What’s the difference between varicose and thread veins?
They’re actually both a type of varicose vein. Trunk varicose veins are near to the surface of the skin, are often long, thick and knobbly; reticular varicose veins are red and sometimes grouped close together in a network; and telangiectasia varicose veins – also known as spider or thread veins – are small clusters of blue or red veins that sometimes appear on your face or legs.
Unlike other types of varicose veins, thread veins are harmless and, unlike trunk varicose veins, they don't bulge underneath the surface of the skin. They also don’t cause common symptoms of varicose veins, such as aching, heavy and uncomfortable legs; swollen feet and ankles; and dry, itchy and thin skin over the affected vein – these symptoms are usually worse during warm weather or if you've been standing for a long period of time.
What causes them?
In a healthy vein, blood flows smoothly to the heart and is prevented from flowing backwards by a series of tiny valves that open and close to let blood through. However, if the valves weaken or are damaged, the blood can flow backwards and collect in the vein, eventually causing it to be swollen and enlarged.
According to the NHS, women are more likely to develop varicose veins than men due to female hormones, and certain things can increase your chances of developing varicose veins, such as having a close family member with varicose veins, being older, being overweight or being pregnant.
Dr Hilary Allan, cosmetic doctor and founder of Woodford Medical adds that trauma to the legs, including bruising, can also give rise to thread veins – and so can your job. “Standing a lot, especially with certain jobs like teaching and hairdressing, will increase the pressure in the venous system of the legs which gives rise to the formation of all types of varicose veins,” she explains.
And when it comes to thread veins or broken capillaries on the face, Dr Allan says that sun damage or weathering can be a factor, as UV destroys the collagen and elastin in the skin, allowing the formation of new vessels that are seen visibly as broken capillaries.
Can you prevent them?
There's little evidence to suggest you can stop varicose veins getting worse or completely prevent new ones developing, but there are ways to ease symptoms of existing varicose veins. The NHS advises:
- Avoiding standing or sitting still for long periods and trying to move around every 30 minutes
- Taking regular breaks throughout the day, raising the legs on pillows while resting to ease discomfort
- Exercising regularly to improve circulation and help maintain a healthy weight
Dr Allan adds that in the case of preventing facial thread veins, using SPF50 every day and reapplying in a hot climate is key.
How can they be treated?
If you have trunk varicose veins and your GP deems treatment necessary, they may recommend you wear compression stockings for six months, along with exercising regularly and elevating your legs while resting. Should this prove unsuccessful, the most common treatment options include endothermal ablation (where heat is used to seal affected veins), sclerotherapy (which uses a special solution to close the veins) or ligation and stripping (surgically removing the affected veins).
It's unlikely you'll receive treatment on the NHS for cosmetic reasons alone, but private clinics offer a range of services to help. Dr Allan says she recommends sclerotherapy to most of her patients with varicose veins. "In this treatment, the affected veins are injected with a solution that’s an irritant – this sets up a reaction in the vessels that destroys them, then they behave like a bruise and gradually fade away,” she explains. “I’ve been doing this treatment on my clients for the past 20 years and I can virtually guarantee the results with minimal fuss.”
Dr Allen adds that other treatment options involve the use of lasers, but that these are often painful, expensive and can leave marks on the legs if the surrounding tissue is heated up too much. She recommends avoiding diathermy treatments – which involve using a heated needle, similar to electrolysis – on the legs, too.
“Some beauty therapists try to treat these vessels with shortwave diathermy, but this should definitely not be used on leg veins as it always causes marking from a burning effect on the skin,” she explains. “I’ve also seen some scarring left by this technique – it can be used on the face for tiny vessels with more success simply because the blood supply is so good, but the blood supply to the legs is poor so healing of damaged tissue is slow; hence the risk of scarring.”
For facial thread veins, Dr Allen advises treating with IPL or laser – which are highly effective at targeting red vessels. “The light is absorbed by the red in the vessels converted to heat and the heat destroys the vessels,” she says. “IPL will also stimulate collagen leading to rejuvenation of the skin, and will also target brown spots of pigmentation.”
When should you see your GP?
Varicose veins are rarely a serious condition and don't usually require treatment, so if yours aren’t causing you any discomfort, you may not need to visit a doctor. The NHS recommend speaking to your GP if:
- Your varicose veins are causing you pain or discomfort
- The skin over your veins is sore and irritated
- The aching in your legs is causing irritation at night and disturbing your sleep
This is because painful varicose veins can be a sign of a more serious problem, such as a blood clot, an open sore or a skin infection. Painful varicose veins can also get worse and cause new conditions to develop as a result – these include swelling, infection, ulcers and deep vein thrombosis – so it’s vital you seek medical help if you’re at all concerned.