Laser
Thread Vein Removal
Anatomy
Thread veins most commonly occur on the face and legs. They
are in fact tiny blood vessels that run very close to the
surface and are usually blue or red in colour. They are
often called spider veins. They are in fact telangiectasia
which are fine capillary veins. They normally develop as
a consequence of age. They appear quite commonly after pregnancy
and therefore there may well be an underlying hormonal cause.
They are also associated with exposure to the elements and
the sun. Long term use of oral steroids is also associated
with formation. Thread veins may occur with varicose veins.
Indications
Thread veins are normally removed for cosmetic reasons only
and laser surgery is only applicable if the veins are less
than 4 mm in size. Larger veins may be treated by injecting
a substance called a sclerosant which causes the vein to
shrink over a period of 8 weeks.
Anaesthetic
Laser removal for thread veins does not normally need an
anaesthetic although topical anaesthesia using a special
gel may be used.
Technique
The best type of laser is a YAG laser which has a longer
wavelength that is preferentially absorbed by the blood
in the veins, thereby sparing any damage to the surrounding
tissue. The laser produces pulse energy, each pulse being
less than 1,000th of a second, this therefore reduces the
heat generation tissue damage and hence it is normally quite
painless. It may often feel like a rubber band hitting the
skin.
Length of Operation
The length of operation depends on the area that needs to
be treated.
Time in Hospital
It is normally performed as a day case.
Time off Work
No time off work is required.
Risks and Complications
Using a pulse laser carries very few risks although it needs
to be carried out by an experienced consultant with the
proper precautions such as using special eye protection.
Occasionally if the power is set too high for the veins
there might be a small localised burn which may be painful
for a few days. Normally however the only side effects might
be slight reddening of the area for the first few days.
Healing is normally complete within 2 weeks.
Outcome and Prognosis
For small veins laser treatment is the treatment of choice
and is usually successful as long as the vein runs very
close to the surface of the skin.
Alternative Treatment
Sclerotherapy can be used for larger veins. It does carry
more risks of complications such as infection and bruising.
