Superficial Varicose Vein and Thread Vein Treatment in North Cyprus

• Telangiectasia (spider veins): Fine networks of superficial red-purple vessels with a diameter of under 1 mm. They typically cluster below the knee, on the outer thigh, or around the heel. In most cases they are a cosmetic concern — they cause no pain and carry no health risk. Hormonal factors, pregnancy, prolonged standing, and a family history of venous disease are common triggers.
• Reticular veins: Blue-greenish vessels of 1–3 mm in diameter, slightly raised beneath the skin. Deeper than telangiectasia but still in the superficial layer. They sometimes act as "feeder" veins for clusters of spider veins — which is why treating the spider veins alone can be insufficient; the reticular feeder vessel may also need to be addressed.
• Varicose veins: Enlarged, tortuous vessels with a diameter of over 3 mm that are visibly raised above the skin surface. Behind this presentation there is usually saphenous valve insufficiency (venous reflux). The complaint is not limited to appearance: there may be medical consequences including pain, heaviness, end-of-day leg swelling, itching, and — rarely — skin discolouration and ulceration. This category is the domain of vascular surgery — it is not within our remit.

We determine which category applies to you at examination. In most cases visual assessment is sufficient; duplex ultrasonography (DUS) is recommended in uncertain cases. The fact that DUS is not performed at Nis Clinic is not a limitation — it is a deliberate scope decision: this investigation, and the treatment that follows it (endovenous laser ablation, radiofrequency ablation, great saphenous stripping), is the work of vascular surgery.

Honesty is required here. Nis Clinic is a plastic surgery and medical aesthetics focused clinic. Thread vein and fine reticular vein treatment falls naturally within this spectrum; our treatment aim is aesthetic. Major varicose vein surgery is a separate specialty:

• Within our remit: Telangiectasia (<1 mm spider veins) and reticular veins (1–3 mm) — treated with sclerotherapy and Nd:YAG laser.
• Outside our remit: Varicose veins larger than 3 mm, great saphenous reflux, deep vein thrombosis (DVT) history, venous ulceration, active oedema, and chronic venous insufficiency with skin changes. These require vascular surgery: endovenous laser ablation (EVLA), radiofrequency ablation (RFA), saphenous stripping, and prior detailed duplex ultrasound mapping.

Why does this boundary matter? Because treating only the superficial branches of a large varicose vein when there is an underlying saphenous reflux feeding them will not produce a durable result — the veins return within a short time. Sending such a patient away after collecting a fee is not clinically ethical; referring them to the right centre from the outset is the only responsible course. If a consultation raises suspicion of significant varicose disease, we recommend a vascular surgery assessment and defer treatment until after DUS.

Taking responsibility for the patient's outcome, rather than maximising our own throughput, is part of our clinical character. We are not a clinic that tries to do everything — we are a clinic that knows clearly what it does and what it refers.

Sclerotherapy involves injecting a sclerosing agent (polidocanol or sodium tetradecyl sulphate) directly into the vessel, causing controlled damage to the vessel wall from within, followed by absorption by the body. It is recognised in the international literature as the gold standard for telangiectasia and reticular veins.

Two forms are used:

• Liquid sclerotherapy: Suitable for fine telangiectasia (<1 mm) and small reticular veins. A fine-gauge needle is used to deliver small volumes of agent directly into the vessel.
• Foam sclerotherapy: The sclerosing liquid is mixed with air to form a foam, then injected. Foam has a greater contact surface with the vessel wall; it is more effective than the liquid form in reticular veins of 1–3 mm and small feeder vessels.

Practical advantages:

• Safe for darker skin tones: Unlike laser, it is unaffected by the melanin content of the epidermis. It can be used safely in Fitzpatrick IV–VI skin types — which includes a large proportion of patients at Nis Clinic in Northern Cyprus.
• Quick and in-clinic: A session typically lasts 20–40 minutes. No anaesthesia is required; mild burning and tingling during injection is normal.
• Compatible with combination treatment: Sclerotherapy and laser can be applied in the same session. A typical combination plan is to treat the feeder reticular vein with sclerotherapy, then address the superficial spider web networks with laser.

Limitations:

• Very fine superficial red capillaries (0.1–0.3 mm) may not be accessible with a needle; laser is more appropriate for these structures.
• Uncommon side effects: hyperpigmentation (brown discolouration along the injection track, which may persist for several months), matting (appearance of new fine capillary networks in the treated area — seen in 10–20% of patients), and very rarely skin necrosis (in cases of incorrect injection or agent extravasation).

