Spider veins are the fine red, blue and purple lines that sit in the skin itself. They are usually a cosmetic concern rather than a medical one, but they can be a surface sign of a larger problem underneath, which is why the leg is scanned before they are treated.
Spider veins, also called thread veins, are treated with microsclerotherapy: a very fine needle delivers a small amount of dilute sclerosant into each vein so that it closes and fades. Two to four sessions spaced several weeks apart are usual. Any underlying saphenous reflux must be treated first, or the thread veins return quickly.
Spider veins sit in the skin itself and are generally harmless. Most people who want them treated want them treated for appearance, which is a perfectly reasonable thing to want and is treated honestly as such.
The important point is that they can be the visible surface of a deeper problem. If a saphenous trunk is refluxing, pressure is transmitted into the small skin vessels and keeps producing new ones. Treating the surface veins in that situation is like mopping a floor with the tap still running: they clear briefly and come back.
So the leg is scanned first. If the deep and trunk veins are normal, the thread veins are treated directly. If there is reflux, that is dealt with first and the thread veins are treated afterwards, when the results last.
Treatment itself is microsclerotherapy. A very fine needle delivers a small volume of dilute sclerosant into each vessel. The vessel closes, and over the following weeks it is absorbed and fades from view.
This is elective, cosmetic treatment in most cases, and the honest conversation about what it can and cannot deliver happens before the first session.
The leg is examined standing and scanned to exclude reflux in the deeper veins.
Treatment is planned in zones rather than chasing individual veins across the whole leg in one sitting.
A very fine needle delivers a small volume of dilute sclerosant into each vessel. Magnification and good lighting matter more than speed here.
A stocking is fitted before you leave and worn for the period advised.
The area is reviewed after several weeks, once the initial reaction has settled, and any remaining vessels treated at the next session.
Normal activity straight away. Small red bumps and mild stinging where injected.
The treated veins often look darker and more obvious. This phase is expected and is the commonest reason people worry.
Vessels begin to fade. Any staining is at its most visible now.
Final result becomes apparent. Staining fades in most people. Further sessions, if needed, are planned.
Expect substantial improvement rather than perfection. A realistic aim is that the treated area looks clearly better at conversational distance and that you stop noticing it. Individual vessels usually need more than one treatment, veins can look worse before they look better, and brown staining or a blush of fine new vessels can occur. New thread veins also continue to appear over the years, particularly with standing occupations, pregnancy and family history, so occasional maintenance sessions are normal. Because this is usually cosmetic, none of it is covered by insurance.
These are small procedures, but the risks matter more than usual because the reason for treatment is appearance.
Sun and compression are the two things that most affect the final look.
Usually they do not. They are commonly a skin level, cosmetic matter. They can occasionally be the surface sign of deeper reflux, which is exactly why the scan is done.
Two to four sessions are usual, and individual vessels often need repeating. Anyone promising a single session clearance is overselling.
For most leg thread veins, fine needle sclerotherapy remains the more reliable treatment. Laser has a role for very fine vessels and for people who cannot tolerate needles.
It does not. New vessels appear over the years, especially with standing work, pregnancy and family history. Occasional maintenance is normal.
Thread veins are scanned before they are injected, and if the scan shows reflux you will be told that treating the surface first is a waste of your money. That conversation is the main thing that separates a good result from a disappointing one.
Charged per session, with the number of sessions estimated after assessment. Treatment of thread veins for appearance is not covered by health insurance or government schemes, and that is made clear before you start. If the scan shows underlying reflux, treating that is a separate and often covered matter.
The honest answers people want before spending their own money.
Ask your question →Because if a larger vein underneath is refluxing, it keeps producing new thread veins and anything we treat on the surface returns within months. The scan takes a few minutes and decides whether treating the surface is worth your money.
Usually two to four, spaced several weeks apart. It depends on how many vessels there are and how they respond. You get an estimate after assessment.
For the first two to three weeks the treated vessels are inflamed and often look darker. That is the treatment working. Judge the result at the review, not at two weeks.
In most people, over six to twelve months. Occasionally they persist. Sun exposure makes staining worse and longer lasting, so keep the area covered or use sunscreen.
No. Treatment of thread veins for appearance is not covered by health insurance or government schemes. If the scan finds underlying reflux, treating that is a separate matter and often is covered.
The needles are very fine and most people describe a brief sting with each injection. No anaesthetic is needed, and you walk out and carry on with the day.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
