Vein Conditions & Symptoms
Spider Veins: Cosmetic or Medical?
When they are only skin-deep — and when they are not
Spider veins are the most common vein problem I see, and the one patients most often apologise for. “I know it's only cosmetic,” they tell me — and usually they are right. But not always. Some spider veins are the visible tip of a leaking vein deeper in the leg, and treating the surface without knowing what lies underneath is the most common reason spider-vein treatment disappoints.
The short version
- Spider veins are tiny widened veins in the skin, less than 1 mm across. They are extremely common — most adults have at least a few.
- Most are a cosmetic concern only. But they can be the visible sign of a leaking (refluxing) vein deeper in the leg, and their appearance alone cannot tell you which.
- They are not a sign of poor circulation and do not cause blood clots. Occasionally they bleed.
- Aching, heaviness, swelling or skin changes are not usually caused by spider veins themselves. They point to something else — often underlying venous reflux — and deserve a proper assessment.
- European guidelines recommend a duplex ultrasound scan before spider veins are treated. In our practice every patient has one.
- Sclerotherapy (injection treatment) is the standard treatment for leg spider veins. Most people need two to four sessions, and treated veins fade over three to six months.
- Treated veins usually stay gone, but new ones can form over the years. Cosmetic treatment is not funded by medical schemes; treatment of proven underlying reflux often is.
The deep dive
What exactly are spider veins?
Spider veins — doctors call them telangiectasias, and they are also known as thread veins or broken veins — are small, permanently widened veins in the skin. They are red, purple or blue, less than 1 mm across, and form fine lines, starbursts or web-like patterns, most often on the thighs, around the knees and on the lower legs.
They rarely exist on their own. Slightly deeper, just under the skin, run reticular veins — bluish-green veins of 1 to 3 mm. These often act as feeder veins, supplying a cluster of spider veins on the surface. Deeper still are the main surface veins of the leg, the saphenous veins, and below the muscle layer the deep veins.1
Spider veins are very common. In the Edinburgh Vein Study, more than 80% of adults aged 18 to 64 had at least mild spider or reticular veins.2
Are spider veins the same as varicose veins?
No, although they belong to the same family. Varicose veins are larger — 3 mm or more — and lie under the skin, where they often bulge and twist. Spider veins are much smaller and lie within the skin itself. In the international CEAP classification of vein disease, spider and reticular veins are grade C1 and varicose veins are grade C2.3 The two often occur together, and both can grow out of the same underlying problem.
Are spider veins just cosmetic?
For most people, yes — in the sense that the spider veins themselves do no harm. The European Society for Vascular Surgery is clear that when the concern is mainly cosmetic, treatment is not medically required.1
But “the spider veins are harmless” and “there is nothing wrong underneath” are two different statements.
In the Edinburgh Vein Study, which scanned the veins of more than 1 000 randomly selected adults, the more extensive a person's spider veins, the more likely they were to have reflux — failing valves that allow blood to run backwards down the leg — in their surface veins.4 In a Brazilian study that scanned 269 legs of women whose only visible vein problem was spider veins, almost half (46%) had reflux in a saphenous vein, nearly always the great saphenous vein in the thigh, including legs without any symptoms.5
So spider veins fall broadly into three groups:
- Purely cosmetic. A cluster of spider veins with healthy veins beneath. This is the majority.
- A sign of underlying reflux. The spider veins are the visible surface of a leaking vein further up. Treating the surface alone tends to give poor or short-lived results.
- Part of more advanced vein disease. A fan of fine veins around the ankle or on the foot — called corona phlebectatica — is now classified as an early skin change of chronic venous disease, not as a cosmetic finding.3
The difficulty is that all three can look much the same. You cannot tell them apart by looking — and without a scan, neither can a doctor.
