Venous flares (also known as "spider veins" or "thread veins") are small red or purple visible veins in the skin usually on the legs. They often occur in people with varicose veins (unusually large, prominent and tortuous veins under the skin) but may sometimes occur on their own. Venous flares are not, in themselves, a serious condition and do not carry any long-term risk of complications (such ulcers or clots in the deep veins or DVT). They do not have to be treated but all those with both varicose veins and venous flares may benefit from wearing compression stockings to help prevent new varicose veins or flares. Stockings will not, however, get rid of the existing flares and there are a number of treatments available to eliminate flares that you consider unsightly.
There are a number of different types of treatment used to eliminate venous flares. These include injection sclerotherapy, visible light (photodynamic) therapy and laser therapy. Only injection sclerotherapy is available in our clinic.
It is important that the function of the larger veins in the leg be assessed (which may require an ultrasound scan) before local treatment is given to venous flares. If varicose veins are present, then treatment of your varicose veins may need to be considered before any local therapy to the flares is used. This may involve a surgical procedure and your doctor will discuss this with you.
Injection sclerotherapy works by injecting the vein with an irritant solution (polidocanol). This acts like a glue and makes the vein wall stick to itself. It no longer fills with blood and become invisible. For this reason, the compression applied after the injection is an essential part of the therapy. This treatment is performed on an outpatient basis and takes only a few minutes. However, the treatment may need to be repeated several times before a satisfactory result is obtained.
You will be measured for an elastic stocking and then asked to lie on a couch in the clinic.
A small amount of fluid (Sclerovein™) is injected directly into the flare at one or more sites on one or both legs. The needle used is very small and most patients do not experience much pain or discomfort. A Band-Aid is placed over the injection sites and an elastic stocking applied. You should wear the stocking day and night for 5-7 days. You may change the stocking but you should wear it all the time.
It is common for the area to itch or sting afterwards but this will usually go away quite quickly. You may walk immediately after the injection (wearing your stockings) and it is not usually necessary to take time off work. Walking for at least 20 minutes each day (for the 5 days after treatment) helps prevent stiffness and encourage circulation. You should avoid hot baths or showers for 5 days as the skin will often be quite sensitive to heat immediately following injection therapy.
An appointment will be made for other sessions if necessary. It is better not be treat the same area of skin within 3 to 6 weeks to allow for complete healing of the area.
Over the first few weeks following the injection, you may notice slight discomfort, hardness, tenderness and redness at the injection site(s). You may take simple painkillers (Tylex, Paracetamol) but if there is extensive redness, swelling or severe pain, you should contact your GP or the vascular team at the number below.
Complications are uncommon (less than 1%). These include:
- brown discoloration of the skin (resulting from the escape of blood into the skin at the time of treatment). This usually disappears within a year, but a small percentage may last for years.
- rarely, an ulcer of the skin at the injection site will develop (which may be very slow to heal and require special treatment). When this does occur, it may leave a permanent mark or scar.
- the injection therapy is not always successful at obliterating the vein and it is almost impossible to ensure every vein is removed.