Thread veins on the legs

Thread veins are an extremely common concern, believed to affect around 80% of all adults, usually found on the legs and face.

Microsclerotherapy is recommended for thread vein removal on the legs, which is minimally invasive and highly successful.


Overview and definitions

Thread veins are a type of varicose vein, most commonly found on the legs or face, though they can appear anywhere on the body. Thread veins are often referred to as spider veins due to their spider-web like appearance.

They are small, thin, yet visible veins which usually have a pink, red, blue or purple tinge. Their prominence and colouring is determined by their size and proximity to the surface of the skin. The medical name for this condition is telangiectasia.

Thread veins are an extremely common concern, believed to affect around 80% of all adults. While they are not usually harmful or painful, many people find them unsightly and choose to have them removed for aesthetic reasons.

Thankfully, thread vein removal treatment is extremely common and our experts are highly experienced in the removal procedures – most commonly, microsclerotherapy for thread veins on the legs, and thermocoagulation for thread veins on the face.


Thread veins are caused by small blood vessels that have become dilated just below the skin’s surface. However, it is difficult to determine why this happens.

Experts believe that in some instances, thread veins may be hereditary and thus unavoidable. Other risk factors may also play a part in their appearance.

Occasionally, they may be an indication of other venous conditions, though this is rare.

Risk factors

Whilst there is no definitive cause of thread veins, a number of risk factors have been identified:

  • Varicose veins and/or venous insufficiency – thread veins are more common in those who also have varicose veins. Increased pressure in the veins can push pooled blood back into smaller veins, causing them to become damaged and appear through the surface of the skin

  • Older age – as you get older veins start to lose some of their elasticity. Aging also causes wear and tear to the valves in the veins that help control blood flow

  • Pregnancy – during pregnancy, the blood volume in the body increases. This change supports the growing baby but can also enlarge veins throughout the body. Increased oestrogen during pregnancy also weakens vein valves

  • Hormones – birth control and hormonal treatments for menopause may increase the risk of spider veins because oestrogen can allow the walls of the veins to stretch and weaken vein valves

  • Local trauma to the skin – injuries or trauma to the skin can damage blood vessels and contribute to the formation of thread veins

  • Localised steroid use – long-term overuse of topical steroids like hydrocortisone cream could result in more prominent thread veins due to thinning of the skin

  • Smoking – cigarette smoke contains chemicals, such as nicotine and carbon monoxide that make it harder for your veins and heart to work efficiently. When these chemicals are introduced into your body they constrict your veins, leading to blood pooling in your veins, causing varicose and thread veins

  • Excessive alcohol consumption – If you drink excessive alcohol this makes your veins temporarily dilate and can eventually cause blood vessels to burst

  • Sun damage – UV light from prolonged sun exposure can weaken the skin and blood vessels, potentially contributing to the development of thread veins. It also draws the veins closer to the surface of the skin, where the redness then becomes more visible

  • Standing or sitting for long periods of time – movement helps blood flow so sitting for long periods can hinder circulation, whereas with standing, the problem is that it becomes harder for blood to circulate upwards (it simply goes against gravity!). Sitting with crossed legs or crossed ankles can also make it harder for your blood to keep flowing due to compression of the veins close to the surface of the skin

  • Obesity or poor weight management – being overweight puts added pressure on the veins which means they have to work harder to send blood back to your heart


Unfortunately, there is no known way to prevent thread veins and the chances of them appearing increases with age.

However, experts do believe that improving circulation in the legs may prevent or reduce the appearance of thread veins, especially in the legs. As such, the following is encouraged:

  • Regular exercise – muscles in the legs help your veins push blood back to the heart, against the force of gravity. If you have varicose veins or spider veins in your legs, any exercise that works the muscles in your legs (particularly your calves) will help prevent new thread veins from forming

  • Avoid standing or sitting for prolonged periods – if you have to sit or stand at work or home for a long time, take a break every 30 minutes to walk around. This makes the muscles in your legs move the blood back up to your heart so it doesn’t pool in your veins

  • Elevate your legs – raising the legs when sitting or lying down can help prevent blood from pooling downward in the legs

  • Wear compression stockings – compression socks improve blood flow in your lower legs and can help reduce fluid buildup that causes spider veins

  • Maintaining a healthy lifestyle – losing excess weight, stopping smoking and avoiding excessive alcohol consumption can reduce the pressure on your veins and improve circulation


Thread veins don’t typically cause any symptoms. In rare cases they may cause burning, itching or discomfort (especially in your legs), but this is more likely to be associated with varicose veins or underlying venous insufficiency. However, they can be unsightly and most people who come to us are seeking thread vein removal for cosmetic reasons.

Thread veins can vary in colour, appearing pink, red, blue or purple. They can also vary in size and pattern, from single, short, straight veins to larger ‘spider web’ patterns.