Signs that suggest more than a cosmetic problem
- aching, heaviness, throbbing or swelling of the legs, particularly towards the end of the day
- varicose veins as well as spider veins
- dense spider veins on the inner thigh or inner knee, or a fan of veins around the ankle or on the foot
- brown discolouration, eczema or hardening of the skin around the ankle
- spider veins that came back quickly after previous treatment
- a previous deep vein thrombosis (DVT) in that leg
Why am I getting spider veins?
There is rarely a single cause, and the precise mechanism is still not fully understood.6 What we do know is which factors make spider veins more likely:
- Your genes. This is the strongest factor. Vein disease runs in families: in a French study that examined 134 families, the risk of varicose veins was about 90% when both parents had them, and far lower when neither did.7 Spider veins show the same family pattern in everyday practice — many patients point out that their mother's legs looked just the same.
- Being female, and female hormones. Oestrogen and progesterone relax the walls of the veins. Spider veins often appear or flare during pregnancy, while taking the contraceptive pill or hormone replacement therapy, and around the menopause.
- Pregnancy. Pregnancy increases spider veins, reticular veins and varicose veins — although many improve in the months after the birth.1
- Age. Spider veins become more common with every decade.
- Long hours on your feet. Standing or sitting still for long periods raises the pressure in the leg veins. It does not cause spider veins on its own, but it adds to a predisposition you already have.
- Body weight. Extra weight raises the pressure in the veins of the legs.
- Underlying venous reflux. A leaking saphenous or feeder vein transmits high pressure to the small veins in the skin.
- Local skin injury accounts for a small number.
Several popular explanations — crossing your legs, wearing high heels, hot baths, tight clothing — have no good evidence behind them. More on those myths on our spider veins page.
Can exercise, weight or lifestyle prevent them?
Not entirely, because you cannot change your genes. Staying active, keeping a healthy weight and breaking up long periods of standing or sitting are good for your veins and may ease symptoms, but they will not stop spider veins forming in someone who is predisposed. No cream, tablet or supplement has been shown to prevent or remove spider veins.
Why am I suddenly getting more spider veins?
This is one of the most common questions I am asked. Spider veins usually develop slowly, but there are periods when they appear to multiply. The usual reasons are:
- Pregnancy — sometimes within weeks, and often worse with each pregnancy.
- A change in hormones — starting or changing the contraceptive pill, starting hormone replacement therapy, or the years around the menopause.
- Weight gain, a new job on your feet, or less activity.
- Previous treatment. Sometimes fine new veins form around a treated area (called matting — see the questions below), and a predisposed person will continue to form new spider veins elsewhere.
- Progression of underlying reflux. Vein disease tends to progress over time: in the Edinburgh Vein Study, more than half of people with varicose veins had deteriorated after 13 years.8 Spider veins that are spreading quickly — especially with new aching, heaviness or swelling — are a reason for a scan.
Not every new red mark is a spider vein. A small red spot with a central dot and fine “legs” radiating from it, on the face, neck, chest or hands, is a spider angioma — a different condition. A few are common and harmless, particularly in pregnancy and in children, but a sudden crop of them in an adult should be shown to your GP, as they can occasionally be linked to liver disease.
From the consulting room
“Why do my spider veins keep coming back?” A typical example: a woman in her forties tells me that a patch of spider veins on the inside of her knee has been spreading down towards her ankle. She has had injections twice elsewhere, and both times the veins returned within months. Her legs feel tired by the evening, which she has put down to her job. On the duplex scan the reason is clear: the great saphenous vein in her thigh is leaking, and that pressure is being passed down to the small veins in her skin. We treat the leaking vein first and the spider veins afterwards — and this time they stay away.
This is a composite of a pattern I see often, not a single patient. Not everyone with spider veins has a story like this, but it is common enough that I scan every patient before treatment.
Are spider veins dangerous?
Spider veins themselves are not dangerous. They are veins, not arteries, so they are not a sign of poor circulation or of blocked arteries. And they are not a recognised cause of a deep vein thrombosis (DVT). Larger varicose veins are associated with a modestly higher clot risk — although guidelines note it is unclear whether that link is causal or reflects shared risk factors1 — but spider veins on their own do not increase it.
