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CEAP – C1 score: Telangectasia (Thread veins / Spider veins / Broken veins)

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CEAP – C1 Telangectasia (Thread veins / Spider veins / Broken veins)

The least severe of the CEAP clinical scores is C1.

CEAP C1 means that on examination, only telangiectasia (aka thread veins, spider veins or broken veins) can be seen on the leg being examined.

It is very interesting that research performed in Scotland on a large population of the general public showed that 88% of adult women have leg telangiectasia as do 79% of adult men.


CEAP – C1: What you can see in leg telangiectasia

These telangiectasia can be tiny and red, or can be slightly larger and darker being purple or blue.

Green veins that are visible near the telangiectasia are called reticular veins if they do not bulge out on standing. As soon as they start to bulge when standing, they are then called varicose veins and will be classified under CEAP C2


CEAP – C1: What is the underlying cause of leg telangiectasia

Although they may appear to be small and cosmetic only on clinical examination, research has shown that telangiectasia are associated with underlying venous reflux that feeds them in a high proportion of cases.

Typical thread veins on thigh - Telangectasia spider veins - CEAP-C1

Published research in peer-reviewed medical journals have shown that leg telangiectasia (thread veins, spider veins or broken veins) are fed by underlying veins as follows:

  • 89% of patients with leg telangiectasia are fed by underlying venous reflux
  • 40% of patients with leg telangiectasia have underlying major hidden varicose veins (truncal venous reflux) that cannot be seen clinic from the surface
  • 15% of patients with leg telangiectasia have underlying reflux from incompetent perforating veins
  • Only 11% of patients with leg telangiectasia have simple cosmetic thread veins, spider veins or broken veins that can be fully assessed clinic, by vision alone

CEAP – C1: What you need if you have leg telangiectasia

If you have leg telangiectasia (thread veins / spider veins) and no other symptoms or signs, then one option is to do nothing. Many people opt for this and wait until any problems occur before they seek help. Doing nothing will usually result in the telangiectasia (thread veins / spider veins) getting worse. In addition, doing nothing and not getting a scan will mean that you won’t know if there is a more serious underlying condition.

Large thread veins on thigh - Telangectasia spider veins CEAP-C1

As so many patients with CEAP C1 telangiectasia (thread veins, spider veins or broken veins) have underlying venous reflux or hidden varicose veins feeding blood into them, it is absolutely essential to have a venous duplex ultrasound scan to look for underlying venous reflux before any treatment can be thought of or suggested.

Telangiectasia of the legs should never be treated by beauty clinics, cosmetic clinics or even vein clinics unless they have the full assessment by venous duplex ultrasonography. If underlying venous reflux is found, then this needs to be treated by the new endovenous techniques to get rid of the problem before the leg telangiectasia can be successfully treated.

It is therefore not surprising that so many people with leg telangiectasia go to beauty clinics, cosmetic clinics or even vein clinics for treatment and if they do not have a full venous duplex ultrasound performed by a specialist vascular scientist, end up with either a poor result or getting their telangiectasia back again after treatment.


CEAP – C1: What treatment is needed for leg telangiectasia

If a venous duplex ultrasound scan has been performed by a specially trained vascular scientist and no underlying reflux has been found, or treated, the telangiectasia (thread veins, spider veins, broken veins) can then be treated with micro-sclerotherapy with a very high chance of success.

Before and after Microsclerotherapy treatment for thread veins - telangectasia spider veins CEAP-C1

Other forms of treatment such as laser, IPL or using electric currents through needles to heat the vein and surrounding skin, have not been shown to have great results in the medium to long term. Whereas micro-sclerotherapy treats the veins that you can see and also other veins in the area that might be under the skin, these other modalities only treat the exact area that can be seen at any time. In addition, they can also damage the skin.

Of course it is possible for micro-sclerotherapy to cause complications as well, but our very long experience and scientific study has shown these risks and poor results to be very low when used as part of The Whiteley Protocol®.

However we are always striving to improve our results and the ways that patients can be treated and so The Whiteley Clinic have founded the research led “leg thread vein project” which will slowly improve the assessment and treatment of leg telangiectasia (thread veins, spider veins, broken veins).