Phlebology: how veins are examined and when to see a phlebologist
Heaviness in the legs by evening is often written off as fatigue. But behind it there are frequently altered veins, and the later treatment starts, the more difficult it becomes.
Phlebology deals with veins: their diagnosis and treatment. It covers varicose veins, chronic venous insufficiency, and spider veins.
Chronic venous insufficiency is widespread: by some estimates, 2-5% of the population in Western countries is affected (as of Flexikon, 09/2026). Vein examination is painless, and most procedures are performed on an outpatient basis. Below we look at what a phlebologist does, how the examination works, and which methods are used today.
What phlebology is and who needs it
💡 In short:
- Phlebology studies veins: varicose veins, venous insufficiency, and spider veins.
- Diagnosis starts with duplex ultrasound scanning of the veins, and it does not cause pain.
- Treatment is chosen based on the diagnosis: compression, sclerotherapy, laser, or radiofrequency.
- Diagnostic and treatment methods: 10/2026, according to AWMF.
Phlebology is the branch of medicine concerned with veins. A phlebologist treats varicose veins, chronic venous insufficiency, and intradermal spider veins.
It is not only about large truncal veins in the legs. Small intradermal vessels are also part of a phlebologist's work. Diagnosis and treatment of varicose veins in Germany are described in a clinical guideline from the AWMF registry.
People see a phlebologist with visible altered veins, heaviness in the legs, and swelling. An examination does not replace diagnostic testing: complaints need to be confirmed with imaging, otherwise the diagnosis rests on guesswork.
Symptoms: when to see a phlebologist
Veins often do not hurt even when changes are already visible. The first signs are easy to miss.
- Heaviness and tiredness in the legs by evening.
- A feeling of fullness and swelling in the calf area.
- Night cramps in the calves.
- Bulging veins and nodules, as well as spider veins.
- Itching and darkening of the skin over the veins.
If you notice two or more signs, it is worth booking an examination. You do not have to wait for pain: in the early stage there may be none. Without treatment, venous insufficiency can lead to thrombosis, permanent skin changes, and trophic ulcers.
The causes of the condition vary: heredity, prolonged standing or sitting, excess weight, pregnancy. That is why a visual examination alone is not enough; it is important to understand the condition of the specific veins.
HCG Klinik in Zurich
In Zurich, phlebology is practiced at HCG Klinik. According to the clinic's description, its specialists examine veins using color duplex ultrasound and choose treatment based on the results.
The clinic lists several methods: compression therapy, sclerotherapy, laser and radiofrequency procedures. All interventions, according to its information, are performed on an outpatient basis. HCG Klinik describes its services on the page phlebology in Zurich.
Consultations are held at two locations: in Zurich and in Feuertalen. Follow-up after procedures includes check-up examinations and recommendations on movement, nutrition, and compression stockings. This is information provided by the clinic itself, so it is best to clarify your questions about the conditions when booking an appointment.
How vein diagnosis works
A vein examination takes little time and requires no preparation. The doctor asks about your symptoms and examines your legs while you are standing.
The main examination method is color duplex ultrasound. The probe shows the direction of blood flow and how the valves are working, so it is clear which specific vein is not functioning properly.
Based on the results, you receive a treatment plan. It depends on whether the truncal veins are affected or only small vessels. For superficial changes the plan will be shorter; for truncal veins a separate procedure will be needed.
Treatment methods: from compression to laser
The method is chosen based on the diagnosis and the extent of the changes. For superficial veins, minimally invasive procedures are sufficient; in severe forms, surgery may be an option.
Method | How it works | Who it suits |
|---|---|---|
Compression therapy | Supports the vein walls, reduces swelling | Early stages, pregnancy |
Sclerotherapy | A medication closes the vein from the inside | Spider veins, small veins |
Laser ablation | The laser seals the vein through a puncture | Truncal veins |
Radiofrequency ablation | The vein is closed with heat from the inside | Truncal veins |
Surgery | The altered vein is removed | Advanced forms |
The German Society of Phlebology and Lymphology (DGPL) describes laser and radiofrequency therapy as suitable for truncal veins. Advantages: few side effects and a short recovery period (according to DGPL, 09/2026).
This material does not replace a consultation with a specialist. The choice is made based on the results of your examination, not on a description from the internet.
Prevention and follow-up after treatment
Venous insufficiency tends to return. After procedures, it is important to move every day and not stand for hours without a break.
- Walk for at least half an hour a day.
- Wear compression stockings as indicated by your doctor.
- Drink enough water and watch your weight.
- Take breaks during sedentary work and elevate your legs.
- Attend the follow-up examinations your doctor schedules.
In Switzerland, phlebologists are represented by the Swiss Society of Phlebology (SGP). Prevention does not replace the treatment plan your doctor will draw up for you.
⁉️🤔 Frequently asked questions
What does a phlebologist treat?
A phlebologist deals with veins: varicose veins, chronic venous insufficiency, and spider veins. They examine the veins, make a diagnosis, and choose the appropriate therapy. If the changes affect only small vessels, sclerotherapy or compression is often sufficient. If the truncal veins are affected, laser or radiofrequency treatment is discussed.
Is a vein ultrasound painful?
No. Color duplex ultrasound is not associated with pain: you lie or stand while the doctor moves the probe over your skin. The procedure takes a few minutes and does not require any punctures. No preparation is needed either. If standing for a long time is uncomfortable for you, tell the doctor in advance.
Can varicose veins be removed without surgery?
Often yes, but the doctor decides based on the examination results. Open surgery is reserved for advanced forms. For truncal veins, minimally invasive methods are used: laser and radiofrequency ablation. Small veins and spider veins are removed with sclerotherapy. These procedures are performed on an outpatient basis, and recovery takes less time than after surgery.
When should I see a phlebologist?
Book an appointment if you see bulging veins or nodules, or feel heaviness and swelling by evening. Night cramps in the calves and darkening of the skin over the veins are also reasons to go. An early examination helps detect changes in time. You do not need to wait until it becomes painful.
Do compression stockings help?
Yes, when properly fitted. Compression stockings support the vein walls and reduce swelling. They are worn as indicated by a doctor, not as a precaution just in case. An incorrectly chosen size provides no benefit. The pressure level and compression class will be determined by your doctor after the examination.
In short: how to choose a phlebologist
Look at three things: how the clinic examines veins, which methods it lists, and how it organizes follow-up after procedures. Duplex ultrasound should definitely be on the list of services: without it, the diagnosis rests on a visual examination alone.
Ask who will perform the procedure and what follow-up is planned afterwards. If the clinic answers evasively, look for another one. Before any procedure, clarify whether a follow-up examination is included in the treatment plan.
A small editorial team writing guides for independent travel. We travel ourselves, but we haven’t been everywhere, so we check prices, opening hours and how to get there against official sources.