avoided and feet kept elevated whilst sitting.
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