Can spider veins bleed?
Yes, occasionally. Thin-walled veins around the ankle and on the foot, and small blue “blebs” that bulge from the skin, are the most likely to bleed — often after a knock, shaving or a hot shower. Bleeding from a surface vein can be surprisingly heavy, and in rare cases dangerous.1
If a vein bleeds
Lie down, raise the leg above the level of your heart, and press firmly on the spot with a clean cloth for 10 minutes without lifting it to check. If the bleeding will not stop, or you feel faint, call an ambulance on 10177 or 112 from a mobile phone. A vein that has bled should be assessed afterwards, because it tends to bleed again.
Spider veins around the ankle or foot
A fan of fine blue and red veins around the inner ankle or across the arch of the foot deserves particular attention. This pattern, corona phlebectatica, reflects high pressure in the veins near the ankle and is classified as an early skin change of chronic venous disease (CEAP C4c).3 It is not a cosmetic finding, and it calls for a duplex scan — because the skin around the ankle is where, over years, pigmentation, hardening and eventually venous ulcers develop.
When should spider veins make me concerned?
- a vein has bled
- a tender, red, hard cord develops along a vein — this is superficial phlebitis and should be scanned
- brown staining, eczema, hardening of the skin or a sore that does not heal near the ankle
- spider veins together with leg aching, heaviness or swelling
- one leg becomes swollen and painful — this needs a doctor the same day, as it can be a DVT
Can spider veins cause pain, burning or itching?
Some can. Itching, burning or a localised throbbing over a cluster of spider veins is recognised, and is often worse in hot weather or before a period. The CEAP classification has a separate label for spider veins that cause symptoms.3 These symptoms are usually mild and confined to the area of the veins.
Aching, heaviness, tiredness and swelling of the whole leg are a different matter. They are rarely caused by the spider veins themselves. When they are present, they suggest either underlying venous reflux or a cause outside the veins altogether. Leg symptoms are common in people with and without visible veins: in the Edinburgh Vein Study, the link between symptoms and visible veins was too weak to diagnose one from the other.9 I have written separately about when leg swelling is — and is not — caused by veins.
Either way, symptoms are worth explaining rather than dismissing. That is what the scan is for.
Do I need an ultrasound scan for spider veins?
If you have a few spider veins, no symptoms and no wish to have them treated, you do not need a scan. If you have symptoms, or you are considering treatment, the answer is yes.
Since 2022 the European guidelines have firmly recommended that anyone with spider or reticular veins has a duplex ultrasound scan of the leg veins before treatment, specifically to look for leaking veins underneath. They also recommend that any significant leaking veins are treated first, before the smaller veins.1
In our practice, every new patient is assessed by me with a duplex scan before any treatment is recommended — including patients who come in only for spider veins. A scan is particularly important when there are:
- aching, heaviness, swelling or skin changes
- varicose veins as well
- spider veins around the ankle or on the foot
- extensive spider veins on the inner thigh or inner knee
- spider veins that have come back quickly after earlier treatment
- a previous DVT
How does a vein specialist look for underlying reflux?
A venous duplex ultrasound shows both the structure of the veins and the direction in which blood flows through them. It is painless, uses no needles and no radiation, and is done with you standing, because that is when faulty valves show themselves. The leg is gently squeezed while the scan watches whether blood falls back down through the valves. Hand-held Doppler “pen” devices are not accurate enough for this and are not used in our centres.
Why feeder veins and reflux matter before treatment
The spider veins you can see are the end of a chain: saphenous vein, then tributary and reticular feeder veins, then the skin. If there is a leak higher up the chain, injecting only the surface is like mopping the floor while the tap is still running. The veins clear poorly, return quickly, and fine new veins (matting) are more likely. Finding and treating the feeder veins and any underlying reflux first is what makes cosmetic treatment last.
