Vicky

Good evening, everyone. Thanks for joining us. We're just going to give it a moment or two to allow everyone to join and get settled.

Once again, good evening and a very warm welcome to our webinar on varicose veins and ThermaVein treatment. My name is Vicky and I’m hosting this evening. I’m delighted to be joined by our expert speakers: Mr. Aaron Sweeney, Consultant Vascular Surgeon, and Dr. George Taggart, Private GP and Thread Vein Specialist.

Tonight’s session will begin with a presentation from Mr. Sweeney and Dr. Taggart, followed by a live Q&A. If you have questions at any point, please feel free to submit them using the Q&A icon at the bottom of your screen. You’re welcome to ask anonymously or include your name, but please note that as the session is being recorded, any names shared will be visible in the recording. To help us get through as many questions as possible, we kindly ask that you keep your questions brief.

If you're interested in booking a consultation, we’ll share all relevant contact details at the end of the session.

I’ll now hand over to Mr. Sweeney, and you’ll hear from me again later.

Mr. Sweeney

Good evening, and thank you very much for joining us. I’ll run through a few things. I’m a vascular surgeon and became a consultant in 2002. I’ve performed several thousand of these procedures over the past 20‑plus years, and we carry out a large number here each year.

I’d like to say I introduced EVLT, and that’s true - myself and another surgeon in London brought it in, and it took off from there. That was quite a long time ago now. The treatments we use today aren’t brand new, but they are proven to work.

Dr. Taggart

Good evening. My name is George Taggart. I qualified from St. Thomas’ Hospital in 1991, and I’ve been a GP in East Sussex since 1999. I developed a special interest in the treatment of thread veins in 2017 and have worked actively in that field ever since.

Mr. Sweeney

We’re going to run through what we do so that by the end you’ll hopefully have a clearer understanding of varicose and thread veins, as well as the treatment options available. The Q&A session at the end is particularly important, as many people arrive with specific questions in mind.

The CQC rating for this hospital is Outstanding, which is relatively rare. It’s a brand‑new, modern facility and extremely clean.

Varicose veins can be thought of like a Christmas tree. You have a large artery that takes blood down your leg and a large vein that brings it back up. From that large vein, many smaller veins branch off, like the branches of a tree. The large veins are surrounded by muscle, which helps pump blood upwards toward the heart. The smaller veins, which drain the skin, have tiny valves that keep blood flowing the right way. When these valves fail, blood begins to pool.

Depending on the size of the affected vein, the symptoms can vary. Larger veins often appear as bumpy blue veins and may cause aching, heaviness - typically worse in the evening - ankle swelling, night‑time cramps, and dry or itchy skin, especially around the lower leg.

We class veins in grades 1–4.

• Grade 1: Cosmetic thread or spider veins, usually treated with sclerotherapy (Dr. Taggart’s specialty).
• Grade 2: Small veins that can be felt slightly.
• Grade 3–4: Larger palpable veins which may cause discomfort or skin changes, such as discolouration or inflammation.

Ulcers are possible but uncommon.

During a consultation, I perform an ultrasound to assess the veins beneath the skin. I explain everything clearly using diagrams. You can book your procedure immediately or take time to decide - there’s no pressure.

Historically, varicose veins were treated with surgical stripping, which involved making incisions and physically pulling out the vein. Although effective in removal, the procedure often led to the development of new veins later on.

Today, we use minimally invasive techniques, mainly EVLT (Endovenous Laser Treatment). This involves inserting a small wire-like laser fibre into the vein and heating the inside lining to seal it shut. Local anaesthetic is used to make the procedure comfortable, though some people choose a general anaesthetic.

Other techniques include foam sclerotherapy, radiofrequency ablation, and Clarivein. Heat‑based methods generally work best for larger veins.

If needed, we can also perform phlebectomy, making tiny incisions to remove bumpy surface veins. This causes some bruising but heals well.

Dr. Taggart

Mr. Sweeney has explained the treatment of larger varicose veins. At the other end of the scale are the small grade‑one veins—thread veins—which commonly appear on the face and legs. Although they don’t usually cause physical symptoms, they can be a significant cosmetic concern.

For leg thread veins, we use microsclerotherapy, which involves injecting a solution into the vein to cause controlled scarring and closure. Once closed, the vein is reabsorbed by the body and fades from view. Treatment sessions last about 30 minutes, and multiple injections may be needed depending on how many veins require treatment. Small dressings are applied and must be kept dry for around three days. We encourage patients to remain active afterwards.

For facial thread veins, we use ThermaVein, a technology that delivers precise bursts of heat through an ultra-fine insulated probe. This collapses and seals the vein with pinpoint accuracy while minimising side effects. A mild inflammatory reaction is common but usually settles within a few days. Aloe vera gel is used afterwards to soothe the skin.

Patients typically require a course of treatments spaced one month apart. During the consultation, we also assess for related conditions such as rosacea, which may require additional management.

In summary, thread veins are common and can be distressing for some people, but microsclerotherapy and ThermaVein are safe, well‑established and highly effective treatments.

Q&A session

I’m a 74‑year‑old active man. I had varicose veins stripped 30 years ago. I now have new veins around my right knee. If I have EVLT, am I likely to get more veins in the next 10–20 years?

Not necessarily. It depends on what was done during your previous surgery. Sometimes parts of the vein remain or weren't fully removed. An ultrasound will show exactly what’s happening.

When I treat veins properly with EVLT, I expect:

• About 1% of patients to return within a year with a small side branch
• About 10% to develop new veins after 10 years, usually in the other leg

If your new veins are simple and treated with EVLT, they should not return.

Are varicose veins behind the knees problematic, especially if they’ve been repeatedly treated?

They can be, but not always. Behind the knee, veins can sometimes have multiple sources, making them more complex. However, many are simple to treat. An ultrasound would give us a clear picture.

How soon after EVLT can I fly?

Medically, you can fly the next day. The risk of DVT after EVLT is extremely low—less than 1 in 1,000. However, EVLT can leave your leg feeling stiff for around two weeks, similar to having exercised intensely. Walking long distances in airports may be uncomfortable, so factor that in.

Most people feel fully normal again after about six weeks.

What about flying after sclerotherapy?

I recommend avoiding long‑haul flights for one week. There’s no proven increased risk of DVT, but we prefer to avoid prolonged periods of immobility immediately after treatment.

I have a cluster of spider veins behind my knee. How is that treated?

Spider veins in that area are usually ideal for microsclerotherapy. However, if any are larger or fed by deeper veins, you may need an ultrasound with Mr. Sweeney first. A consultation would allow us to assess the best treatment.

My GP put me on a statin after a Doppler ultrasound. Is it still safe to have my varicose veins treated?

Yes. Being on a statin does not affect varicose vein treatment. Many of my patients take multiple medications, including blood thinners. EVLT is still safe and effective.

Closing Remarks

Thank you very much for joining us. If we didn’t cover your question and you provided your name when registering, we’ll follow up with you by email.

As a thank‑you for attending, we’re pleased to offer:

• 50% off your initial consultation (if booked before 31 March)
• A callback from your dedicated private patient adviser
• A recording of this session
• Treatment information
• Loyalty reward points
• Updates on future events

We’d really appreciate it if you could complete the short survey at the end, as it helps us improve future events.

If you’d like to book a consultation, our private patient team is available until 8:30 p.m. this evening and from 8:00 a.m. to 6:00 p.m., Monday to Friday. Their contact details are on your screen.

Thank you again, and have a wonderful evening.