MICROSCLEROTHERAPY FOR SPIDER VEINS ESSEX

Private Microsclerotherapy for Spider and Thread Veins

Doctor-led treatment for thread veins and spider veins in Essex

If you have fine blue or red veins on your legs that you would rather not look at, we can help. At Essex Private Doctors, we offer microsclerotherapy – a safe and effective treatment – for thread/spider veins.

Fine leg veins are usually harmless and largely a cosmetic concern, but occasionally they point to something happening deeper in the leg. That’s why it’s important to be assessed by an experienced doctor rather than in a beauty clinic.

  • Full medical assessment by a GP
  • Separate assessment and treatment appointments, so you are never rushed
  • Injections reach the small feeding veins that laser and IPL cannot
  • Honest guidance when treatment is not the right answer for you

Dr Henry Grundy-Wheeler MBBS MRCGP GP with specialist training in microsclerotherapy | Minor surgery and procedural medicine | Essex Private Doctors, Brentwood.

What Are Thread Veins and Spider Veins?

Thread veins and spider veins are two names for the same thing. They are the very fine blue, red or purple veins that sit just under the surface of the skin, sometimes as single lines, sometimes in little clusters or a starburst.

You may also come across the term telangiectasia, and the distinction is worth knowing. Spider veins describes what you can actually see: those web-like clusters of fine vessels sitting on the surface of the skin.

Telangiectasia is the wider medical category. It covers any small, dilated blood vessel, which can appear in places you might not expect, including the eyes and the moist linings of the mouth and nose. It also shows up as a feature of other conditions, from rosacea through to some rare inherited disorders.Put simply, every spider vein is a telangiectasia, but not every telangiectasia is a spider vein.

On the legs they turn up most often around the knee, on the thigh and on the inner or outer calf. Underneath a visible spider vein there is frequently a slightly larger feeding vein, called a reticular vein, which is filling it. These are usually a couple of millimetres across and sit a fraction deeper.

Microsclerotherapy is designed for exactly these vessels: tiny superficial veins. It is not a treatment for varicose veins.

Thread veins are not the same as varicose veins

Varicose veins are larger than three millimetres in diameter, often raised, lumpy or ropey to look at, and they can ache or throb. They need a different treatment altogether, usually foam sclerotherapy or surgery with a vascular specialist. We do not treat varicose veins here, and if we find them during your assessment we will tell you honestly and refer on for further care if needed.

Thread veins are not usually a sign of anything worrying. They are a normal part of getting older and living in a body. But they can be an early marker that the valves in your leg veins are starting to give a little, and in some people that is the beginning of a process that goes on to produce varicose veins later.

That is a good reason to have them looked at by a doctor rather than simply treated. If there is something going on further upstream, you want to know about it, because it changes both what treatment is sensible and how long the results will last.

What Causes Thread Veins?

If one or both of your parents had significant leg veins, you are more likely to develop them.

 Valve function in veins declines gradually throughout adult life.

Teachers, hairdressers, retail and hospitality staff, surgeons and nurses all know this one.

A desk job carries its own risk, for the opposite reason.

Endurance athletes and track and field athletes frequently develop them.

Thread veins commonly appear or worsen during pregnancy.

More load through the leg veins over time increases the risk of spider veins.

How Microsclerotherapy Works

A tiny amount of a medical sclerosant solution is injected directly into the vein through a very fine needle. The solution deliberately irritates the lining of the vein wall so that the vein becomes sticky inside, finds it harder to fill with blood, and gradually seals itself closed. Over the following weeks your body reabsorbs it and the vein fades from view.

The technique itself is not new. Sclerosant treatment for veins has been used for years, and the current generation of solutions has been used safely for decades. One detail worth knowing: the solution is deactivated within a few millimetres of where it is injected. It does its work locally and then stops. This is a large part of why the procedure is as safe as it is.

Why we treat a small area at a time

Each injection treats roughly two centimetres square. You may see the solution flash along a wider stretch of vein, but it will not be doing much beyond that small radius. So if you have a spider covering ten centimetres, that means a lot of small injections rather than a few big ones. It takes a little time and it is not a procedure to rush.

Are You Suitable for Microsclerotherapy?

