We asked a Consultant Vascular Surgeon to separate the fact from the fiction to find out what really works and what doesn't

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Do you suffer from thread veins, varicose veins or spider veins? If so, you’re not alone.

A much more common problem than people realise, finding a way to treat them can often prove to be a distressing and time-consuming task. Frequently mistaken to be a skin problem that solely affects women, thread veins is an ailment that also widely affects men too. “Research from Scotland has shown over 80% of all adult women have some thread veins of the legs – and over 70% of males too,” says Professor Mark Whiteley, Consultant Vascular Surgeon, founder of  The Whiteley Clinic , and  Get The Gloss Expert .

We asked Professor Whiteley to share his expertise and recommended treatments for thread and varicose vein removal to separate the fact from the fiction and to make sure we invest wisely. With his plan of action and sage advice to hand, you’ll be equipped with all the tools you need to achieve thread vein-free legs for good.

GTG: What causes thread veins on the legs?

MW: There is no known single cause of thread veins – however most have underlying varicose veins and just under half (40%) have underlying major but hidden varicose veins (they are called this as they cannot be seen on the surface).

Almost 9 out of every 10 people with thread veins have malfunctioning valves in underlying veins, causing blood to fall backwards refluxing down the veins and into the thread veins.

Failure to identify the underlying hidden varicose veins with ultrasound and then treating them before treating the thread veins themselves is likely to result in poor results, such as red stains, ineffective treatment or early recurrence after treatment.

They are NOT caused by crossing legs, hot baths, tight jeans etc.

They can be caused by severe injury to the skin.

Pregnancy can make them worse – but doesn’t cause them.

MORE GLOSS: What should and shouldn’t we be eating during pregnancy?

GTG: What can people do to prevent them?

MW: Nothing has ever been shown to prevent them. There are lots of products that claim to prevent them – but none have ever been shown scientifically to work.

GTG: Are there are any products available for thread vein removal?

MW: There are no products that you can buy to treat leg thread veins. Many products that are sold say that they work but none have been shown to really work when tested scientifically.

You can buy cosmetic creams and artificial sun-tanning products that make them look better by staining the skin and hiding the thread veins temporarily.

MORE GLOSS: The best body foundations and concealers for all skin tones

GTG: Are there any products available by prescription that can help?

MW: There are no products that you can get on prescription that can treat leg thread veins unless administered by a specialist.

GTG: What specialist thread and varicose vein removal treatments would you recommend?

MW: The optimal treatment for leg thread veins is:

a) Duplex ultrasound scanning by a specialist experienced in vein treatments, to identify any underlying “hidden” varicose veins.

b) Treatment of underlying “hidden” varicose veins if present using local anaesthetic walk-in walk-out techniques.

The techniques for treating the underlying hidden varicose veins depend totally on what is found on the duplex ultrasound scan. The underlying veins might be in the pelvis or leg, they might be deep or superficial, long or short, winding or straight.

All good vein units will be able to offer any combination of pelvic vein embolisation using coils, endovenous laser therapy, radiofrequency ablation, phlebectomy, ultrasound guided foam sclerotherapy and then the latest treatments such as glue or clarivein. Unless a vein clinic is able to offer a selection of these, they will not be able to adequately treat all the different sorts of underlying hidden varicose veins.

c)  Microsclerotherapy  of the leg thread veins that remain, after getting rid of any underlying problem.

GTG: What is the best form of thread vein removal for the face?

MW: Facial thread veins are above the heart and therefore there is no gravitational effect keeping them open. As such, there is no underlying hidden problem due to hidden varicose veins. In addition, the skin of the face is used to heat because it is always exposed to sunshine and so it is very hard to damage. Because of the very good blood supply, the skin on the face also heals very well. For all of these reasons, the best way to treat thread veins of the face is by direct electrolysis, intense pulsed light (IPL) or laser.

Follow us  @getthegloss , Ayesha  @Ayesha_Muttu  and Professor Mark Whiteley  @MarkWhiteley .