What are thread veins?
Thread veins, broken veins or telangiectasia are the small red or blue veins which can appear anywhere on the body but are most common on the face and legs. Facial vessels are always treated by laser and are explained on a separate sheet.

Thread veins can appear as single veins, widely dispersed or as a collection of broken veins close together. They can also appear as a collection of vessels arising from a single point; these are known as Spider Naevi.

There are currently two main methods available to treat thread veins: sclerotherapy (the injection of a sclerosing agent into the vessels) and laser treatment. We can treat using sclerotherapy, laser, or a combination treatment.

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 thread veins.

Some individuals are genetically 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 and develop leg veins. 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 laser and sclerotherapy treatments, we are able to maximise our ability to clear thread veins. However, some very large veins or varicose veins may need to be dealt with prior to treatment on the thread veins. You will be advised in advance during consultation if a consultation with a vascular surgeon is recommended.

Will I have to have laser treatment?
Sclerotherapy is only used on leg veins and is not suitable for all people; selection is usually dictated by the size and distribution of the veins. The initial assessment allows the assessor to inspect the treatment site and select the appropriate treatment.

Which laser would be used?
We use a Diolix diode laser, to remove blood vessels up to a diameter of about 2mm.

How does the laser work?
All lasers work by producing light of a very specific wavelength. If the wavelength of the laser is matched to a target colour (such as the red of blood in the vessel wall), the energy of the laser is absorbed specifically by the target but not by the surrounding tissues.

The diode laser delivers a series of focused energy pulses generating heat for very short periods of time; this energy closes down the thread veins, without perforating them; it is rather like spot welding. The damaged veins are gradually dissolved and removed by the body's immune system over several weeks after treatment.

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 uncomfortable. Paracetamol taken 1 hour before treatment may help. During and after treatment the skin may be cooled to reduce discomfort.

What can I expect after laser treatment?
This varies. There may some skin reaction in the form of a light crusting that can develop after a day or two and rarely slight blistering can occur. There can also be some bruising which may take a few weeks to fade away completely.

How many treatments will I need and how often?
The number of treatments needed will depend on the site and the extent of the affected area and will be estimated at your consultation. It is unusual for less than 2 treatments to be required. Treatments are usually planned at six week intervals.

What are the possible complications of laser therapy?
In general, laser therapy is safe and effective. Complications do sometimes occur but the risk of scarring is very low. We have been using this particular laser for more than 4 years and have had only two cases of pin-point scarring, due to clients picking off crusted areas.

Other side-effects may include: blistering and fine 'crusting', particularly on very fine vessels. The area around the ankle is more likely to have complications than other areas, as the skin is thin and fine, consequently this area is not suitable for sclerotherapy.

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 carry out treatment in patients who are tanned or recently exposed to UV.

What is sclerotherapy?
Sclerotherapy is the injection of a sclerosing liquid, through an extremely fine needle, causing microscopic damage to the cells lining the vein. The internal walls of the vein become 'sticky' and close up. This prevents further flow of blood through the vessels. The body's own immune system then clears away the dead vessels.

What does it feel like?
The sclerosing agent is used in tiny amounts and causes a brief tingling sensation as the agent enters the vessels.

What happens after sclerotherapy?
For a day or two after treatment the injection sites look rather like insect bites, but these subside quickly. Small bruises will be visible at the injection sites but will fade within a week or two. For one or two weeks the veins will probably appear more prominent than before treatment but will then usually begin to fade and continue to do so for up to eight weeks or longer. From 6-8 weeks later, 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 discolouration of the skin, which is due to the deposition of an iron-containing pigment (haemosiderin) in the skin. This pigment may take time to fade away or, in very rare cases, can be permanent, although we have never experienced this.

Other much rarer complications include a reaction to the agent, causing inflammation at the injection sites. If these are not treated correctly, small superficial ulcers can form. In our experience, this is extremely rare.

For these reasons, pregnant or breast feeding women will be asked to postpone treatment and patients taking certain medications (such as anticoagulants) will be advised against sclerotherapy. All clients are given a medical evaluation and post treatment advice to minimise any risk of complications.

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

Work-outs and weights should be avoided as the increased blood pressure will put extra pressure on the treated veins and can render the treatment ineffective.

How can I be sure that treatment is safe ?
Lasers have been used in medicine for over 30 years and sclerotherapy for even longer. You may not know that it a legal requirement for all users of lasers, IPL and LHE systems to be registered with the Commission. Registered facilities have a Registration number - ours is CO. xxxxxxxxx

When enquiring, be sure to ask for a registration number - if you do not get a number that matches the format above, the clinic is not registered and is operating illegally.

Our clinical staff are all trained to a very high standard and regularly update their clinical knowledge and skills.

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