You are likely to be suitable if:

  • You have fine thread veins, spider veins or small reticular veins on the legs
  • The veins are under about three millimetres across
  • They are above the ankle: on the calf, knee or thigh
  • You are bothered by how they look and would like something done about them
  • You are in reasonable general health with no history of significant vein disease

Microsclerotherapy is not suitable if you:

  • Are pregnant. This is temporary, and we can treat you once your pregnancy is over
  • Have had a DVT, or are taking an anticoagulant because of a previous DVT
  • Have had a leg ulcer, or have skin changes suggesting long-standing venous disease
  • Have had an episode of critical limb ischaemia or significant arterial disease
  • Have large varicose veins that need vascular treatment first
  • Want treatment on your face or your feet, which we cannot offer

Aspirin on its own is not a barrier to treatment, and neither is every anticoagulant.
What matters is why you are taking it. We will go through your full medication list at assessment.

Skin Changes

When long-standing venous disease is present, the skin of the lower leg often tells the story before anything else does. We look for brown or rusty pigmentation, where iron-rich pigment has leached out of pooled blood, skin that has become thickened, waxy or tight, or dry, scaly, itchy or eczema-like skin around the ankle.

If those changes are marked over the lower leg, microsclerotherapy is not the right treatment and we will say so. Where the changes are milder and the veins that trouble you are higher up on the thigh, treatment may still be sensible.

Why We Do Not Treat the Face or Feet

On the face and on the feet, the small arteries and veins run closely connected to one another. If a sclerosant is injected into an artery in those areas rather than a vein, the consequence can be an ischaemic event, meaning tissue loses its blood supply. The risk is small but the outcome is serious, and it is not a risk worth taking for a cosmetic result.  So we do not treat below the ankle, and we do not treat facial thread veins with injections.

Your Treatment Journey

Assessment and treatment are two separate appointments. That is deliberate. It gives you time to think, and it gives me time to be sure treatment is right for you.

We will want to understand which areas you are concerned about, as well as:

  • Your medical history, and any previous vein problems, DVT, ulcers, or circulation problems
  • Your current medications, including any blood thinners
  • An examination of both legs, looking at the veins themselves and at the condition of the skin
  • Whether there are larger varicose veins that change the picture
  • A realistic conversation about what we can and cannot achieve
  • Measuring you for compression stockings
  • Consent, so that everything is settled before treatment day

You will lie on your back or your side, and you will turn as needed to reach both the inner and outer thigh. The leg is cleaned, and then the injections begin.

The needle used for the treatment is really fine- the same as the needles used for insulin injections. It is a series of small pricks and tiny volumes of solution, one small area at a time. No anaesthetic is required, but if you are needle-phobic, we can discuss topical anaesthetic.

There is no dressing afterwards. There is usually nothing to see on the leg at all, other than the reaction described below.

You should expect your leg to look worse before it looks better, and this catches people out if they are not warned.

The sclerosant releases histamine from the vein walls, which produces a raised, bumpy, blotchy reaction that looks very much like a nettle rash. It can be quite marked. It is entirely normal, it is not an allergic reaction to worry about, and it settles within a few hours.

Wear your stockings for the first 24 hours, then overnight for a further three to five days.
Beyond that, there are very few restrictions. You can bathe, shower, walk, run and exercise.

You will be reviewed in clinic at around four to six weeks after treatment to assess how the veins have responded.

Some people are delighted after one treatment. Others need a second, and very occasionally a third treatment to get the desired outcome.

Results: What to Expect and How Long They Last

The treatment does not work instantly. The vein has to seal, and your body then has to clear it, which is a process of weeks rather than days.

Where treatment has worked well, you should expect a good result lasting somewhere in excess of twelve to eighteen months, and often two years or more. That range is wide because people genuinely do differ.

New thread veins can and often do appear over time. That is not treatment failure, it is the same underlying tendency continuing to do what it does. Many patients come back every couple of years for a top-up and are perfectly happy with that arrangement.

One important exception:

If a treated vein disappears and then returns within twelve months, it usually means there is a refluxing vein further upstream refilling

Potential Risks and Side Effects

Common and expected:
Histamine reaction. A raised, itchy, nettle-rash appearance immediately after treatment, settling within hours. Minor and short-lived.
Temporary worsening. Treated veins can look darker before they fade.

Less common:
Brown staining. Pigmentation along the line of a treated vein, which usually fades over several months. Avoiding strong sun on the treated area helps.
Tiny new vessels appearing near a treated area. Usually settles on its own.
Incomplete response. Some veins simply need a second session.

Rare:
Infection at an injection site, and localised skin reactions, are both uncommon.

