Sclerotherapy is a minimally invasive procedure that can permanently remove spider veins, thread veins, small reticular veins, and other vascular malformations on the legs.

These are usually small, damaged veins that can appear on the surface of an area.

Spider veins can be blue, purple, or red and may appear in the form of thin lines, webs, or branches.

Varicose vein treatment is not available at Westfield Clinic.

​

If you have thread veins on the face sclerotherapy is not suitable. Please click here for the correct procedure.

 

​

HOW DOES IT WORK?

We will clean and sterilize the affected areas and then using a very fine needle we inject a tiny amount of a sclerosing agent-Fibrovein into the visible veins that are being treated. When injected, the sclerosant liquid damages the lining of the vein walls, causing swelling, which immediately diverts the blood into unaffected veins, causing immediate blanching or whitening of the treated veins.

The treated veins will become inflamed and blocked from the sclerosant which then closes the veins shut to stop them opening up with blood. The closed-up veins then fade away and are harmlessly reabsorbed into the body. Because this treatment is very targeted on individual veins, it may take more than one treatment to eliminate them all.

.

​

WHAT CAUSES THREAD VEINS?

A variety of factors...

They are usually inherited.  Hormonal changes for example with pregnancy and HRT may increase their likelihood. Trauma/surgery to the legs can cause an eruption of thread veins. They become more prominent and numerous with increasing age.
Spider and thread veins of the legs are permanently dilated superficial skin veins that often appear in the early 30’s and 40’s, more commonly affected women. They are often caused by hormonal changes especially during pregnancy and due to hormonal changes associated with low levels of progesterone.
Localised trauma/bumps to the legs can also cause damage to the superficial veins leading to thread veins

Low levels of tissue oxygen levels reaching the tissues is another factor. This may happen if the skin is compressed by tight clothing such as skinny jeans or there has been poor tissue circulation from varicose veins or prolonged standing.

Usually, thread veins are asymptomatic but sometimes can be associated with aching of the legs and itching.

​

TELL ME MORE...

The veins in the legs have to return blood from the feet back up towards the heart against gravity. There are two main systems of veins in the legs. The deep system lies within the muscles in the legs and carries the majority of the blood. As the muscles contract the veins are squeezed and blood moves up the veins. Valves attached to the walls of the vessels prevent backward flow and as the blood moves up it is drawn into the deep system from the superficial system in the skin. In healthy veins the valves close and blood only moves in one direction. Approximately 50% of the population will at some point develop a problem with their veins. Varicose veins occur when the valves in the veins do not close properly and blood leaks back against the flow, this is called reflux. Reflux causes back pressure in the superficial veins which are not supported by muscle and can dilate. As they stretch their valves do not close properly, and so the problem develops, leading to varicose veins and thread veins.

Though varicose veins can be very unsightly and uncomfortable only 2% of sufferers will go on to develop skin problems such as swelling, pigmentation, and leg ulcers caused by poor circulation. For this reason, the NHS does not usually offer treatment for varicose veins which are considered largely a cosmetic problem.

​

HOW CAN I PREVENT THEM?

Unfortunately, if you have this tendency there is very little that can be done to stop them appearing. There is no clinical evidence that any homeopathic remedies will either remove or stop them appearing. Varicose veins and thread veins may be symptoms of an underlying problem. Whilst these symptoms can be treated there is no cure to prevent them from occurring again in the future.

Maintain a healthy weight. Avoid standing or sitting for long periods, remember the veins need the squeeze of active muscles to move the blood . Wearing compression hosiery will improve the circulation in the legs and manage any symptoms of poor circulation such as aches or swelling. Give up smoking.

​

​

HOW LONG DOES THE PROCEDURE TAKE?

Treatment time will vary depending on how large an area you want treated and how many veins are visible but normally a treatment session can range from 20 to 45 mins. You may be required to elevate your legs for 10 minutes after the procedure, you will be able to go home after your treatment.

​

DOES IT HURT?

This is not a painful procedure. The injections are made superficially with a tiny needle. Most individuals tolerate the procedure and do not require any type of anesthesia. You may experience a slight burning or stinging sensation as the solution is applied, but nothing severe. This will vary from person to person.  