We share these limitations from the outset; a promise that "everything will go perfectly" is not clinically honest.

Nd:YAG 1064 nm laser passes through the skin surface to target haemoglobin within the capillary. The mechanism: laser energy is absorbed by haemoglobin, generating localised heat within the vessel; the vessel wall contracts in a controlled manner and is gradually absorbed by the body.

Practical characteristics:

• Long wavelength → deeper penetration: 1064 nm affects the melanin of the epidermis relatively little, reaching the vessel at greater depth. This profile enables safe use in Fitzpatrick IV–VI skin types.
• Advantage in very fine capillaries: It is the first-line option for superficial red capillaries in the 0.3–1 mm range, where needle access is difficult.
• For superficial networks unresponsive to sclerotherapy: Some patients retain fine, resistant networks after sclerotherapy; these tend to respond better to laser.

Long-pulse Alexandrite (755 nm) is another alternative cited in the literature for thread vein treatment; however, it is suitable only for Fitzpatrick 1–3 and, given the risk of burns and hyperpigmentation in the darker skin types common among Northern Cyprus patients, it is not our first choice. IPL (intense pulsed light) can be effective on small, superficial red capillaries but has limited efficacy and does not replace Nd:YAG.

For the laser platform and device policy at Nis Clinic, visit our Laser Clinic page. The clinical rationale for laser applications — device selection, Fitzpatrick classification and cooling system principles — is covered in the same framework on our laser hair removal detail page.

Following examination, the treatment plan is generally formed within this framework:

• Diameter <0.3 mm, red, superficial: Nd:YAG laser.
• Diameter 0.3–1 mm, purple-red spider networks: Sclerotherapy (liquid) as first choice; Nd:YAG in patients where needle access is not achievable.
• Diameter 1–3 mm, blue reticular vein: Sclerotherapy (foam) as first choice.
• Feeder reticular vein + superficial spider vein combination: In the same session, foam sclerotherapy to the reticular feeder first, then Nd:YAG laser to the superficial networks.
• Varicose vein >3 mm in diameter, suspicion of reflux: Vascular surgery referral and DUS assessment. We do not initiate treatment.

This algorithm is reassessed for each patient individually. At consultation, we explain clearly what we are planning and why — the patient should understand the rationale behind their own treatment.

At the initial appointment we carry out a full examination and take a medical history. We focus on three areas:

• Vessel classification: Is this telangiectasia, reticular vein or varicose vein? Distribution (one leg or both, below the knee or thigh), colour, diameter, depth. If significant varicose veins are found, we make a vascular surgery referral; for small, superficial presentations, a treatment plan is drawn up.
• Risk factors and contraindications: Pregnancy, breastfeeding, active deep vein thrombosis (DVT) or a history of DVT, prolonged immobilisation, a known condition predisposing to thrombosis (thrombophilia), hormonal contraceptive use, a known allergy to the sclerosing agent, or an active skin infection or ulceration on the leg.
• Skin type and sun history: Fitzpatrick skin type, recent sun exposure, recent tanning. In darker and tanned skin, Nd:YAG is used with care; Alexandrite is contraindicated.

This assessment is sufficient with the naked eye in most patients; imaging is not required. When a large vein is suspected, duplex ultrasonography is recommended — at which point the patient is referred to vascular surgery. DUS is not performed at Nis Clinic; attempting to do so would be an ethically inappropriate overreach.

A typical treatment session, from arrival to departure:

1. Preparation: The leg is cleansed and the patient is positioned on the treatment couch. Vessel mapping is reviewed visually; the starting point is marked.
2. Sclerotherapy: A fine-gauge needle delivers liquid or foam agent into the selected vessel. Mild burning and tingling lasts 10–20 seconds; discomfort after that is minimal. 5–30 injections may be given in a session lasting 20–40 minutes.
3. Laser treatment: If laser is indicated, it is applied after sclerotherapy (or directly if laser only is planned). The patient and practitioner wear protective eyewear. Each Nd:YAG pulse creates a brief sensation of localised warmth; the integrated cooling system protects the epidermis. Laser application takes 10–20 minutes depending on the area.
4. Compression: A compression stocking is fitted at the end of the session (typically medical class II, 20–30 mmHg). Compression promotes collapse of the treated vessel and significantly improves outcomes. The stocking is worn during the day for 7–14 days after the session; the patient receives written instructions on how many days, how to wear it, and when to remove it.
5. Immediately afterwards: The patient stands and leaves as they arrived; a 15–20 minute walk is recommended (beneficial for venous circulation). They may drive and return to work.

