What are thread veins?
Thread veins are extremely common and are usually left untreated due to constraints on the NHS. Most thread veins cause no symptoms apart from minor aching or throbbing but the cosmetic appearance may be a considerable cause of distress.
It is important to treat any underlying varicose veins before considering treatment of thread veins. This will be part of the full clinical assessment before deciding on the correct treatment. It should also be noted that no treatment for thread veins can be guaranteed to be 100% effective; the aim is to improve the cosmetic appearance.
Sclerotherapy involves injecting a solution (sclerosant) into the thread veins which causes damage to the cells that line the vein causing it firstly to clot and then to form scar tissue
(sclerosis). The commonest solution is a detergent (sodium tetradecyl sulphate) although sometimes other solutions such as chromated glycerine (Sclérémo) can be used.
No local anaesthetic is needed as the needle is tiny (less than 0.5 mm). The skin is cleaned with an alcohol wipe and the needle placed in the thread vein. A small volume of the sclerosant solution is injected, the needle removed and a cotton wool ball taped over the area. Multiple injections are usually needed. The leg is then dressed with a bandage and a compression stocking.
Inflammation of the vein from the sclerosant (phlebitis) is a reasonably common complication. Occasionally this can be painful and can be treated by using a needle to aspirate (remove) the small clot. The main risk from sclerotherapy is brown pigmentation over the site of treatment (1 to 10% risk) although this is minimised by reducing the concentration of the sclerosant when treating smaller veins. Matting (formation of tiny red veins) may also occur in 1 to 10% of cases and of course new thread veins can develop at other sites. Rarer risks (less than 1:1000 cases) include a small ulcer over the injection site, deep vein thrombosis and an allergic reaction.
After the procedure
The dressing should be left undisturbed for 3 days after which it should be removed and then you are able to bath/shower. The stocking should then be worn during the day only for a further 2 weeks. Sunbathing should ideally be avoided for 2 weeks. Repeat treatments are usually booked at a minimum of 6 week intervals.
What is Veinwave?
Veinwave uses a technique known as thermo-coagulation. A fine nickel needle is introduced through the skin (less than 1 mm depth) and a high frequency electric current used to heat the vein, often causing it to instantly disappear. The needle only has to make contact with the vein and nothing is injected. This is more straightforward than sclerotherapy. Treatment sessions last up to 20 minutes allowing 50 cm of thread veins to be treated in one session. Most patients find this slightly uncomfortable rather than painful. Treatment can be repeated every 6 to 8 weeks. Most people need several sessions, depending on the extent of the veins and the desired cosmetic appearance. The leg does not need to be bandaged after the procedure. You may drive immediately and can bath/shower and return to work straight away.
Are there any side effects or complications from Veinwave?
The procedure is not recommended for pregnant women, those with skin infections or patients with epilepsy. Alternative (gold) needles are available for those with a nickel allergy.
Usually there is minor crusting overlying the needle sites that disappears within a few days although this can persist for a few weeks. There is often redness of the overlying skin after treatment which usually improves within 24 hours but can persist up to 2 to 3 weeks. If this is uncomfortable a topical antihistamine cream (e.g. Anthisan) will help.
Veinwave treatment is usually not funded by the medical insurance companies.
LASER treatment can be an option for tiny superficial red thread veins (<1 mm diameter). The effects of LASER on the skin can be unpredictable on the skin (e.g. causing an increase or decrease in pigmentation) and therefore some consultants do not recommend this for the majority of thread veins but will refer you to a Consultant Plastic Surgeon with expertise in LASER if this is the right treatment for you.