Small, superficial vessels are often removed for cosmetic reasons

Thread veins on the legs can be a source of cosmetic dissatisfaction, raising issues of self-confidence when exposing legs in the summertime, as well as being uncomfortable for some people. Treatments to remove vascular malformations, such as spider veins or smaller varicose veins are generally regarded in primary care settings as cosmetic, rather than of significant medical concern, so treatment is often only available within the private sector.

Sclerotherapy and micro-sclerotherapy treatments are undertaken by specialist vascular surgeon Mr Giuseppe Serpieri.who has pioneered several cutting edge procedures.

Conditions treated with include:

Thread veins, spider veins, small varicose veins, and other vascular malformations.


Sclerotherapy has been used as a medical treatment for veins, like varicose veins for many decades. In that time innovation has meant some changes in the medicines used during the procedure, whilst the broad technique has remained virtually the same, with the recent introduction of foam sclerotherapy. Micro-sclerotherapy simply refers to the same procedure but on smaller veins like thread and spider veins, which uses finer needles and less product.

During sclerotherapy a special solution called a sclerosant is injected into the vein, where it damages the internal lining of the vessel, causing it to break down and be removed through the body’s natural metabolism and healing.

Commonly used medicines for sclerotherapy include Fibrovein (sodium tetradecyl sulphate), which can be used as a solution, but also made into a foam with the addition of air and agitation prior to injection. By injecting the solution as a foam, it can be more effective, depending on the size of the vein being treated, because it won’t mix or be diluted by the blood within the vessel; instead, it fills the vein initially due to the added air (which will dissipate), blocking the blood flow so it can get to work on compromising the lining of the vessel to destroy it over time.

Sclerotherapy, foam sclerotherapy, and micro-sclerotherapy treatments are undertaken for the Blemish Clinic by vascular surgeon Mr Giuseppe Serpieri.

Italian doctor, Mr Giuseppe Serpieri is a highly respected vascular surgeon who specialises in a range of cosmetic vascular procedures. Mr Serpieri qualified as a doctor in 1986, attaining a specialist qualification as a cardiac and vascular surgeon in 1991 at the University of Turin.

He is internationally renowned for his development and use of innovative techniques and technology and is one of very few surgeons who offer procedures using super glue as a closer of the veins during surgery. In 2004, he invented the transilluminated endovenous laser coagulation technique (TELC), a cutting-edge treatment for varicose veins that is now widely used.

His research interests focus on innovative technology for leg, foot, and hand vein care, with a focus on minimally invasive techniques.

Sclerotherapy, foam sclerotherapy, and micro-sclerotherapy are used to treat so-called vascular malformations such as thread veins or spider veins, and small varicose veins in the legs and feet.

They cannot be used to treat thread veins on the face, due to the risk of scarring, but we can treat those with IPL thread vein removal.

During the procedure the surgeon will use an ultrasound probe to locate the exact positioning of the veins to be treated, not all the veins needing targeting will be directly visible from the surface of the skin. Under anaesthesia, if required, a needle is inserted into the vein and the sclerosant solution or foam is injected. This is monitored using the ultrasound probe and progress can be seen on the screen. Once enough of the sclerosant has been added to the vein, the needle is removed, and compression pads are applied to the leg.

You may require more than one treatment session to achieve the desired reduction in the vascular malformation being treated.

Sclerotherapy and micro-sclerotherapy provide a safe and effective solution for unsightly or problem thread and varicose veins in the legs of both men and women.

Your suitability for sclerotherapy will depend on your specific vascular concern, the extent of any veins that are bothering you, whether there is pain and discomfort or cosmetic dissatisfaction alone, and any underlying medical concerns. For these reasons, a full and thorough consultation will be required with Mr Giuseppe Serpieri to discuss your medical history and assess your veins, often using an ultrasound device, before he will agree to undertake treatment.

Sclerotherapy and micro-sclerotherapy can only be used on the legs, so if you have troublesome threads veins elsewhere, such as on the face, we may recommend IPL thread vein removal. Similarly, Mr Serpieri can advise on more extensive vascular surgical options, if required, to treat more extensive varicose veins.

Certain blood-related ailments like clotting issues, heart disease, kidney disease, uncontrolled diabetes, a history of deep vein thrombosis (DVT), pulmonary embolism, or morbid obesity can make you unsuitable for sclerotherapy treatment.

Certain medications can also impact on your suitability, hence why a full list of any medicines you are currently taking is required, examples include the contraceptive pill and blood thinners like Warfarin.

If you have an active skin infection in the area to be treated, or feel unwell with any bacterial, viral, or fungal infection, like a cold or flu, you will not be suitable to undertake the procedure until this has resolved.

If you are pregnant or breast feeding, you will not be able to have sclerotherapy or micro-sclerotherapy treatment and will be required to wait.

Sclerotherapy and micro-sclerotherapy are usually performed using local anaesthesia, injection of a numbing agent (lidocaine) to minimise any discomfort during the procedure. For very small thread veins, a very thin needle is used during treatment thus no anaesthetic may be required. The comfort of our patients is of paramount importance, and Mr Serpieri will advise on the need for anaesthesia depending on the extent of the procedure.

After the procedure there is usually little discomfort, although you may feel achy for up to 24 hours. Patients can resume normal activity straight away, including returning to work, and are encouraged to keep active and walk around, although you will be advised to avoid vigorous exercise.

You will leave the clinic with compression pads and bandages/stockings in place to assist with targeting the sclerosant to achieve vessel collapse. It is imperative that these remain in place for a few days (minimum 72 hours) and will be removed at a follow-up appointment.

You should expect some bruising in the area treated, usually this is mild and will fade over a few weeks. The extent of any bruising is dependent on the size of the area treated and the severity of the vascular malformations.

Swelling, tingling, itching, redness, or tenderness are common in the treated area, or at the injection site for the first few days.

Compression bandages or stockings will be required for several days post treatment which can be restrictive and feel tight.

Although some thread veins will appear to vanish immediately, you can expect the action of the sclerosant to cause spider type veins to disappear in 1-2 months and varicose veins in 3-4 months, dependent on size and severity.

Often patients might need more than one sclerotherapy or micro-sclerotherapy session to completely remove the thread or varicose veins, but usually when treatment is completed, they will no longer be visible. The result is permanent, because the veins have been destroyed, however, over time, and factoring in ageing and lifestyle, there is a chance that new thread veins or varicose veins could develop in the same area in years to come.

We believe in being transparent with our prices and want you to be fully aware and comfortable with the cost of your treatment. A full list of our prices can be found here. We will always agree a final price with you though before treatment commences.

What to expect


To improve and decrease cosmetically unsightly red and blue vessels on the legs, such as thread veins or small varicose veins.

How it works

The fibrovein sclerosant acts to cause irritation to the inner lining of the vessels injected, this irritation causes the walls to become sticky, and when compression is applied, the vessel walls collapse over time. Once all the vessels collapse, the body can no longer use them and absorbs them back into the metabolic system.


Depending on the extent and severity of the vessels, you may require more than one treatment session of sclerotherapy or micro-sclerotherapy before you notice a reduction or complete eradication of the vessels.

Treatment Time

Treatment takes approximately 45-60 minutes, depending on the amount of veins being treated on one or both legs.

Pain / Discomfort Level

You can expect a small scratch from the insertion of the needle. If required, depending on the extent of the veins being treated, a local anaesthesia can be used to numb the area.

Recovery Time

There will be a small amount of initial discomfort, but this will pass within 24 hours. The use of graduated compression stockings is imperative to the success of this treatment. They need to be worn for a minimum of 72 hours after treatment.


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