Spider veins
Treatments
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.
- 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.
- 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.
- 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.
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.
Spider veins
What are Dermal Fillers used for?
- Replace volume loss from the mid-face and temples
- Elevate and reposition eyebrows which have dropped
- Replace volume loss in the temples
- Lift Jowels and sagging of the jawline
- Treat volume loss in the hands
- Reshape the nose
- Enhance Cheeks
What Dermal Fillers do you use?
- Belotero
- Juvederm
- Teosyal
- Restylane/Perlane
These products are made from Hyaluronic Acid which is a complex polysaccharide (sugar) found in a number of sites in our bodies – Joints, Skin, Eyes. As the structure is identical to that in our bodies and as there is no animal product, the risk of allergies is minimal and allergy testing is not therefore required.
Other fillers used for specific indications include:
- Radiesse
- Ellanse
- Sculptra
Who will perform the treatment?
What are the common Side effects with Dermal Filler Treatments
Before deciding the treatment with dermal fillers, a number of general health aspects need to be clarified. A particular tendency to bruising, medication that thins the blood, like aspirin, warfarin or clopidogrel may also lead to significantly more bruising and swelling and needs to be known in advance. The risk or allergic reactions with current dermal fillers is very low and they do not require preliminary allergy testing. Redness, swelling and bruising at the point of injection are possible with all types of fillers, and most frequently are limited to one or two days after the treatment. More prolonged redness or swelling is possible and will been to be brought to the attention of your doctor promptly.
The risk of infection is present whenever using injectable treatments and is a consideration also with fillers. Typically, the treatment does not require an antibiotic cover, but if you have any suspicion of an infection, you need to discuss your concerns promptly with your doctor. Thorough cleaning of the skin before treatment is essential.
Pain at the injection site is usually limited, and the treatment can be carried out either using local anaesthetic cream, local anaesthetic injections or no anaesthetic depending on individual preferences.
Delayed side effects include the formation of lumps. if the Dermal Filler used is composed of Hyaluronic Acid ( Juvederm, Beltero, Teosyal, Restylane etc) this is rare and these can usually be dissolved quite easily with Hyalase. Other products such as Radiesse, Sculptra, Ellanse etc that are often promoted as longer lasting but may have an increased risk and this should be discussed with your doctor. They can often be managed medically but in very rare circumstances surgical removal may be required.
How and where are the treatments provided?
Treatment with injectable dermal fillers is an office based procedure that usually takes less than 30 minutes. It is possible to apply local anaesthetic cream on the skin or on the lips to decrease sensation and reduce the discomfort related to the treatment, although many people find this unnecessary.
Volume augmentation of the lips can also be carried out using regional nerve block which means that the lips become completely numb, but they will take several hours to recover, similar to the dental local anaesthetic.
The results after the treatment are immediate and depending on the area treated and product used these results.
What should I do after the treatment?
After the treatment, it is important to avoid excessive rubbing to the treatment areas and application of cold is sometimes suggested. Specific advice will be given to you by Dr Jones appropriate to the area treated and product used.