Can you get rid of spider veins?
Yes — in most cases spider veins can be cleared or greatly reduced. But not in a single visit, and treatment cannot stop new ones forming in the future.
Sclerotherapy: the standard treatment
Sclerotherapy involves injecting a medicine (a sclerosant) into the vein through a very fine needle. The medicine irritates the lining of the vein, which then seals closed and is gradually absorbed by the body. European guidelines describe sclerotherapy as the gold standard for spider and reticular veins, with success rates above 90% reported in a large clinical trial.1 A Cochrane review confirmed that it works far better than placebo, and found no single sclerosant clearly better than the others.10
In our centres, sclerotherapy is performed by registered nurse sclerotherapists whom I have trained, once I have assessed the leg and the duplex scan. The feeder veins are treated in the same session as the spider veins.
How many sessions will I need?
Most patients need two to four sessions, spaced two to four weeks apart — usually about a month. Very extensive spider veins may need more. Each session treats a defined area, and the next one picks up the veins that remain.
How long before they disappear?
Spider veins fade gradually rather than vanishing on the day. For the first weeks, treated veins often look darker or bruised. They then fade progressively, and the final result is usually seen after three to six months. It is worth judging the outcome at that point rather than after the first session.
Why can spider veins look worse before they look better?
In the first weeks after treatment it is normal to see bruising, redness and veins that look darker than before. Sometimes a little blood becomes trapped in a treated vein, which feels like a tender, firm line. Releasing this trapped blood with a tiny needle prick one to three weeks after treatment eases discomfort, and in the finest veins it has been shown to reduce brown staining.11
Two longer-lasting effects are worth knowing about before treatment. Pigmentation — brown staining along a treated vein — occurs in roughly 10% to 30% of patients; most of it fades within months, and almost all within a year.12 Matting — a blush of very fine new red veins around a treated area — occurs in roughly 15% to 20%, and usually settles over several months.12,13 Serious complications are rare: in a French registry of more than 12 000 sclerotherapy sessions, complications of any kind occurred in about 0.2% of sessions using liquid sclerosant.14
Will they come back?
A spider vein that has been properly closed usually stays closed. But the tendency that produced it remains. Most people who are predisposed will form new spider veins over the years — more so with a strong family history, further pregnancies or hormone treatment. It is best to think of spider vein treatment as maintenance, with occasional top-up sessions, rather than a permanent cure.
Where the scan shows underlying reflux, treating it first removes the pressure that drives the spider veins, which is why guidelines recommend that order.1 In my experience, spider veins return far more quickly when that step is skipped.
Are compression stockings needed afterwards?
We use compression stockings after treatment when extensive veins have been treated. In a randomised trial, wearing compression stockings for three weeks after sclerotherapy of thigh spider veins improved how well the veins cleared.15 For a small area of fine veins, compression is often not necessary.
What about creams, tablets and supplements?
There is no good evidence that any cream, tablet or supplement removes spider veins. Some creams and make-up products can mask them temporarily.
Sclerotherapy or laser: which is better?
Both work, and they suit different veins.
For spider veins on the legs, trials that treated one leg with sclerotherapy and the other with a long-pulsed laser found broadly similar clearance by the end of follow-up. Sclerotherapy produced its results more quickly, and laser was more painful.16,17 A 2023 analysis that combined the available trials found laser performed particularly well for the very finest spider veins.18
The European guidelines recommend sclerotherapy as the first choice for reticular veins, and consider either sclerotherapy or laser reasonable for fine spider veins. They suggest laser is best suited to particular situations: needle phobia, allergy to the sclerosant, veins that have not responded to sclerotherapy, and fine matting. They advise against intense pulsed light (IPL) as a first-line treatment.1
Which spider veins suit laser, and which suit injections?
- Laser is usually better for: fine red veins on the face and neck; leg veins too fine to inject; matting after sclerotherapy; and people who cannot have injections.