Immediately after treatment the vessel may look more prominent; redness, swelling and mild bruising at the injection site are normal. This appearance settles over the following weeks, and the true result emerges over 4–12 weeks. Absorption of a treated vessel is a biological process that cannot be accelerated.

Expected outcomes:

• Telangiectasia: A 70–80% improvement over 2–4 sessions is a typical result. Remaining vessels are finer and paler. "Everything disappears in one session" is not realistic.
• Reticular veins: A marked reduction is seen over 2–3 sessions; treating the feeder vessel reduces the likelihood of surface networks recurring.
• Matting (new capillary networks): New fine networks may appear in the treated area in 10–20% of patients. These generally resolve on their own within 6–12 months or are addressed with a small additional session.
• Hyperpigmentation: Brown discolouration along the injection track occurs in 10–30% of patients; it resolves in most cases within 3–12 months, though in rare instances it may persist longer. The likelihood is slightly higher in darker skin types.

Number of sessions: Typically 2–4 sessions, spaced 4–6 weeks apart. More sessions is not necessarily better — after each session it is correct protocol to wait for the vessel to be absorbed and observe the true result before planning the next.

The rules to follow after treatment have a significant impact on the outcome. We provide these in writing to every patient:

• Compression stocking worn during the day for 7–14 days. It may be removed for showering, sleeping and rest. The stocking class (II, 20–30 mmHg) is selected according to vessel diameter and patient tolerability.
• Hot baths, sauna, hammam, hot showers — avoided for 7–10 days. Heat triggers vessel dilatation and reduces treatment efficacy.
• Strenuous exercise, running and heavy lifting — avoided for 5–7 days. However, daily walking should continue — regular walking supports healing and venous return.
• Sun exposure: The treated area should have no direct sun exposure for at least 4–6 weeks. Sun increases the risk of hyperpigmentation. Beach, swimming pool and tanning are not permitted during this period. In Northern Cyprus, summer treatment is generally planned for the cooler months — September to March — for this reason; for patients with summer holiday plans, we are able to defer sessions to a later date.
• SPF 50+ sunscreen: Daily use, including on exposed areas.
• Hair removal: Shaving the leg is fine; waxing should be deferred for 2 weeks (follicular trauma risk).
• Bruising at injection sites: Resolves on its own within 1–2 weeks. Arnica cream may be used if desired.
• Massage and lymphatic drainage should not be applied to the treated area for at least 2 weeks.

For international patients visiting Northern Cyprus as medical tourists who are planning thread vein treatment: shift your treatment outside the sun season, or be prepared to defer sessions through the summer. A session performed on a tanned leg is both less effective and carries a higher risk of lasting discolouration.

• Spider veins and reticular veins with cosmetic concern: Patients without medical complaints such as pain or swelling, and without significant varicose veins. The clearest outcomes are seen in this group.
• Fitzpatrick I–III (fair to medium skin): Both sclerotherapy and Nd:YAG can be applied safely. The risk of hyperpigmentation is relatively low.
• Fitzpatrick IV–VI (darker skin): Nd:YAG is safe; Alexandrite is contraindicated (risk of burns and hyperpigmentation). Sclerotherapy can be applied regardless of skin tone, though the risk of post-inflammatory hyperpigmentation (PIH) is slightly elevated — agent dose and concentration are selected with care.
• Thread veins that appeared during or after pregnancy: A suitable candidate once breastfeeding has ended and the menstrual cycle has stabilised. Treatment is deferred during pregnancy itself.
• Occupations involving prolonged standing: Nurses, teachers, hairdressers, retail workers and similar professionals are among the most frequent patient groups. Alongside treatment, we recommend regular compression stocking use and periodic rest as lifestyle adjustments.

Under 18: Thread vein treatment is rarely necessary in adolescents; cosmetic concern alone is not an indication. In the uncommon cases where treatment is warranted, parental consent and a specific assessment are required.

