Spider Veins

What are “Threadveins”?

Thread veins on the leg are commonly called spider veins, broken veins, surface veins or venous flares.

They are dilated blood vessels (veins) in the most superficial layer of the skin – a layer called the dermis. Generally, the dermis is about 2-3 mm thick so the deeper the thread vein is in the dermis, the less distinct and colourful it looks. Lumpy varicose veins and green looking reticular veins, also known as feeder veins, lie underneath the dermis.

Thread veins of the legs differ in 2 main respects from thread veins on the face.

  1. Thread veins on the face are above the heart whereas thread veins on the leg are below the heart.
    • This is very important to know as it changes how we approach the different thread veins. Those on the face should easily drain blood away to the heart by gravity and so, the fact they are open and can be seen shows they probably have some arterial pressure within them. Thread veins on the legs are below the heart and so often there is a column of blood above them, keeping them open when standing or sitting. Therefore, further and appropriate assessment, of leg thread veins may be necessary. Dr Jones will perfom an initial ultrasound examination to select those individuals who will benefit from treatment and those who further assessment/treatment.
  2. The surrounding skin on the face and legs is totally different.
    • The skin on the face is always open to the environment and so is very resistant to the sun and other factors such as heat and radiation. The skin on the face has a great blood supply and heals quickly and well.
      However, the skin on the legs is usually hidden away from the outside and is normally protected by clothes or stockings. Hence the skin is very sensitive to heat or radiation and often reacts badly to injury, especially heat injury like strong laser, which can leave permanent scars. In addition the blood supply to the skin on the legs is not as good as the skin on the face, making healing slower and more difficult.
      These factors have major effects on the way that leg thread veins are investigated and treated. Unlike thread veins on the face, it is essential to first find out what is going on beneath the skin and this can be achieved with a scan. Simple treatment of the veins on the surface may not give good results in the long term.


What will happen at my initial consultation?

As with all initial consultations at the HSJ Clinic there is no charge. This allows you to have time and confidence to discuss your concerns. We will carry out a full consultation, examination and hand held ultrasound assessment to determine whether treatment or further investigation is warranted. An estimate of the number of treatment sessions will then be made.


How is the procedure performed?

Microsclerotherapy involves the injection of a solution (sclerosant) into the small blood vessels. The vessels become inflamed and gradually close diverting the blood back into deeper vessels which are not visible. This reduces the appearance of the skin veins without affecting the venous drainage.


Are there any side effects of the treatments?

Appropriate selection of patients reduces the risks of side effects. However the following side effects can develop:

  • Bruising
  • Itching
  • Infection
  • Pigmentation
  • Small ulcers/scars

Complications are reduced with experience. Dr Jones has been assessing and treting leg veins for nearly 30 years!


Is the treatment painful?

The treatment is mildly uncomfortable. There is a warm irritation similar to an insect bite. Topical soothing products such as Aloe Vera may be applied. It may be advised to use grade 2 surgical sockings to further improve outcomes. Avoidance of sun exposure before and for 4 weeks after treatment will reduce the risk of pigmentation.


Are there any other treatment options?

Whilst laser treatments are more appropriate for facial vascular problems, microsclerotherapy remains the gold standard treatment for leg threadveins.