What is microsclerotherapy?
Microsclerotherapy is the gold standard treatment for thread veins on the legs. It involves the injection of a sclerosing agent into these small blood vessels causing irritation to the wall of the vessel and therefore stopping the blood flowing through it. This causes the visible blue or red vein you have noticed to disappear.
Why have I developed thread veins?
There are many causes of leg thread veins:
- Hormonal – many patients report worsening of their thread veins following pregnancy
- Prolonged standing
- Age – thread veins become more common as we age
- Trauma – a knock to the leg can be enough to cause a patch of thread veins
- Varicose veins – patients with varicose veins are more prone to developing fine thread veins.
Am I a suitable candidate for microsclerotherapy?
Most people are suitable for microsclerotherapy, but there are some patients we are unable to treat or may have to exercise extra caution with:
- Pregnant women and breastfeeding mothers.
- Patients with a current infection, including antibiotics in the last fortnight.
- Patients with varicose veins – if you have varicose veins as well as thread veins, then you need to have treatment of the varicose veins first. If we treated the smaller thread veins first then the high pressure in your veins would mean the treatment of the finer veins would be unsuccessful.
- Patients who have had a previous deep vein thrombosis or pulmonary embolism.
- People with medical conditions prone to blood clots (such as Factor V Leiden or cancer).
- Patients who have skin changes associated with their thread veins (such as pigmentation of the skin, eczema or skin ulcers).
- Patients with a history of inflamed leg veins (thrombophlebitis) over the previous 12 weeks.
- Patients who are unable to walk.
- Patients with a recent heart problem in the last 12 weeks.
- Patients currently taking Tamoxifen (this increases the risk of inflammation of the blood vessels).
- Patients currently taking Disulfiram (some sclerosing agents contain alcohol and can therefore provided unwanted symptoms whilst on Disulfiram).
- You should avoid shaving your legs for 24 hours prior to treatment. This is because applying the alcohol-based cleaning solution we use can irritate recently shaved skin, and also because shaving injuries can hide some of the blood vessels you would like treatment for.
- Do not apply moisturisers or lotions to your legs on the day of treatment.
- You should buy some class 1 compression hosiery of your choice. These can be bought over the counter in most pharmacies.
- You may choose to wear a swimming costume or shorts for your treatment, as we will ask you to remove your trousers or skirt.
- Injection of the sclerosing agent into the tissue around a vein can cause irritation and changes in the pigment of the skin for upto 1 year.
- Post Inflammatory Hyperpigmentation (darkening of the skin)
- Skin ulceration and necrosis
- Allergic reactions
- Low blood pressure
- Formation of a matt of fine blood vessels – these can be treated with laser if necessary
- Superficial thrombophlebitis (inflammation of the blood vessels) – this responds well to Non-Steroidal Anti-Inflammatory drugs like Ibuprofen.
- Deep vein thrombosis and pulmonary embolism.
- You can remove the dressings we have applied when you go to bed on the night of your treatment.
- Take some mild exercise, such as a 30 minute walk or gentle cycle ride, twice a day for 1 week after your treatment. This helps to improve the effectiveness of your treatment. Make sure the exercise is not too vigorous as this can be counter-productive.
- Wear your compression stockings immediately after treatment and for 1 week after treatment, including overnight for the first 3 days. This improves the effectiveness of your treatment.
- Avoid hot baths or showers for 1 week after your treatment, and use lukewarm water instead.
- Avoid sun exposure to your legs for 6 weeks after treatment.
- If you develop darkening of your skin you should avoid sun exposure for at least 12 months.
- If you develop any leg swelling or shortness of breath you should attend your local Accident & Emergency department to rule out a blood clot.
- The healing process can take several weeks, and you may experience some tenderness, discolouration, hardening, or develop a mat of tiny red blood vessels. This is normal and should resolve spontaneously over a few months.
- Avoid air travel for 4 weeks after treatment.
Is there anything I need to do to prepare for my microsclerotherapy treatment?
What will my microsclerotherapy appointment involve?
We will start by taking a thorough medical history from you, and performing a thorough examination. We will also take photographs of the area to be treated as a record of your starting point. If there is any suspicion that you have varicose veins we will refer you to a vascular surgeon for a thorough assessment to ensure treatment is suitable for you.
When we proceed with microsclerotherapy you will be asked to remove your trousers or skirt and lie on a couch on your side. The area to be treated will be cleaned with an alcohol solution. We will perform multiple injections with tiny needles to the vessels we have identified. Dressings will then be applied and we will ask you to put on the compression stockings you have brought with you.
What are the complications of microsclerotherapy?
Will my microsclerotherapy treatment hurt?
Most people find the treatment comfortable, since we use tiny needles to perform the injections. If you are concerned then you can take some Paracetamol before your appointment.
Will one microsclerotherapy treatment be enough?
For small uncomplicated areas one treatment with microsclerotherapy may be enough. However you should attend a review at 4-6 weeks and should expect to require a second treatment session.
How do you decide what a small, medium and large area are?
A small area is the size of a female hand or less, a large area is at least the size of two hands, and a medium area is between these two.
What should I do after my microsclerotherapy treatment?
Can you use microsclerotherapy for thread veins on the face?
No – this is an unsafe technique, which can result in blindness in the most severe cases. We offer Thermavein treatments for facial thread veins which have an excellent safety profile.