Visible veins alone do not always need treatment. But aching, swelling, itching or changes in the skin around your ankle are reasons to arrange an assessment. These symptoms can have several causes, and a consultation helps establish whether your veins are responsible.

Varicose veins develop when the valves that help blood travel up the leg no longer close properly. Blood flows backwards and the surface veins enlarge. A scan can show exactly where this happens; the size of the vein you can see is only part of the picture.

If a vein starts bleeding, lie down, raise your leg and apply firm pressure. Seek urgent medical help, even if the bleeding stops. Sudden swelling and pain in one leg also need urgent assessment. Chest pain or breathlessness require emergency care: call 998.

Arrange a vein consultation for persistent discomfort, darkening or eczema of the skin around the ankle, a tender hard vein, or a wound that is slow to heal. A healed leg ulcer matters too, so tell the doctor about it. UK NICE guidance lists all of these as reasons to see a vascular specialist.

Small spider veins without symptoms are a different situation. Treatment is often a personal cosmetic choice rather than a medical necessity.

For symptomatic varicose veins, a duplex ultrasound examines blood flow and shows where the valves leak (reflux). It tells the surgeon which vein, if any, needs treatment, and confirms that the deep veins are working. Treating only the bulges you can see may leave the underlying leak untreated.

Not every patient with a few spider veins needs a full reflux scan. Your examination and symptoms guide the assessment.

EVLA closes a faulty main surface vein from the inside, without the traditional stripping operation. For suitable patients it is planned as a day procedure.

1. Mapping. The surgeon marks the vein on the skin using ultrasound.
2. Local anaesthetic. The skin is numbed at one small access point, then local anaesthetic is placed around the vein under ultrasound.
3. The fibre. A thin laser fibre is passed into the vein through a needle, guided by ultrasound.
4. Closing the vein. As the fibre is slowly withdrawn, laser energy seals the vein wall. Blood continues to return to the heart through other, healthy veins.
5. Afterwards. A dressing is applied and walking is encouraged the same day. You receive written instructions about activity, dressings and, if prescribed, compression.

For a leaking main vein, European (ESVS 2022) and UK (NICE) guidelines place endovenous thermal ablation, such as laser, ahead of traditional surgery. In a large UK randomised trial (CLASS), quality of life related to the veins five years after treatment was better after laser ablation or surgery than after foam sclerotherapy alone.

What EVLA does not do: it does not remove every visible vein, and some patients need additional treatment of branches. Bruising, tenderness and temporary altered sensation can occur. Less common complications include skin burns and a blood clot.

Sclerotherapy closes selected veins with an injection. A liquid is commonly used for small veins and spider veins; an ultrasound-guided foam can be used for larger branches. It may be offered on its own or together with treatment of a leaking main vein, including for veins that remain after EVLA.

More than one session may be needed. Temporary staining, inflammation or fine new vessels can develop. Rare complications include clotting and reactions to the injected medicine.

Neither method guarantees that new varicose veins will never appear. Your anatomy, symptoms, previous treatment and preferences all affect the choice.

Compression can help symptoms in appropriate patients, but it does not repair a faulty valve. Where intervention is suitable, guidelines favour treating the reflux rather than relying on stockings alone. If thermal ablation is unsuitable, foam sclerotherapy or surgery may be considered.

An operation is still a valid option for some patients. The useful question is which approach fits your veins and your health, not which sounds newest.

Ask about your own work and activities. Sitting at a desk, standing all day and returning to heavy exercise are different demands. Follow-up ultrasound is arranged according to the procedure, your symptoms, clotting risk and the surgeon's assessment, rather than one fixed schedule for everyone. New leg swelling, worsening pain, chest pain or breathlessness after treatment need prompt medical assessment.

Dr Peter Lassu, Consultant General Surgeon, assesses patients with vein symptoms at ELEMENTAL Day Surgical Center in Jumeirah 1.

Published prices: consultation AED 750 · duplex ultrasound AED 1,200 (one leg) or AED 1,600 (both legs) · endovenous laser ablation from AED 14,000 · sclerotherapy from AED 2,500 per session. The exact plan and quotation are given in writing after the scan.

Bring previous scan reports and a list of your medicines, including blood thinners. After the assessment, ask for a written plan explaining which vein would be treated, whether further sessions may be needed and what the quotation includes.

Book a vein consultation · Read about EVLA · Read about sclerotherapy · WhatsApp +971 4 383 0500

This is general information. Your doctor will discuss the benefits, risks and alternatives for your circumstances.

Medically reviewed by Dr Peter Lassu, Consultant General Surgeon, DHA licence 64033332-005, ELEMENTAL Day Surgical Center. Reviewed 8 October 2026.

1. NICE. Varicose veins: diagnosis and management (CG168). https://www.nice.org.uk/guidance/cg168
2. De Maeseneer MG, Kakkos SK, et al. ESVS 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg 2022;63:184–267. https://doi.org/10.1016/j.ejvs.2021.12.024
3. Gloviczki P, et al. 2023 SVS/AVF/AVLS clinical practice guidelines for the management of varicose veins of the lower extremities, Part II. J Vasc Surg Venous Lymphat Disord 2024;12(1):101670. https://doi.org/10.1016/j.jvsv.2023.08.011
4. Brittenden J, et al. Five-year outcomes of a randomized trial of treatments for varicose veins (CLASS). N Engl J Med 2019;381:912–922. https://doi.org/10.1056/NEJMoa1805186