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Treatments for Thread Veins: Sclerotherapy and Vascular laser treatment

Client information: question and answer sheet

What are thread veins?

Thread veins, broken veins or telangectaesia are the small red or blue veins which can appear at various sites on the body. They can appear as single veins, either widely dispersed or as a collection of broken veins close together. They can also appear as a collection of blood vessels arising from a single point; these are known as Spider Naevi.

How can they be treated?

There are currently two main methods available to treat thread veins - laser treatment and sclerotherapy (the injection of a sclerosing agent into the veins). At Laserase we can offer either treatment or a combination of these therapies in order to achieve the best results.

Why do thread veins develop?

Thread veins are caused by a variety of factors including exposure to ultra violet light, wind and extremes of temperature. Steroid creams and the hormonal changes that occur during pregnancy can also induce them. For genetic reasons some individuals are more prone to develop thread veins than others and some people are more at risk because of old injuries or because they have occupations where they stand for long periods. It is possible that hormone treatments, such as the contraceptive pill and HRT can increase the likelihood of forming thread veins.

Can all thread veins be removed?

By combining both laser and sclerotherapy treatments, we are able to maximise our ability to clear thread veins. However, some very large veins may be resistant to either treatment and may not respond; you will be advised in advance during consultation about any likely problems.

Will I have laser treatment or sclerotherapy?

Whether you have treatment by laser or sclerotherapy is usually dictated by the size of the veins and where they are on the body. The initial free assessment will allow the doctor or nurse to inspect the treatment site and select the appropriate treatment.

Treatment by Laser

How does laser therapy work?

Lasers produce light of a very specific wavelength. The wavelength is matched to a target colour (such as the red of blood or the vessel wall). The laser light is absorbed by the target but not the surrounding tissue. The heat energy from the laser pulses breaks down the thread veins into tiny particles. These particles are then dispersed naturally in the body and therefore the veins fade or disappear over several weeks.

Which laser will be used?

We use a new diode laser - the Diolix Vascular Laser which is proving to be very efficient at removing blood vessels up to a diameter of about 2mm.

What is laser treatment like?

The laser is fired in short bursts at the thread veins. This feels like a hot pin-prick on the skin and some patients may find this a little uncomfortable. Following treatment the skin can be cooled which reduces this sensation.

What can I expect after laser treatment?

Immediately after treatment the majority of treated veins are likely to be more visible. In the case of thicker veins there may be some skin reaction in the form of slight blistering, or light crusting. This usually subsides within a few days. Fine facial veins can sometimes disappear at the time of treatment, although this cannot be guaranteed. Any discoloration/bruising usually fades after 7-10 days.

How many treatments will I need and how often?

The number of treatments needed will depend upon the site and the extent of the affected area. It will be estimated at your consultation. Treatments are usually planned at 6 - 8 week intervals.

What are the possible complications of laser therapy?

In general laser therapy is safe and effective. Whilst complications do sometimes occur, the risk of scarring is very low. Complications may include: blistering, fine crusting, particularly on very fine vessels, scarring, ulceration, loss of skin pigment or increased pigmentation. Whilst we have never experienced any long lasting complications we cannot guarantee that they would not be permanent. The area around the ankle is more likely to have complications than other areas. It is very important that you give details of any medication you are taking and any medical problems you have, which may be relevant to the treatment. We do not recommend treatment in patients who are heavily tanned.

Are all thread veins suitable for laser therapy?

Not all thread veins respond to laser therapy, as they may be too large or situated too deeply within the skin for the laser to penetrate. In these cases, sclerotherapy may be more effective.

Treatment by sclerotherapy

What is sclerotherapy?

Sclerotherapy involves the introduction of an extremely fine needle into the vein to be treated. The vein is then filled with a sclerosing liquid, which causes microscopic damage to the cells lining the vein. The body responds to this damage causing the vessel to shrink and eventually to be obliterated.

What does it feel like?

The sclerosing agent is used in tiny amounts and causes minimal discomfort, like a tiny pin prick. It is much less painful than other injections or blood tests.

What happens after sclerotherapy?

For a day or two after treatment the injection sites look rather like insect bites, but these subside quickly. Tiny scabs may form at the injection site and the treated area will appear bruised. The bruising may last up to a week. After eight weeks remaining veins can be re-injected to reduce them further.

What are the possible complications of sclerotherapy?

Complications of sclerotherapy are rare but can occur. Following treatment some patients develop brown discoloration of the skin, which is due to the deposition of an iron-containing pigment (haemosiderin) in the skin. This pigment may take a long time to fade away or, in very rare cases, can even be permanent. Other much rarer complications include, allergic reactions to the sclerosing solution, inflammation and skin injury, which may lead to the development of a small ulcer and permanent scar. The area around the ankle is more likely to have complications than other areas. For the above reasons pregnant or breast feeding ladies will be asked to postpone treatment and patients taking certain medications (such as anticoagulants) will be advised against sclerotherapy. All clients are given a comprehensive medical evaluation and post treatment advice to minimise any risk of complications.

What can I do after treatment?

After both laser therapy and sclerotherapy it is quite safe to perform all daily activities and exercise is encouraged, with the exception of swimming which should be avoided until the skin is completely healed. If the treated area is a little sore or dry then the application of aloe vera gel may help.

© 2004 Laserase