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Unsightly leg veins can be a problem for millions of men and women, the world over. It is estimated that in many areas over 60 percent of the adult population suffers from varicose veins, thread veins or spider veins. Sometimes thread and spider veins are like the tip of an iceberg but the majority occur in absence of problems with the deep veins. Often people who have had surgery for varicose veins are left with thread and spider veins and these can be treated very well too. 
A medical history and clinical examination which includes ‘pattern recognition’, use of hand held doppler and transillumination device is undertaken. If this indicates problems with underlying venous valves and varicose veins then these have to be treated before addressing thread and spider veins. If no underlying problem is suspected then the treatment can commence. A duplex venous scan is ideal but not mandatory in every case. 
Usually sclerotherapy is undertaken - micro injections of medication into veins that destroy the vein lining and veins are subsequently slowly absorbed by the body. Anywhere between 50-80% of injected veins respond and further injections in the same area can be carried out 5-6 weeks later. Treated veins appear worse before they disintegrate and disappear. Sclerotherapy is considered the ‘gold-standard’ treatment for thread and spider veins.
Lasers are also available and can be used in combination with sclerotherapy.  I find long pulsed Nd-Yag particularly useful. Higher energies and deeper penetration is required which means that laser treatment can sometimes be painful. With careful patient selection these treatments can provide excellent outcomes as shown here.
<img border="0" alt="Reticular Veins Before Treatment" src="/uploads/Image_Directory/Blog Images/reticular-veins.jpg" width="299" height="450" /><img border="0" alt="Reticular Veins After Treatment - Sclerotherapy" src="http://www.consultingroom.com/uploads/Image_Directory/Blog%20Images/veins-after-Rx.jpg" width="290" height="450" />
Reticular veins, before (left) and after (right) treatment

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Order	Change	Type - Title	Update
1	↑ ↓	Right Aligned Image-Thread vein treatment	EDIT
2	↑ ↓	Text Block-thread and spider vein treatments	EDIT
3	↑ ↓	Text Block-ConsultingRoom FAQs	EDIT

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