The appearance of thread veins is influenced by a number of different factors. These include the size of the vein, the flow of blood and the proximity of the vein to the skin’s surface. Veins closer to the surface will be more vivid, while deeper veins will have a less distinct appearance.


Thread veins are primarily cosmetic, so diagnosis can be easily done through a visual examination. However, this will simply confirm the presence of thread veins and not the cause.

It is important, even with thread veins, to discover if there is an underlying cause for them, and this will need to be established prior to any treatment being undertaken. The only way to determine if there is an underlying cause is by having a colour duplex ultrasound scan of your legs.

Whilst it is unlikely that patients suffering only with thread veins will have an underlying problem, if one is found, we strongly recommend that this is treated before tackling the visible veins. Failure to recognise and treat any underlying venous insufficiency could cause the treatment to fail, or the thread veins to return.

If an underlying cause is identified, this will usually be a small reticular vein feeding a clump of thread veins. We would then recommend treating the reticular vein using foam sclerotherapy. This can usually be performed at the same time as the microsclerotherapy for thread vein removal, provided that the total dose of the sclerosant used is not exceeded.

If an underlying valve problem is found, please note that your treatment pathway is likely to involve the stages within the varicose vein treatment pathway instead.


Thread vein removal treatment is extremely common. The procedures are minimally-invasive and highly successful, with most occurrences of thread veins being completely removed within just 2-4 sessions.

We recommend either microsclerotherapy or thermocoagulation thread vein removal treatments, depending on the size and location of your thread veins.

In brief: Microsclerotherapy

Microsclerotherapy is a common, minimally invasive thread vein removal procedure for the legs and body.

A liquid drug (sclerosant) is injected directly into the affected veins. This causes them to dilate and the vein walls stick together. The veins then shrivel up and your body absorbs them naturally. 

It is likely that you will see immediate results from this treatment, though you may require a few sessions before the veins completely disappear. The average client requires 2-4 sessions for thread veins to be completely removed.

Your outpatient appointment will usually last 30-45 minutes and does not require any recovery time. You can usually resume normal activities straight away, and even head straight back to work if you need to. 

If you have larger visible veins, our experts may recommend foam sclerotherapy.

Read more about our microsclerotherapy treatment for thread veins on the legs.

In brief: Thermocoagulation

Thermocoagulation is our recommended thread vein removal treatment for the face. It involves applying microwave energy to heat and destroy the walls of the affected veins.

Heat is applied using microwave energy at the end of a tiny needle, which pricks the surface of the skin that is overlaying the vein at 2-3mm intervals. This causes the permanent destruction and disappearance of the thin-walled thread veins. 

Your outpatient appointment will usually last around 30 minutes and does not require any recovery time. While the results of thermocoagulation will be instantly noticeable, the average client requires two sessions for complete removal of facial thread veins.

Read more about the thermocoagulation procedure for thread veins on the face.

Treatment costs

We have a clear pricing structure, whether you are using health insurance, or self-funding your treatment with us. We outline the total costs involved in the diagnosis and treatment of thread veins, if the primary treatment required is microsclerotherapy, foam sclerotherapy or thermocoagulation.

Our prices are upfront and fixed. We charge per leg, not per vein. There are no ‘from’ prices and no hidden fees. Consultant fees and clinic fees are included in all of our prices. Our quoted prices remain fixed for 6 months from the date of your initial consultation, so you can be sure our fees won’t increase during this time.

Medical Insurance rarely funds thread vein treatment, as insurers class thread veins as a cosmetic issue. That said, insurers should fund a consultation to rule out a medical cause for your problems, especially if you’re suffering with symptoms. If you have health insurance, please disregard our self-funding prices.

Read more information on treatment costs.

Treatment risks

As with all medical procedures, it’s important that you weigh up the benefits of having thread vein removal treatment, versus the risks of side effects. You can find a full list of risks for all our vein treatments on our treatment FAQs page.


Our microsclerotherapy and thermocoagulation thread vein removal treatments are minimally invasive and carried out on an outpatient basis.

After your appointment, you’ll need to wear a support stocking for a week. This will prevent you from swimming, but shouldn’t restrict your movement.

You are unlikely to feel any pain following your thread vein removal procedure. The majority of patients describe the post recovery for foam sclerotherapy as uncomfortable as opposed to painful. For microsclerotherapy and thermocoagulation, you may not even feel discomfort.

You will be able to drive and resume your normal activities on the same day as either microsclerotherapy or thermocoagulation treatment.

We encourage you to walk for at least 20 minutes each day following thread vein removal procedures on the legs, to aid healing and prevent blood clots. 

Frequently asked questions

What are thread veins?

Do I need a consultation and scan if I just have thread veins?

You can find the answers to these questions and many more in the thread veins section of our conditions FAQs page.

If you have any other questions, please do not hesitate to contact us, and a member of our clinic team will be pleased to help.

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