- Sclerotherapy is usually better for: most spider veins on the legs, particularly the lower leg and ankle; spider veins with visible blue feeder veins; and reticular veins.
The main limitation of surface laser on the legs is that it treats only the vessel visible at the skin, not the feeder vein beneath it. Laser also carries a risk of burns and of lighter or darker patches of skin, which is greater in darker skin types. We do not offer laser treatment in our practice. For leg spider veins we use sclerotherapy, which allows the feeder veins to be treated in the same session. For facial spider veins, laser from a dermatologist is usually the better choice.
Will my medical aid pay for spider vein treatment?
Usually not. South African medical schemes regard sclerotherapy for spider veins as cosmetic, so it is paid for by the patient, per session. We do not publish prices on the website, because the number of sessions varies so much from person to person. Current session pricing is available from reception at any of our centres.
The assessment can change the picture. If the duplex scan shows underlying reflux that is causing symptoms or complications, treating that leaking vein — for example with radiofrequency ablation — is medically indicated, and is generally considered for funding by medical schemes, subject to your benefit option and pre-authorisation. Any spider veins that remain afterwards are still regarded as cosmetic.
When is treatment cosmetic rather than medically necessary?
Medically indicated treatment addresses reflux demonstrated on a duplex scan and the symptoms and complications it causes. Cosmetic treatment addresses the appearance of veins where there is no underlying reflux needing treatment. Which applies to you can only be determined after an examination and a scan. After your consultation, we provide a written estimate with the relevant procedure codes and, where required, submit the pre-authorisation on your behalf. More on our medical schemes and pricing page.
So, cosmetic or medical?
In summary
Most spider veins are a cosmetic concern, and they are not a sign of poor circulation or a risk for blood clots. But spider veins can also be the visible sign of a leaking vein underneath — and you cannot tell which by looking. Aching, heaviness, swelling, skin changes, veins around the ankle and spider veins that keep returning all point towards an underlying problem. A duplex scan answers the question, and when reflux is found, treating it first is what makes spider-vein treatment work and last.
Whether your spider veins are cosmetic or medical, they deserve the same starting point: a proper look at the veins you cannot see.
For a shorter overview of causes and treatment, see our spider veins condition page, and for what a treatment session involves, our cosmetic sclerotherapy page.
Frequently asked questions
Are spider veins just a cosmetic problem?
Usually, yes. Spider veins themselves are harmless, and when the concern is mainly cosmetic, treatment is not medically required. But they can be the visible sign of a leaking vein deeper in the leg, especially when there is aching, heaviness, swelling, skin changes or veins around the ankle. A duplex ultrasound scan is the only reliable way to tell.
Are spider veins dangerous?
No. Spider veins are not a sign of poor circulation and are not a recognised cause of DVT. They can occasionally bleed, particularly around the ankle. If a vein bleeds, lie down, raise the leg and press firmly for 10 minutes. A vein that has bled should be assessed.
Do I need an ultrasound scan for spider veins?
If you have symptoms, or you are planning treatment, yes. European guidelines recommend a duplex ultrasound scan before spider veins are treated, to look for leaking veins underneath, and recommend that significant leaking veins are treated first. In our practice every patient has a duplex scan before treatment.
Does sclerotherapy for spider veins hurt?
Most people find it very tolerable. A very fine needle is used, and you feel a brief sting and sometimes a mild burning or cramp for a few seconds as each vein is injected. No anaesthetic is needed. In comparative trials, laser treatment of leg spider veins was more painful than sclerotherapy.
How many sclerotherapy sessions will I need?
Most patients need two to four sessions, spaced two to four weeks apart, usually about a month. Very extensive spider veins may need more. The final result is usually seen three to six months after the last session.
How long does it take for spider veins to disappear after treatment?
Treated veins fade gradually. They often look darker or bruised for the first few weeks, then fade progressively, with the final result usually seen after three to six months.
Why do spider veins look worse after treatment?