In the following circumstances treatment is not performed, is deferred, or requires a specific protocol:

• Pregnancy and breastfeeding: Safety data on sclerosing agents in pregnancy and breastfeeding is insufficient, and the hormonal environment of pregnancy alters treatment response unpredictably. Treatment is deferred until after breastfeeding.
• Active deep vein thrombosis (DVT) or a history of DVT: This is considered an absolute contraindication; sclerotherapy may increase thrombotic risk. These patients are assessed by vascular surgery.
• Known thrombophilia (hereditary clotting disorder): Specific assessment is required; in most cases treatment is not undertaken.
• Active leg infection, cellulitis or ulceration: Deferred until the area has healed.
• Marked leg oedema or signs of chronic venous insufficiency (skin discolouration, ulcer scarring): An underlying large vein pathology is suspected; vascular surgery referral is made.
• Known allergy to the sclerosing agent: If there is a history of allergy to polidocanol or sodium tetradecyl sulphate, an alternative agent is not substituted — treatment is not performed.
• Uncontrolled diabetes, immunosuppression or active autoimmune disease: Risk of impaired healing; a review by the relevant specialist is required first.
• Active tanning or recent sunburn: A minimum of 2–4 weeks must elapse before treatment.
• Large varicose vein (>3 mm) or suspected reflux: Vascular surgery referral; treatment is not initiated pending DUS assessment.
• Active retinol, tretinoin or isotretinoin use: For laser treatment, at least 2 weeks must elapse (6 months for isotretinoin). Not an absolute contraindication for sclerotherapy, but skin response may be altered.

Telling a patient "this is not appropriate for you right now" may look like a missed opportunity — but patient safety sits at the centre of our clinical approach.

Superficial varicose vein and thread vein treatment is within our remit. Large varicose vein surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA) and great saphenous stripping are outside our remit; these procedures require specialist vascular surgery expertise and rely on prior duplex ultrasound mapping.

If we identify suspected significant varicose disease at consultation:

• We do not initiate treatment.
• We refer you to vascular surgery; we provide specific guidance on appropriate centres in Northern Cyprus and in Türkiye.
• After DUS assessment, we can treat any remaining superficial thread veins where they fall within our scope.

This approach protects the patient — in contrast to a "we'll fix it here" mentality. Every clinic has boundaries; knowing those boundaries is part of being a professional. Some patients may prefer the convenience of a quick local fix, but an incorrect intervention is not reversible — we make the right decision from the start.

At Nis Clinic we do not commit to a single technique. The diameter, depth and colour of the vessel determines the plan; we explain to every patient clearly which modality we are using and why.

• For sclerotherapy: Standard polidocanol (or sodium tetradecyl sulphate where indicated) is used; both liquid and foam forms are available. Foam is prepared in line with current clinical standards.
• Nd:YAG 1064 nm laser is applied on a medical-grade platform with an integrated cooling system. The device's safe profile for Fitzpatrick IV–VI is well matched to the patient spectrum at our Northern Cyprus clinics. For device platform details, see our Laser Clinic page.
• Combination treatment in a single session: Sclerotherapy and Nd:YAG laser can be applied in the same visit. This reduces the total number of sessions for the patient and delivers better outcomes in feeder reticular vein plus superficial network combinations.

After each session, the energy settings, agent volume, treatment location and patient response are recorded in the patient's file; the next session is planned on the basis of that record.

The process at Nis Clinic:

• Consultation and candidacy decision: Medical assessment is conducted under physician supervision. The referral decision for suspected large varicose disease or reflux rests with the clinician.
• Treatment delivery: Carried out by a certified practitioner in accordance with clinical protocol. Energy parameters and agent volumes are recorded session by session in the patient's file.
• Complication management: In the event of an uncommon reaction (marked inflammation, vesiculation, suspected necrosis), a physician review takes place the same day; topical or systemic treatment is initiated if required. This clinical safety chain is not available in a beauty salon setting. For Op. Dr. İbrahim Meyzin's full clinical profile, visit the doctor profile page.

Pricing policy. We do not price on a per-pulse or per-flash basis — we charge a per-session package fee. The number of pulses is a technical detail; what matters is the area treated and the outcome.

Current 2026 per-session price ranges (per session, € EUR):

The price within the range is determined by vessel density, the size of the area treated, and whether sclerotherapy, laser or a combination is used. When a typical 2–4 session package is purchased upfront, the per-session price moves from the upper end of the range towards the lower. All sessions include the consultation, the first pair of compression stockings, in-session cooling, and post-treatment care guidance; there are no hidden charges.

International patients wishing to combine a visit to Northern Cyprus with thread vein treatment can find information about our medical tourism packages — though a reminder: sessions planned during the summer season are usually deferred due to the post-treatment sun avoidance requirement. Spring or autumn visitors will find the timing considerably more suitable.

For patients who would like a general health assessment before medical tourism, see our check-up packages. For related laser treatments, visit our laser hair removal and laser pigmentation treatment pages. If you are considering combining thread vein treatment with skin resurfacing, our chemical peel page may also be helpful. To book, reach us via contact or the appointment form.