Visible thread veins on the legs, also called telangiectasias, are small superficial blood vessels that appear red, blue or purple. They may be primarily an aesthetic concern or occur alongside reticular veins, varicose veins or venous insufficiency. Treatment is therefore chosen after a phlebological assessment, rather than assuming that all spider veins are the same problem.
Why an assessment before treatment is useful
Looking at the skin alone does not always reveal the origin of visible vessels. Some telangiectasias are isolated; others may be fed by reticular veins or associated with venous reflux. The consultation assesses their distribution, size and depth, and the characteristics of the skin. If sclerotherapy at Centro Medico Gargano is being considered, a vascular assessment with venous colour Doppler ultrasound is carried out beforehand to examine the venous circulation properly and plan treatment.
Sclerotherapy and VeinGogh: how the technique is chosen
Treatment with spider vein sclerotherapy involves injecting a sclerosant medicine into selected vessels. Different approaches may be used for telangiectasias, reticular veins and some superficial varicose veins. VeinGogh uses thermal energy to treat small, very superficial vessels selectively. In some cases, the two methods can be combined; in others, it is preferable to use a single technique or postpone treatment.
The choice depends on the location, diameter and depth of the vessels, the presence of feeding veins, skin sensitivity, skin phototype, previous treatments and the overall venous condition. No method is automatically the best for everyone.
How many sessions may be needed
The number of sessions cannot be reliably determined without an assessment. It may depend on the extent of the spider veins, the individual’s response, the type of vessel and the agreed goal. Improvement is generally gradual and may require follow-up or further sessions. Even after a good result, new spider veins may appear over time because treatment does not remove the individual’s predisposition.
Possible adverse effects and limitations
Temporary redness, small bruises, local tenderness, vessel hardening or pigmentation may occur after treatment. The frequency and type of adverse effects depend on the technique and the patient’s characteristics. Less common events should be discussed during informed consent. It is not appropriate to promise complete freedom from pain, complete removal in a single session or a permanent result.
The pathway at Centro Medico Gargano
Assessment is carried out by Dr Ciro Gargano. Following the clinical examination, he advises whether it is appropriate to treat the visible vessels, investigate the venous circulation further or take a different approach. For an overview of venous conditions and the consultation, see the page on phlebology in Naples.
Reference sources
The general information is consistent with the ESVS guidelines on chronic venous disease of the lower limbs and NICE guidance on the diagnosis and management of varicose veins. Clinical decisions remain individual and are made during the consultation.