Bruising, redness and darker-looking veins are normal in the first weeks. Sometimes blood becomes trapped in a treated vein; releasing it with a tiny needle prick one to three weeks later eases tenderness and can reduce brown staining. These changes settle as the treated veins are absorbed.
Can sclerotherapy leave brown marks or scars?
Brown staining along a treated vein occurs in roughly 10% to 30% of patients. Most of it fades within months and almost all within a year, although it can occasionally take longer. Avoid tanning before and after treatment. Scarring and permanent staining are uncommon in experienced hands.
What is matting after sclerotherapy?
Matting is a blush of very fine new red veins that can appear around a treated area. It occurs in roughly 15% to 20% of patients and usually settles over several months. It is more likely when underlying reflux has not been found and treated.
Will my spider veins come back after treatment?
Veins that have been properly closed usually stay closed. But the tendency to form spider veins remains, so new ones can appear over the years, especially with a strong family history, pregnancy or hormone treatment. Treating any underlying reflux first reduces early return.
Is sclerotherapy safe?
Yes. Serious complications are rare. In a French registry of more than 12 000 sclerotherapy sessions, complications of any kind occurred in about 0.2% of sessions using liquid sclerosant. Most side effects, such as bruising, staining and matting, are temporary.
Can spider veins be treated during pregnancy or breastfeeding?
No. Vein treatment is not offered during pregnancy, and European guidelines advise waiting three to six months after delivery, as many spider veins improve on their own after the birth. We also prefer to wait until breastfeeding has finished.
When is the best time of year to treat spider veins?
Autumn and winter are ideal. You are less likely to have a tan, which increases the risk of staining; compression stockings are more comfortable in cooler weather; and because the final result takes three to six months, your legs should be at their best by summer.
Who should not have sclerotherapy?
Sclerotherapy is not suitable for people with a known allergy to the sclerosant, a current DVT or pulmonary embolism, an infection in the area, or during pregnancy. A previous blood clot or a known clotting disorder does not always rule it out, but needs to be discussed first.
Does medical aid cover spider vein treatment?
Usually not. Medical schemes regard sclerotherapy for spider veins as cosmetic, and it is paid for by the patient. If a duplex scan shows underlying reflux causing symptoms, treatment of that leaking vein is medically indicated and is generally considered for funding, subject to your benefit option and pre-authorisation.
Should I see a vein specialist or a cosmetic clinic for spider veins?
See a vein specialist if you have aching, heaviness, swelling, varicose veins, skin changes, spider veins around the ankle, or spider veins that came back after earlier treatment. A vein specialist can scan for underlying reflux and treat it, which a clinic offering only surface treatment cannot.
What happens at a first consultation for spider veins?
At our centres, Dr Blignaut takes a history, examines your legs standing, and performs a duplex ultrasound scan. He explains what the scan shows and whether any underlying vein needs treatment first. If sclerotherapy is all you need, sessions are booked with one of our nurse sclerotherapists, and you receive a written estimate.
