Do I need a consultation and scan if I just have thread veins? Regardless of the vein condition that you seem to have, whether prominent varicose veins or simply thread veins (AKA spider veins), it is necessary to have a consultation and duplex ultrasound scan prior to undergoing any treatment. A duplex ultrasound scan is the only way to accurately determine whether there is an underlying problem causing the veins visible on the outside of the legs, not to mention any other associated symptoms, such as throbbing, aching, itching, swelling, etc. If a patient presents with thread veins or minor varicose veins (i.e. no obvious bulging), it is important to rule out whether there is an underlying cause before commencing treatment. Often, superficial veins on the surface, e.g. thread veins, will be treated without first fixing the cause. It is really important to us that, if the scan reveals an underlying cause, this is dealt with first. If the visible veins are treated but the source is not, the veins will more than likely recur. A simple analogy is if you have a leaky pipe: you can mop up the water on the floor, but if you don’t fix the pipe, the water will continue to come back again and again. This is not to say that patients will always have an underlying cause that needs treating, e.g. with EVLA, because there often isn’t any major reflux in the veins. If this is the case, the visible veins can be treated simply using treatments like foam sclerotherapy or microsclerotherapy, or sometimes with thermocoagulation or micro-avulsions. Our consultation costs £250 and includes a colour duplex ultrasound scan.