Thread veins, or dermal flares, are very fine dilated veins situated just beneath the surface of the skin. Heredity, as with larger varicose veins, is an influencing factor as are hormonal surges as at the onset of periods and during pregnancy. In some patients they are associated with varicose veins but in other people they occur without any problems associated with their deeper veins. It is essential that patients with dermal flares undergo a venous assessment to make sure that there is no underlying condition causing them. Treating surface veins in the presence of varicose veins, even though they are not visible, results in them not disappearing or returning quickly giving an unsatisfactory result.
Mild to severe pain can be associated with dermal flares as well as fatigue, aching and throbbing. This can quite often be cyclical in women and related to their periods. Such symptoms that present with larger varicose veins do not always disappear following surgery but do diminish with subsequent sclerotherapy treatment for thread veins. The best form of treatment for these small veins is microsclerotherapy.