References
- De Maeseneer MG, Kakkos SK, Aherne T, et al. European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184–267. doi:10.1016/j.ejvs.2021.12.024
- Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53(3):149–153. doi:10.1136/jech.53.3.149
- Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020;8(3):342–352. doi:10.1016/j.jvsv.2019.12.075
- Ruckley CV, Allan PL, Evans CJ, Lee AJ, Fowkes FG. Telangiectasia and venous reflux in the Edinburgh Vein Study. Phlebology. 2012;27(6):297–302. doi:10.1258/phleb.2011.011007
- Engelhorn CA, Engelhorn AL, Cassou MF, Salles-Cunha S. Patterns of saphenous venous reflux in women presenting with lower extremity telangiectasias. Dermatol Surg. 2007;33(3):282–288. doi:10.1111/j.1524-4725.2007.33063.x
- Kern P. Pathophysiology of telangiectasias of the lower legs and its therapeutic implication: a systematic review. Phlebology. 2018;33(4):225–233. doi:10.1177/0268355518756480
- Cornu-Thenard A, Boivin P, Baud JM, De Vincenzi I, Carpentier PH. Importance of the familial factor in varicose disease: clinical study of 134 families. J Dermatol Surg Oncol. 1994;20(5):318–326. doi:10.1111/j.1524-4725.1994.tb01631.x
- Lee AJ, Robertson LA, Boghossian SM, et al. Progression of varicose veins and chronic venous insufficiency in the general population in the Edinburgh Vein Study. J Vasc Surg Venous Lymphat Disord. 2015;3(1):18–26. doi:10.1016/j.jvsv.2014.09.008
- Bradbury A, Evans C, Allan P, Lee A, Ruckley CV, Fowkes FG. What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. BMJ. 1999;318(7180):353–356. doi:10.1136/bmj.318.7180.353
- Schwartz L, Maxwell H. Sclerotherapy for lower limb telangiectasias. Cochrane Database Syst Rev. 2011;(12):CD008826. doi:10.1002/14651858.CD008826.pub2
- Scultetus AH, Villavicencio JL, Kao TC, et al. Microthrombectomy reduces postsclerotherapy pigmentation: multicenter randomized trial. J Vasc Surg. 2003;38(5):896–903. doi:10.1016/S0741-5214(03)00920-0
- Goldman MP, Sadick NS, Weiss RA. Cutaneous necrosis, telangiectatic matting, and hyperpigmentation following sclerotherapy: etiology, prevention, and treatment. Dermatol Surg. 1995;21(1):19–29. PMID: 7600016
- Davis LT, Duffy DM. Determination of incidence and risk factors for postsclerotherapy telangiectatic matting of the lower extremity: a retrospective analysis. J Dermatol Surg Oncol. 1990;16(4):327–330. PMID: 1691217
- Guex JJ. Complications of sclerotherapy: an update. Dermatol Surg. 2010;36(Suppl 2):1056–1063. doi:10.1111/j.1524-4725.2009.01409.x
- Kern P, Ramelet AA, Wütschert R, Hayoz D. Compression after sclerotherapy for telangiectasias and reticular leg veins: a randomized controlled study. J Vasc Surg. 2007;45(6):1212–1216. doi:10.1016/j.jvs.2007.02.039
- Parlar B, Blazek C, Cazzaniga S, et al. Treatment of lower extremity telangiectasias in women by foam sclerotherapy vs. Nd:YAG laser: a prospective, comparative, randomized, open-label trial. J Eur Acad Dermatol Venereol. 2015;29(3):549–554. doi:10.1111/jdv.12627
- Munia MA, Wolosker N, Munia CG, Chao WS, Puech-Leão P. Comparison of laser versus sclerotherapy in the treatment of lower extremity telangiectases: a prospective study. Dermatol Surg. 2012;38(4):635–639. doi:10.1111/j.1524-4725.2011.02226.x
- Bontinis V, Bontinis A, Koutsoumpelis A, et al. Interventions for the treatment of lower limb telangiectasias and reticular veins: a systematic review and network meta-analysis. Eur J Vasc Endovasc Surg. 2023;66(4):560–576. doi:10.1016/j.ejvs.2023.05.029
Guidance reflects the major international guidelines and trials available in October 2026. Practice-specific details — number of sessions, intervals and compression — describe our usual approach at Vein Centres South Africa; your own plan is agreed at consultation.
About the author — Dr Johan Blignaut
Specialist Surgeon · MBChB (UOFS) FCS(SA)
Dr Blignaut is the founder of Vein Centres South Africa, with dedicated vein centres in Fourways, Johannesburg, Umhlanga, Durban and Somerset West. He is a Medtronic-appointed proctor who trains surgeons from South Africa, Africa and the Middle East in endovenous radiofrequency ablation, and has appeared as a guest expert on SAFM Health Matters and SABC Health Talk.