The presence of thread veins can cause great distress, but achieving good results with effective treatments takes experience, explains leading vascular surgeon Michael Gaunt.
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Mr Gaunt, who runs clinics within hospitals in Cambridge, Bury St Edmunds and Harley Street in London, explains more about the condition and how it can be treated.
Q: What are thread veins?
Thread veins, also known as spider veins or reticular veins, are small veins that predominantly affect the skin. They are sometimes caused by varicose veins. They are usually on the legs, but susceptible people can get them in other places too. Sometimes they appear on the face, across the nose, nostrils, cheeks and chin, for example.
These can often unfairly be labelled as a boozer’s nose and can occur in men, as well as women, who spend a lot of time outdoors. You can also get thread veins all over the trunk, breasts, cleavage and back. People can be more prone to thread veins with age, but in those with susceptible skin, they can appear at any time.
Q: Are thread veins dangerous?
Thread veins are not a serious medical condition, but they can sometimes cause itching and irritation, and bleeding if you catch them. They can also sometimes cause extreme psychological stress. People become self-conscious about the way they look; thread veins can limit their choice of clothing, leisure activities, and day-to-day enjoyment of life.
They are often made to feel guilty about being concerned as some people characterise them as trivial and not something to bother the doctor with. While this is understandable – because GPs are swamped with major health problems – if those who are distressed receive effective treatment, then they often feel they can get on with their lives.
Q: What causes thread veins?
Sometimes thread veins are a sign of an underlying problem, such as varicose veins. In our clinics, we can scan to see if there are underlying veins that are feeding into the affected area: unless you get rid of that feeding vein, then treating the thread veins just will not work. Thread veins can also just occur if you have a susceptible skin type. This is often down to the natural wear and tear of everyday life, such as getting up and down and bruising.
They are formed as part of the body’s healing response, which is why you tend to get them in typical areas. There are certain patterns you can recognise. One is where you get a particular pattern on the outer aspect of the thigh and then a further patch on the lower leg. If you know where to look, you will see there’s a connecting vein between the two. Again, the key with this is for specialist treatment of the underlying vein otherwise neither patch will stay faded.
Q: What are the treatments for thread veins?
After treating an underlying cause, then different size veins, sometimes in different places, will require different treatments. The main treatment for most thread veins is injection sclerotherapy. This is where you inject a substance into the vein to kill its inner lining. However, it is very important to inject the vein in the right way and with the right substance. Patients often come to me saying injections received elsewhere haven’t worked for them.
In many cases, a specialist in the field, with years of experience and the right judgement, will achieve much better results than someone with less experience. Injecting too powerful a substance into smaller veins can cause side effects such as skin staining and even skin ulcers; treating a larger vein with an inadequate substance will only seal it off temporarily, resulting in the thread veins coming back. For finer veins, particularly on the face, the Veinwave, thermocoagulation technique works well. Some centres use transdermal laser systems. These can work on little patches of vein, but again don’t address the possible underlying problem. I don’t offer this because I get better results and can treat a much larger area with injections.
Q: How much do treatments for thread veins cost?
It varies. Most people require a course of outpatient treatments, where the veins typically fade by about 20 to 30 per cent with each treatment. The idea is to fade them back so much that the casual observer wouldn’t notice them. However, the number of treatments required to achieve this will vary, depending on the severity of the situation. The average course is three or four treatments. My sessions cost between £270 and £300 each.
Q: What is the difference between going to a beauty therapist and a private specialist?
Beauty salons are convenient, and many employ very skilful people. But, if you find their treatments are just not working, then there might be an underlying problem and you will find the salon is just not set up to investigate in the way we are. In this situation, it would be worth trying something different. Treating thread veins is not something you can learn in a weekend – or even a year. I think it is something that takes several years to perfect.