The adverts promise beautiful legs, zero risk, and treatment in as little as 15 minutes. But unregulated injections to “eliminate” varicose veins are putting clients at risk of serious health complications, surgeons have warned.
Vein removal treatments costing as little as £90 a session are being offered by beauticians without medical supervision across the UK, Observer analysis has found.
Promoted with dramatic before and after photos and billed as a quick fix, microsclerotherapy involves the injection of a chemical irritant to disrupt the vein lining. This causes the vein walls to stick together, making it no longer visible on the skin. When performed correctly on finer veins, known as “thread” or “spider” veins, the procedure is generally considered safe, provided no underlying issues are present.
But beauticians and other non-healthcare professionals are also offering vein treatments for people with varicose veins, which can signify underlying venous disease, analysis of promotional materials shows. In such cases, treatments should be performed by practitioners in a regulated clinic, where specialists first use ultrasound scans to assess the area.
Conducting vein removal incorrectly or when there are underlying problems can lead to complications including leg ulcers, nerve damage, blood clots, stroke, allergic reactions and scarring, the Joint Council for Cosmetic Practitioners (JCCP) said. Even in cases where only thread veins are visible, other problems may be present.
Prof Mark Whiteley, a consultant venous surgeon and chair of the Whiteley chain of clinics, said he had seen cases of women with leg ulcers and permanent scarring after treatment for varicose veins from non-medics. In other cases, people had paid for treatment but saw no effect because the underlying cause was not tackled. “It’s totally disgraceful,” he said.
In one case, a 48-year-old woman suffered a cardiac arrest after an allergic reaction to the solution injected during microsclerotherapy. “Luckily, it was in a medical facility and she survived,” he said. “But if she had had her treatment in a beauty salon, it’s unlikely she would have survived.”
He said claims from one beautician that they could treat “80% of damaged veins” in one session was “utter rubbish”. Another ad promoting vein removal for £120 said clients could “return to normal activities straight away”. “They’re trying to say it’s quick and easy when it’s not,” he said.
In other cases, vein removal is promoted by non-medics as a solution for pain. “For patients suffering from pain with veins, it can alleviate this,” said one ad, from a London salon last month. If veins are causing pain, NHS advice is to speak to a GP to rule out more serious issues.
The Advertising Standards Authority said it was assessing several cases. On Instagram, a quarter of a million posts have been tagged with terms relating to vein treatments; on TikTok, related videos have been watched 152m times.
A recent rush of beauticians offering the treatments in the UK appears to have been spurred by a wave of new courses, including some that are online only and appear to be run by non-healthcare professionals. Promotions for the courses claim students can achieve “amazing” results and profits.
Catherine McGuinness, a vascular surgeon and British Association of Sclerotherapists board member, said she recently had to deal with a patient with a “nasty calf ulcer which required skin grafting”, after having an unregulated vein treatment, which was offered by a non-healthcare professional as part of a voucher offer.The findings have led to calls for greater regulation of vein removal treatments. In Denmark, a regime to oversee the cosmetics sector introduced in 2007 means only consultant dermatologists or plastic surgeons can offer sclerotherapy, and they must be registered with the Danish Health Board. They can delegate “microsclerotherapy” – the name given to treatments for smaller veins – to nurses and junior doctors, but remain responsible for the patient. Non-healthcare professionals cannot carry it out.
In the UK, cosmetic clinics – where non-surgical treatments are performed by medical professionals such as doctors and nurses – are overseen by the Care Quality Commission. But beauticians offering the same treatments are not regulated. The government has pledged to tighten regulation on non-surgical cosmetic treatments, announcing plans for a licensing regime this year, but a timetable is yet to be fixed.
Dr Martyn King, vice-chair of the JCCP, said: “It is our opinion that these procedures should only be performed by appropriately qualified and competent healthcare practitioners due to the potential risks.”
He said many specialists had seen patients with ulcers caused by treatment from non-medics, “often as a result of injections too close to the skin, not within the vein itself, too great a volume, too high a concentration or an inappropriate sclerosant being used. These can take several months to heal and lead to scarring, with very little recourse for patients as the non-medical providers often are not insured and not accountable to a professional body.”
He said anyone considering leg vein treatment should find a suitable medical practitioner and “expect a thorough consultation and examination, which should include full Duplex ultrasound scanning of their legs if underlying venous disease is suspected”.
Dr Alison Cave, chief safety officer at the government’s Medicines and Healthcare products Regulatory Agency, said: “If practitioners appear to be selling or supplying a prescription-only medicine without a prescription, we have the authority to investigate and will take appropriate action if breaches … are identified. We strongly advise that anyone looking to undergo sclerotherapy seeks treatment from a qualified medical practitioner.”