Thread vein removal

Spider and thread veins’ treatment

Spider veins and thread veins are terms used by the public for small, unsightly, superficial veins usually found in clusters on the legs.  They are a frequent cosmetic cause for concern amongst women and the demand for treatment is rapidly increasing.  The prevalence of thread veins and spider veins among adults is over 50%.

Most women are concerned with the cosmetic appearance of their thread veins but they are frequently associated with symptoms of aching, burning, itching, throbbing and cramps2.  These symptoms are often worse at certain times of the menstrual cycle. In addition, the presence of thread veins may indicate an abnormality of the venous system which may require further investigation.

Microsclerotherapy is a safe and effective treatment for thread veins and spider veins which has been practised in Europe for many years.  With appropriate training, it can be practised by doctors and nurses from a wide range of specialities and backgrounds.

Demand for the treatment is high and is expected to increase.  This manual, and the course which accompanies it, provide theoretical and practical training in all aspects of microsclerotherapy to enable the participant to undertake safe, independent practice.


Sclerotherapy is the introduction of a solution into the lumen of a vessel causing thrombosis and subsequent fibrosis. The endothelial cells swell and slough. This then triggers the formation of a thrombus. The thrombus is then lysed and removed and the lumen is fibrosed. This procedure when performed on telangiectasia and venulectasia is called microsclerotherapy.

Model Answers To Frequently Asked Questions
Model Answers To Frequently Asked Questions  

Does it hurt? 

“This is not a painful procedure. *The injections are made with a tiny needle and very superficially. The solution does not sting. Some people feel nothing; some feel little pricks, how uncomfortable varies from one person to another.”

* Detergents are relatively painless on injection if using osmotics or chemical irritants this is a painful procedure.

What will my legs look like immediately after the treatment? 

“The injections will cause some redness and welts, like insect bites. These will have gone by the time you take the stockings down. When you remove the stockings your legs will probably look bruised and the veins usually look worse before they look better. The veins are usually darker, sometimes with blue, black or brown spots under the skin.”

“The appearance has usually improved noticeably by day 10 – 14.  At 4 – 6 weeks the thread veins should look pretty much as they did before injection and thereafter start improving. The full effect of the injection session is apparent at 12 weeks.”

“Please remember that everyone is different.  Do not worry if the above does not apply to you.  This is just a general pattern not a set of definite rules which define success or failure.”

How many treatments do you think I will need? 

“Budget for up to 4 treatments over a period of 4 – 12 months”.

“Remember it is not always possible to achieve 100% clearance but we should aim for at least 60 – 80% improvement in their appearance.  It is possible to get such a result after one treatment but it can take more. Most patients are satisfied with the results somewhere between one and four treatments.”

Will the thread veins come back?

“Sclerotherapy is a treatment for the symptoms rather than a cure for the cause, other thread veins can develop.  Most people need a top up session of treatment every 2 or 3 years.”

You are recommending I see a vascular specialist but I don’t worry about my varicose veins, I just want to get rid of these thread veins.

‘If you are concerned about a puddle on the floor I can mop it up, if it has returned after a short time, I can mop it up again and again.  We are then going to suspect a leak from the ceiling.  If we ignore the leak, the ceiling will need repairing.  If we ignore the source of the leak you will be wasting a lot of money on short term solutions.’

The vascular specialist is the plumber (or roofer), I am the decorator.

I can solve the cosmetic problem on the understanding that results will be at best, short term and, at worst may lead to worsening of failure.”

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