After treatment, the treated areas may experience itching and mild discomfort which usually passes within 1-2 days.

​

WHAT WILL MY LEGS LOOK AFETR?

It is quite common for there to be some immediate itching and redness at the site of the treatment.

You may also experience some localised swelling and irritation. Your legs may look bruised.

The veins may also look worse before they look better. Sometimes a darker colour appears under the skin, but by days 10 to 14 you will see an improvement. Within 4 to 6 weeks the veins will look very much as they did before the treatment and the full benefit will be seen after approximately 12 weeks.

Everyone is different. These guides do not define success or failure.

​

HOW MANY WILL I NEED?

Most people require between 2-4 treatments, but you may require more or less depending on how severe the veins are and your response to treatment.  The results after one treatment vary considerably from one client to another. Some veins may disappear completely whilst others may only fade and some remain unchanged. On completion of a
successful treatment you can expect an improvement in the overall appearance of 60-80%.

After 4-6 weeks a review is booked and/or possible further treatment if required. You should leave a 4-6 week gap in between having further treatments on the same area.

If you have lots of veins you want to be treated, you may visit again after 2 weeks as long as it's a different vein to be treated.

​

CAN I HAVE LARGE AREAS TREATED? 

In any one session up to 3ml of sclerosing agent can be used. You can return 2 weeks later to treat a different vein/area.

​

WILL THEY COME BACK?

The results of treatment are permanent although in some patients they can develop new thread veins occasionally if they have for example, future pregnancies, or venous disease, including underlying or un-treated varicose veins,  these may mean new thread-veins are more likely to recur.

Other veins can develop, and some people come back for a top-up session in 2/3 years time. Sclerotherapy is a treatment for the symptoms rather than a cure for the cause. 

​

WHAT HAPPENS IF I DON'T TREAT THEM?

Absolutely nothing. Thread veins are almost entirely a cosmetic problem. They do not form blood clots and they do not cause swollen feet. A few people find that their veins cause some aching which is relieved by sclerotherapy.

​

IS THERE ANY HARM REMOVING THREAD VEINS?

Thread veins have no function and removing does no harm. The only reason they are removed is because of their unsightly appearance.

​

WHAT ARE THE SIDE EFFECTS AND RISKS?

It is expected most patients will experience some minor bruising, localised swelling, and there may be noticeable discolouration of the treated veins which will slowly resolve over the next 2-3 months after treatment. This is normal and expected and part of the treatment process.

Occasionally hyperpigmentation may occur, which is discoloration of the skin, usually a brownish colour or shadowy in appearance. It occurs in 9-30% of patients. Post-sclerotherapy hyperpigmentation is usually temporary, fading within six months. More severe cases can last up to a year, and in a minimal number of patients, about one percent, hyperpigmentation can be permanent. These effects can be reduced by wearing appropriate compression garments after treatment and avoiding excessive sun exposure to the legs. If you take Hormone Replacement Therapy or Birth Control Pills, beware that they can be angiogenic and increase chances of hyperpigmentation (brown staining of skin).

A few people may develop intense itching at the site of injection.

More serious side effects are rare but can include allergic reactions and skin blistering and necrosis.

In extremely rare cases, patients have suffered deep vein thrombosis but the risk of this is one patient in 10,000.

​

WHAT ARE THE PRE-TREATMENT INSTRUCTIONS?

To reduce the risk of bruising and bleeding, if appropriate, you should avoid anti-inflammatory painkillers (aspirin, ibuprofen, Nurofen, etc), as well as St John's Wort, Vitamin E, Fish oil, Gingko, Ginseng, or Garlic supplements 2 days pre-treatment.

If possible, avoid taking iron supplements (including multi-vitamins containing iron) for 1 week before, this will help decrease chance of hyperpigmentation.

Avoid alcohol and smoking for 2 days before and 2 days after treatment.

Compression garments may be suggested to be worn continuously for up to 72hrs immediately post-treatment, therefore you may like to wash/shower prior to your appointment, but do not use bath oils, lotions or creams on your leg(s) for 24 hours before your treatment.

Make sure that you have had something to eat and drink on the day of your treatment.

