Thread vein treatment (Sclerotherapy) at Parkside Hospital

What is thread vein treatment (sclerotherapy)?

Thread vein treatment (sclerotherapy) is a procedure that closes off small, visible veins just under the skin, most often on the legs or face, so they fade from view. A fine needle is used to inject a solution into each vein, which makes its walls stick together so the vein gradually disappears.

What conditions does it treat?

This treatment is used for thread veins, also called spider veins or broken veins, small blue, purple, red or pink veins that appear:

• on the legs, often linked to a weakened one-way valve inside the vein that lets blood pool and the vein branch out
• on the body or torso, less commonly.

Thread veins are different from varicose veins, which are larger, deeper, and often lumpy or twisted. If a scan suggests an underlying vein problem, you'll be guided towards varicose vein treatment instead.

What are the benefits of having thread vein treatment?

Thread veins aren't dangerous or usually physically uncomfortable, but they can affect confidence, and many people notice a real improvement once they're treated. Sclerotherapy is done without any cuts, requires no anaesthetic, and is carried out as an outpatient appointment, so you can go home the same day.

Most people are back to normal activities straight away, and it's unlikely you'll need any time off work unless your job involves standing still for long periods.

Are there different types of surgical approaches?

Several treatments can be used for thread veins, and your specialist will recommend the one best suited to the size, colour and location of your veins, as well as your skin tone.

Sclerotherapy uses a fine needle to inject a solution into the vein, causing its walls to stick together so the vein closes and fades over weeks or months; it's commonly used on the legs, body and larger veins, and is often preferred over laser for people with darker skin tones. Laser or IPL (intense pulsed light) treatment heats the vein until it collapses, and is often used on the face or for smaller, finer veins.

Thermocoagulation, sometimes called Veinwave, is another needle-based option that applies heat directly to the vein, and can be used on the face, legs or body. Whichever treatment you have, more than one session is usually needed for the best results.

What happens before the operation?

Before treatment:

• you'll have a consultation to discuss your veins and your goals, and in some cases a scan to check the deeper veins in your legs are working normally
• your specialist will confirm which treatment, or combination, suits you, and how many sessions you're likely to need
• you can usually eat, drink and take your normal medication as usual beforehand
• avoid applying fake tan or lotion to the area before your appointment
• it's a good idea to bring a pair of shorts to wear for a leg appointment, and any compression stockings you already have.

What happens during the procedure?

A typical sclerotherapy session involves:

1. Your leg, or the area being treated, may be raised slightly to help the veins show clearly.
2. A very fine needle is used to inject a small amount of solution directly into each vein.
3. You may feel a brief cramping or burning sensation lasting a few seconds as each injection is given.
4. Pressure is applied over the vein straight afterwards to stop blood pooling inside it again.
5. This is repeated for each vein being treated in that session; if you have a lot of thread veins, your specialist may treat some now and the rest at a later session.
6. A compression stocking or dressing is applied before you go home.

What does recovery look like?

Thread vein treatment is done as an outpatient appointment, so there's no overnight stay, and you can drive yourself home afterwards.

You'll likely be given a support stocking or compression garment to wear over the treated area for about a week; if your legs were treated, keeping them raised when resting for the first few days helps too. Most people return to normal activities straight away, though it's sensible to avoid swimming, horse riding and heavy weightlifting for about a week.

A short daily walk is often recommended to support healthy circulation while you recover. Bruising, redness or mild discomfort in the treated area is common at first and usually settles within days, though some bruising after sclerotherapy can occasionally last up to 3 months.

Some improvement is often visible quickly, but full results take longer to develop, typically several weeks, and up to 2 months for many people.

What are the risks and complications?

Thread vein treatments are generally very safe, but possible side effects include:

• bruising, redness, itching or swelling around the treated area, usually settling within days
• a brief cramping or burning feeling at the time of a sclerotherapy injection
• small, firm lumps or raised patches where a vein has been treated, which usually settle over time
• skin discolouration, darker or, less often, lighter patches, which can take weeks to months to fade, though it usually does
• rarely, an allergic reaction to the injected solution, or a blood clot
• new thread veins appearing in the future, even after successful treatment, sometimes needing a further top-up session.