About Thread Veins and Facial Telangiectasia

Sclerotherapy and Short Wave Diathermy are two of the most popular treatments in Aesthetic Medicine for Leg Veins and Facial Telangiectasia.

Thread Veins

Spider veins and are terms used by the public for small, unsightly, superficial veins usually found in clusters on the legs. They are a frequent cosmetic cause for concern amongst women and the demand for treatment is rapidly increasing. The prevalence of thread veins among adults is over 50%.

Spider veins can appear as short and unconnected lines, or they may make patterns resembling a spider’s web or a burst. Spider veins are usually red or bluish in colour, and appear mostly on the legs, but can also be found on the face or on other parts of the body.

Apart from their unattractive appearance thread veins are frequently associated with symptoms of aching, burning, itching, throbbing and cramps. These symptoms are often worse at certain times of the menstrual cycle. In addition, the presence of thread veins may indicate an abnormality of the venous system which may require further investigation.

Thread veins can be associated with varicose veins (enlarged and tortuous veins) found most commonly in the superficial venous system of the legs, which are subject to high pressure when standing. Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. Large varicose veins and other significant abnormality of the venous or arterial system can only be treated by specialist doctors called vascular surgeons.

Why do I get thread veins?

The veins in the legs have to return blood from the feet to the heart against gravity. There are two vein systems in the legs. The deep system lies within the muscles in your legs and carries 95% of the blood being returned to the heart. As the muscles in your legs contract these veins are squeezed forcing blood up them. Valves attached to the vein walls close to prevent blood falling back down the veins when the muscles relax.

The second or superficial system is in the skin, not supported by muscles. The most important superficial veins in the leg include the Great Saphenous and Small Saphenous.

As blood moves up the deep system it is drawn from the superficial veins into the deep system through the perforating veins that connect the superficial and deep systems.

Where varicose veins develop the valves in the veins are failing to work properly. Blood is allowed to flow back on itself increasing the pressure in the venous system. This is called reflux. The deep veins cannot stretch because they are constrained by the muscular fascia (i.e. a sheet of fibrous tissue). However the superficial veins in the skin do stretch leading to a cycle of deteriorating varicose veins associated with incompetent valves. Reflux may be confirmed by Doppler or Duplex.

When thread veins are associated with underlying varicose veins and venous reflux then it is important that the varicose veins are treated before the thread veins otherwise back flow and high pressure will result in re-appearance of your thread veins. Following a thorough assessment of the vein system in your legs with the right medical equipment Dr Sotirios Foutsizoglou will let you know whether microsclerotherapy is the right treatment option for your thread veins.

Risk factors for thread veins in the legs

Any underlying cause that can affect either the integrity of the vein wall and valve, such as congenital disorders, or the drainage of the venous system, such as following a deep vein thrombosis (DVT), can give rise to thread veins and varicose veins.

Important associations and risk factors for the development of thread veins in the legs include:

  • Familial (it may run in your family)
  • Age (Vein walls and valves are made of collagen and will deteriorate with age)
  • Gender (most common in women)
  • Pregnancy
  • Oestrogen/Menopause
  • Obesity
  • Lack of exercise
  • Trauma
  • Surgery
  • Steroids
  • Sauna
  • Sun exposure
  • High heels

Facial telangiectasia

Telangiectasia is the medical term for small red veins which are commonly referred to as red veins, dilated capillaries or broken veins.

Facial telangiectasia arises from a permanent dilation of superficial small blood vessels, such as arterioles, venules, and capillaries particularly around the nose, cheeks and chin. These small blood vessels may be linear or have an enlarged red centre from which ‘legs’ radiate, hence the term ‘spider naevi’.

Facial telangiectasia responds very well to short wave diathermy.

What causes facial telangiectasia?

A number of potential risk factors have been implicated as precipitating or aggravating factors for prominent veins in the face. Namely:

  • Family History
  • Environment (e.g. extremes of heat or cold, sun damage)
  • Skin conditions (e.g. Rosacea)
  • Poor health (e.g. liver disease)
  • Injury (e.g. waxing or plucking of facial hair)
  • Medication (e.g. steroids, inappropriate use of topical retinoids)
  • Pregnancy
  • Hay fever and allergies causing constant sneezing may rupture capillary walls
  • Alcohol
  • Smoking (reduces oxygen supply and destroys collagen)