Thread Vein Treatments


Thread veins are dilated venules (small veins) within the skin, which are of cosmetic concern, but very rarely cause troublesome symptoms. They occur most commonly in the legs and may be associated with underlying, larger varicose veins but not necessarily. For this reason, patients with thread veins should be assessed by a vascular specialist, before considering treatment.

Various treatments have been used, but the most effective are micro-sclerotherapy and Veinwave thermocoagulation. The choice of treatment depends on the size and colour of the veins.

Micro-sclerotherapy explained

This involves injecting a chemical (sclerosant) with a very fine needle, into the tiny veins which are then compressed. It is best used on slightly larger, blue thread veins. The chemical irritates the lining of the vein, which becomes shrivelled and disperses gradually over time.

The leg is usually bandaged for 24 hours and then an elastic stocking is recommended for a further week. The number of injections or treatment sessions will vary according to how extensive the thread veins are and how well the injections spread within them. It is very rarely possible to clear all thread veins by this or any other treatment, but the aim is to significantly improve the overall appearance.

Complications or side effects

Significant complications are rare, however an allergic reaction to the injected material could occur with any injection. Bruising around the site of the injections is common and the early appearance may well be as a darker vein which takes a number of weeks to settle. The skin overlying an injected vein may develop a brownish discolouration which gradually fades over a number of months, although it occasionally leaves a slight permanent discolouration.

What is Veinwave thermocoagulation?

Thermocoagulation is based on a high frequency wave, producing a thermal lesion with protection of the skin. The method is most effective for very fine red spider veins.

Equipped with magnifying loops (spectacles) the practitioner introduces a fine needle over the vein and in most cases, it disappears instantaneously. No bandaging is required and the immediate effect is slight redness and swelling, directly over the treatment sites, which look like a nettle sting. There is slight discomfort, momentarily, at each treatment site. Within 24 hours, any such swelling and redness usually resolves, leaving tiny micro crusts at the treated sites. These settle within 3-4 weeks, hopefully with disappearance of the underlying vein. Veinwave can be applied to any kind of skin complexion. There are no absolute, contraindications to use of Veinwave, although it is best avoided in patients with pacemakers or during pregnancy.


Not all thread veins are suitable for treatment. New thread veins can always develop, but this is particularly likely if underlying valve failure or varicose veins are present. For this reason, proper assessment by a vascular specialist is important.