How are thread veins diagnosed?
Thread veins of the thigh, with underlying green reticular feeding veins
The simplest way of diagnosing thread veins of the legs is by seeing them.
Thread veins of the legs can be seen on the surface of skin as red, blue or purple thread veins. They can appear as single thread veins, clumps of thread veins or can be arranged like a “fan” or like a starburst. In a few severe cases, there can be so many thread veins that the legs can appear blue in large areas.
Occasionally people think that they have a bruise which does not go away and, upon closer examination, or a suggestion from somebody else, they realise it is thread veins.
Although there is little research on the development of leg thread veins, it does appear that when they start to form, they appear firstly as a red “blush”. When this red blush is pushed with the fingertip, the blood can be seen to empty from it, only to return when the fingertip is removed. With time, the red blushes with tiny thread veins slowly mature into areas larger of thread veins that can be more easily seen which are usually darker blue or purple in colour.
Once thread veins have been seen, it is essential to have a hand held Doppler examination as a minimum and preferably a venous duplex ultrasound scan to check for underlying veins that may be causing them. Almost 9 out of every 10 people with thread veins have underlying veins causing the thread veins, and failure to treat the underlying veins first will only result in either poor results from thread vein treatments or thread veins coming back sooner after treatment.
Other conditions that may be confused with leg thread veins:
Occasionally, other conditions can look like leg thread veins.
Discolouration around the inner aspect of the ankle (called venous eczema, or haemosiderin deposition) can look like thread veins. In reality this is skin damage caused by underlying varicose veins or “hidden varicose veins” (venous incompetence).
Other skin conditions such as eczema and psoriasis can also look like clumps of thread veins.
Bruises on the legs can often look like thread veins. However bruises usually disappear within a couple of weeks whereas thread veins will either stay the same will slowly get worse.