Patients frequently ask about blood clots. Given the size of the vessels we are treating and how superficial they are, the risk is as close to zero as anything in medicine gets. Clot risk is a genuine consideration when treating large varicose veins, which is a completely different procedure. It is not a meaningful concern here.

Why Choose Essex Private Doctors

A Doctor, not a beauty therapist – knowing when the answer is ‘no’

Most of the value in medical training here shows up in the cases we decline: recognising venous disease, spotting varicose veins that need a different pathway altogether, and knowing when treatment will not achieve what you are hoping for. Injecting the veins is the easy part.

Assessment that looks beyond the vein

Because we are GPs, an appointment about your legs can also be an appointment about your health. If your veins raise questions about circulation, weight, blood pressure or anything else, we can pick that up in the same conversation rather than leaving it for someone else.

Frequently Asked Questions

There is no difference. They are two names for the same thing.
Spider veins tends to describe the ones in a starburst or web-like cluster, while thread veins tends to describe finer single lines, but they are the same vessels and the treatment is identical.

Very little. The needle is a 30 gauge, similar to an insulin needle, and the injections are superficial. Most people describe a series of small pricks rather than pain. No anaesthetic is normally needed, though topical anaesthetic is available if you are needle-phobic.

Often one. Sometimes two, occasionally three, depending on how many veins there are and how they respond.

Typically in excess of twelve to eighteen months, and frequently longer. New thread veins can appear over time, so some patients return periodically for a top-up.

Not immediately. Expect little visible change in the first few weeks. Four weeks is the earliest point at which the picture is clear, which is why your review is set at four to six weeks.

Not with microsclerotherapy. On the face, arteries and veins run closely connected, and injecting a sclerosant into an artery there can cause a serious loss of blood supply to the tissue. It is not a risk worth taking. Laser is the appropriate treatment for facial thread veins.

No. We do not treat below the ankle, for the same reason we do not treat the face.

No. Microsclerotherapy is for veins under about three millimetres. Varicose veins are larger and need foam sclerotherapy or surgery with a vascular specialist. If I find varicose veins at your assessment, I will explain the position and help you find the right pathway.

The risk is extremely low. We are treating very small, very superficial veins, and the sclerosant is deactivated within millimetres of the injection site. Clot risk is a meaningful consideration for large varicose vein treatment, which is a different procedure entirely.

Not while you are pregnant. Pregnancy itself commonly brings on thread veins, and we are very happy to treat you afterwards.

Possibly. Aspirin is not a barrier. Other anticoagulants depend on why you are taking them. If it is because of a previous DVT, then microsclerotherapy is not appropriate. We will go through this at your assessment.

We recommend them: 24 hours continuously, then overnight for three to five days. The evidence for prolonged compression after microsclerotherapy is mixed, and it is stronger for larger vein treatment, but stockings may help and they are a helpful reminder to take things gently.

Yes. There are no significant restrictions. Taking it easy for 24 to 48 hours is preferable, but walking, exercise, baths and showers are all fine.

That is a histamine reaction from the vein walls, and it looks like a nettle rash. It can be quite pronounced and it settles within a few hours. It is expected rather than a problem.

For legs, generally yes. Visible spider veins are usually fed by a slightly deeper reticular vein, and a needle can reach that feeding vein where a laser cannot without risking a burn. Laser has the advantage on the face.

Usually not at all. They are largely a cosmetic concern. They can occasionally be an early sign that leg vein valves are becoming less efficient, which is one good reason to have them assessed by a doctor.

Cherry angiomas, also called Campbell de Morgan spots, do not respond especially well to sclerosant injection. They are better treated with diathermy, which we can also offer. Do mention them at your assessment.

Please see our fees for microsclerotherapy costs.

Ready to Do Something About Your Leg Veins?

If the fine veins on your legs bother you, the sensible first step is an assessment. We will look at what is actually there, work out whether treatment is likely to give you the result you want, and be honest with you if it is not.

Book Your Microsclerotherapy Assessment with Dr Henry Grundy-Wheeler

Dr Henry Grundy-Wheeler provides private microsclerotherapy for thread veins and spider veins at Essex Private Doctors in Brentwood, Essex. Doctor-led assessment and injection treatment for thread veins, spider veins and small reticular veins on the legs, with full medical assessment before treatment. Serving Brentwood, Chelmsford, Billericay, Romford, Basildon, Southend, Colchester, Harlow, Epping, Loughton and the surrounding Essex areas, with easy access from North and East London via the Elizabeth line.