Thread and Varicose Veins

Image © VladGavriloff - Fotolia.com

Mon 31 July 2006

Causes and treatment of thread and varicose veins

They may be small, they may be tiny, but they are often a source of great embarrassment and distress to many sufferers.

What am I referring to? Those tiny blood vessels that seem to suddenly appear, out of the blue, on the nose, cheeks and legs, and are labelled as thread veins, spider veins or broken capillaries.

Whether you call them thread veins, spider veins or whatever, they are basically the same condition - enlarged tiny blood vessels, easily visible through the skin.

They are part of the body's vascular system, made up of  arteries, veins and capillaries. Arteries carry blood from the heart, veins carry blood back to the heart and capillaries are tiny blood vessels which link the smaller arteries to small veins.

Capillaries are tiny - about 8 to 10 microns in diameter (a micron is 0.001millimetre), just large enough for red blood cells to travel along in single file. The wall of each capillary is only one cell thick, and is therefore quite fragile.

Unlike other larger blood vessels, the wall of the capillary doesn't contain muscle fibres or collagen, and this adds further to it's fragility.

Thread veins appear most commonly on the legs, and in particular around the ankles and on the feet. Other sites affected are the nose and cheeks, whilst some sufferers develop them on the chest or abdomen, depending on the cause of their vascular problem.

Causes

Thread veins on the legs are usually the result of varicose veins and sadly, often appear as early as the mid twenties, although the varicose veins themselves may not be obvious.

An estimated 40% of women in the UK will have obvious varicose veins by the time they reach their fifties, rising to 72% in their seventies.

Varicose veins, sometimes called varicosities, appear as blue, swollen, tortuous vessels over the calf muscles, often extending upwards along the inner aspect of the thighs towards the groin. These veins often appear as a result of weaknesses in valves within the veins, and in many people the weakness is an inherited.

If your mother, father or grandparents had varicose veins, you may inherit that tendency. The weakness in the valves becomes obvious when pressure increases within the interior of the veins, and can affect both men and women. The tendency to develop varicose veins, and therefore thread veins, increases with age, and this is simply due to the effect of walking upright, for a lifetime, on two legs!! A consequence of evolution!!

Another common cause of varicosities and thread veins in women, is pregnancy. As a baby grows within the pregnant uterus, the heavy womb presses down on the veins from the legs as they enter the pelvis, producing a back pressure and resultant distension of weakened veins. This back pressure is greater in the lower part of the leg, due to the column of blood in the veins and the effect of gravity. For this reason, standing for long periods of time, being overweight and lack of exercise predisposes people to varicose and thread veins. Any blockage in the larger veins, as can result from inflammation in the veins (phlebitis) or blood clots (thrombosis) will increase the likelihood of developing thread veins.

More serious causes of varicosities and thread veins include severe liver disease, and tumours inside the pelvis and abdomen which can block the upward drainage of blood from the leg veins.

Thread veins are often labelled as spider veins because, when observed closely, they appear to radiate outwards, resembling thin spiders' legs from a central point. This typical radial pattern is also similar to a spiders web! The smaller thread veins are usually red, whereas the larger ones are blue or purple indicating a slower blood flow.

Other areas affected

Thread veins on the face can be a great source of embarrassment to some people. The commonest cause of these is a disorder called Rosacea. This is quite a common condition in the middle aged people, affecting 1 in 10 of women aged between 30 and 50!

Fair skinned people, especially those of Celtic origin and those who blush easily, are more likely to suffer from Rosacea. The affected blood vessels are permanently enlarged, and present on the nose and both cheeks, and may be accompanied by small acne type spots.

The distended facial blood vessels and facial redness of Rosacea are usually made worse by certain triggers, such as alcohol (especially red wine and spirits), hot foods - both temperature wise and spicy, caffeine containing drinks, tea, coffee, cola, chocolate, pickled food, citrus fruit, smoked food, exposure to sunlight and wind, and when changing from a cold to warm environment. You are likely to be more prone to Rosacea if they is a prior family history.

*facial thread veins are also more common in people who have worked outdoors for years, and in others who have used steroid creams on their faces for long periods of time.

Treatment

Thread veins on the legs and face can reduce the quality of many sufferers lives, as they try to hide their thread veins by wearing trousers, or disguise their condition with heavy make up.

Attempts to make the veins less obvious by sunbathing may actually make the condition worse! Many sufferers will also use 'fake' tans to try and conceal the veins.

The current standard 'medical' treatment of thread veins encompasses camouflage make up, laser treatments and sclerotherapy.

The British Red Cross runs a skin camouflage treatment service and has centres around the country, used by patients with port wine birth marks, burns, scarring and thread veins.

Laser therapy can be helpful, but specific lasers must be used (e.g. Pulsed Dye Laser), and the doctor using laser therapy should be highly experienced in it's use. Treatment may be painful and can cause bruising to the treated area for 7 to 14 days. In the right hands laser therapy is effective, but treatment is not freely available in all areas of the UK.

Sclerotherapy is used to treat larger purple thread veins in the legs. It involves injecting a powerful irritant chemical directly into the affected veins, using tiny needles. This causes inflammation within the walls of the affected vein, causing it to collapse.

With larger veins, the patient may have to wear a tight 'compression' bandage to keep the vein collapsed after the injection. If the sclerosing chemical escapes outside the affected vein small ulcers may develop, so it is important to choose a specialist with good experience of this technique.

As prevention is always better than cure, the chances of developing thread veins and varicose veins can be reduced by exercising regularly, keeping slim, avoid standing for long periods of time, taking up yoga (especially the inverted postures, but check with your GP first), wearing support tights, resting with your 'feet up' and avoiding the triggers listed under Rosacea above.

About 20% of women in their twenties have significant thread veins, and it's important that they take steps to prevent their condition or treat it early. It is always easier to treat any medical condition in it's early stages.