Please dress in loose clean clothing (jogging bottoms or a skirt).

​

HOW LONG DOES TREATMENT TAKE?

Between 10-45 minutes depending on how many veins we're treating in a session. Also allow 15 minutes for consultation.

​

WHAT IS THE AFTERCARE?

Avoid anti-inflammatory painkillers (aspirin, ibuprofen, Nurofen, etc), as well as St John's Wort, Vitamin E, Fish oil, Gingko, Ginseng, or Garlic supplements at least 2 days post-treatment. Avoid iorn 7 days post-treatment.

Avoid periods of prolonged immobility.

• Wear class 1 or 2 compression garments either lower leg or full leg depending on the areas of treatment post-procedure for 24-72hrs continuously. During this time you will not be able to take a bath or shower then 12 hours per day for the next 1-2 weeks following treatment. Wearing a compression garment can reduce the risk of side effects and improve the effectiveness of the treatment.

• Expect your legs to appear worse on removal of the stocking or bandage, at this stage this is normal. They may look worse for up to 2 weeks post-treatment.

• Do not disturb, lift or pick any scabs that form on the skin. Scabs are an important part of the skin healing process and if removed too soon could scar the skin.

• Avoid extremes of temperature for up to 2 weeks ie. very hot baths, and saunas. It is advised that you shower rather than take a bath during this time. Avoid scrubbing the skin over the treated area.

• Do not apply body lotion or creams to the treated area for one week.

• Avoid sun exposure for 4 weeks, pigmentation may take longer to fade.

• Avoid strenuous/high-impact exercise for up to 2 weeks.

• Elevate your legs as much as possible for the next 2 weeks.

• Avoid waxing or shaving the treated area for two weeks.

• Consider delaying long-haul traveling for up to 6 weeks post-treatment.

• You will require a review appointment 4-6 weeks later, where if required a follow-up treatment can take place.

• If you have multiple veins that could not all be treated at your appointment, you may come back 2 weeks later if treating a different area.

​

WILL I NEED TO WEAR COMPRESSION GARMENTS?

Yes, maintaining proper compression is critical because it minimises the blood re-entering the injected area, improves venous blood flow, decreasing the incidence of post-sclerotherapy hyperpigmentation and telangiectatic matting. We advise wearing compression garments either lower leg or full leg depending on the areas of treatment post-procedure for 72hrs continuously then 12 hrs per day for the next 1-2 weeks following treatment. Wearing a compression garment can reduce the risk of side effects.
We can provide you with advice about getting appropriate compression garments prior to your treatment. 

​

Class 1 stockings (light compression) exert a pressure of 14–17 mmHg. Flight socks will suffice for lower leg veins.

Class 2 stockings (medium compression) exert a pressure of 18–24 mmHg.

Class 3 stockings (high compression) exert a pressure of 25–35 mmHg (NOT required for thread veins).

​

AM I SUITABLE?

Injection micro-sclerotherapy is suitable for many patients. However not always suitable if you have any of the following:

If you have a history of DVT (Deep Vein Thrombosis) or (PE) Pulmonary Embolism.

Taking 75mg + of Asprin daily

Patients taking corticosteroids.

Unable to walk for any reason.

Currently pregnant or breastfeeding.

Very overweight (obese).

Experiencing acute inflammation with/or without blood clot formation (phlebitis/superficial thrombophlebitis) in the vein to be treated.

An allergy to the sclerosant (sodium tetradecyl suphate or “fibrovein”).

An infection in the skin on the area to be treated.

An infection throughout the body (systemic infection), such as a virus or a cold.

Diabetes that is not well controlled.

Significant heart disease.

Significant peripheral arterial disease.

Significant kidney disease.

Varicose veins which require surgical/endovenous intervention.

Varicose veins caused by pelvic/abdominal tumours.

Currently on medication to thin the blood (e.g. Warfarin).

Anticoagulant therapy

Varicose Veins which are related to more serious venous disease need to be treated before micro-sclerotherapy is undertaken otherwise the treatment is often less successful.

​

WHAT DOES IT COST?

Up to 3ml of Fibrovein is £150 per session.

​

​