Thread veins are tiny veins that appear most commonly on the cheeks, nose and legs. Small thread veins are red, but larger ones look purplish. They have many names, including:
broken veins (not an accurate name, because they are not actually broken)
Normally, the tiny veins in the skin are invisible, but in some people they expand and show through the skin. One cause of this is too much exposure to the sun over the years. Another is pregnancy or oestrogen treatment. They may also be inherited. Thread veins can sometimes be a sign of rosacea, a skin condition, or can result from overuse of steroid creams. Thread veins are more obvious after mid-life, when the skin becomes thinner and loses some of its collagen.
What you can do about thread veins
Find a good concealer and use it under your make-up. Using an artificial suntan preparation will make leg thread veins less obvious.
Avoid alcoholic drinks, very hot drinks and spicy foods if you find these make the veins more obvious.
Horse chestnut cream (available from health food stores) is said to strengthen the tiny veins in the skin. Apply gently to avoid traumatizing the skin.
Treatments for thread veins
The two main treatments are micro-sclerotherapy and laser treatment. In general:
laser treatment is best for thread veins on the face
micro-sclerotherapy, possibly combined with laser, is best for thread veins on the legs.
Micro-sclerotherapy involves injecting the veins with a chemical using tiny needles. This makes the walls of the veins stick together. After treatment on the legs, you will need to wear compression stockings for 1 week, and the veins will disperse naturally over the following 2-3 weeks. Several treatments may be needed. If the therapist misses the tiny vein, and injects the surrounding skin by mistake, there can be a skin reaction. Some darkening of the skin (hyperpigmentation) may occur. Overall, the results are variable. Micro-sclerotherapy is better for thread veins on the legs than on the face. The veins may come back, but the treatment can be repeated.
Laser treatment gets rid of the veins very successfully and is the best treatment for thread veins on the face, but it does have drawbacks. It cannot be used on dark skin because the pigment in the skin blocks the laser beam, and the pigment may be lost afterwards. Some types of laser, especially the pulsed dye laser, cause bruising, which is at its worst in the first 48 hours, but can last up to 10 days. A different type of laser, the potassium titanyl phosphate laser, does not cause bruising. After treatment, you will have to protect your skin from sunlight. Laser treatment can change the texture of the skin, and sometimes leaves little white scars. It does not work very well on the legs, probably because the thread veins lie deeper in the skin. Some people find it painful, or notice a flicking sensation during the treatment. It is more expensive than sclerotherapy.
High-intensity light treatment (Photoderm) heats the veins to make them coagulate. It can cover a bigger area than laser treatment areas measuring 2 cm by 0.5 cm can be treated by a single flash. Scientific studies of the treatment have produced contradictory results. One study concluded that at least 75% of the veins were cleared in 80% of patients, and that after treatment the skin may look a little red and there may be some tiny blisters, but usually no scarring (Dermatological Surgery 1996;22:32330).
In another study, patients found the treatment uncomfortable and described each light pulse as being like a burn. There was scarring and thinning of the skin in 21% of patients, and 42% had blistering and peeling. Only 9.5% of patients had complete clearance of the thread veins and there was no change in appearance in 56% (Journal of the American Academy of Dermatology 1998;38:618).
So, this technique appears to be more risky and less effective than laser treatment.
Electrolysis is cheap, and offered by many beauty clinics. It is less effective than the other treatments, and there is a greater risk of scarring.
Getting treatment for thread veins
It may be difficult to get treatment for the thread veins through your doctor, because it comes into the cosmetic treatment category. However, if you are very self-conscious about them, and find cover-up creams inadequate, it is worth asking your doctor. If you are in your 20s and notice thread veins, do not think that you are too young to go for treatment this is the ideal age for laser treatment. About a third of people with thread veins on the legs have varicose veins; in this situation the varicose veins
must be treated first.
You may have to use a private clinic. Clinics advertise persuasively, and it is difficult to know which provide good treatment. The best policy is to ask your doctor to find out the name of a good clinic from the local vascular surgeon (blood vessel expert). Some hospitals in the UK are now running private cosmetic laser clinics (to generate money for the purchase of equipment to be used for National Health Service patients). These clinics have a doctor in charge and their standards are high. You could telephone the dermatology department of your nearest large hospital to find out if it runs one of these clinics.
Before committing yourself to treatment, find out exactly what method the clinic uses, how many sessions will be needed and what the cost will be. Ask about problems, such as scarring.
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Wednesday, August 18th 2010
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