Advanced Vascular Centre, Mount Elizabeth
#13-06 Mount Elizabeth Medical Centre
+65 6737 1180
Varicose veins, the swollen and twisted veins in the legs
Treatment can close or remove varicose veins, with a small possibility they grow back
Dr Desmond Ooi, a vascular surgeon, sees patients with varicose veins in English, Mandarin, Malay, Hokkien and Cantonese. Most first visits include a duplex ultrasound scan.
Symptoms of varicose veins, from heaviness and cramps to foot swelling
Some people notice only the veins. Others feel symptoms that are often worse after long hours standing or sitting.
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Heavy, tired or aching legs by the end of the day
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Veins that bulge, twist or look dark blue under the skin
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Ankles and feet that swell by the evening
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Itching over the veins or around the ankles
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Cramps in the calf at night
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Darker, dry or thickened skin near the ankle
Night cramps and leg swelling have other causes too, and the scan helps tell them apart.
Causes of varicose veins, from faulty vein valves to long hours standing
Who is more likely to get varicose veins
Swollen, twisted leg veins are common, and some people are more likely to develop them:
- People whose parents or siblings have them
- Older adults
- Women, including during pregnancy
- People who are overweight
- People whose work keeps them standing for long hours
- People who have had a blood clot in a deep vein
- People with May-Thurner syndrome, in which an artery presses on the main vein from the left leg
How varicose veins are checked with a duplex ultrasound scan
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Dr Ooi asks about your symptoms and examines your legs while you stand, when the veins show most clearly.
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The duplex ultrasound scan takes around 20 to 30 minutes, usually standing, with gel on the skin and a handheld probe. It shows the veins and the direction the blood is flowing in them, so it finds:
- Which valves leak, and where
- Which veins are affected
- Whether the deep veins are working normally
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Any treatment is planned from these findings.
Complications of varicose veins, including bleeding, clots and skin changes
Many of these veins cause no harm beyond how they look. In some people, years of raised pressure in the vein affect the skin and the vein itself:
- Darker, dry or thickened skin near the ankle, sometimes with eczema
- An open sore near the ankle, a venous leg ulcer
- A painful, red, tender vein, when a clot forms inside it
- Bleeding from a vein close to the skin
After the scan: no treatment, compression stockings, or a procedure
No treatment for now
Varicose veins are not life-threatening, so veins that cause little trouble can be left alone.
Compression stockings
Stockings can ease the aching and swelling while you wear them. They do not repair the faulty valves. Vein tablets can also ease how the legs feel, but they do not close or remove the veins.
A procedure
When the symptoms, skin changes or scan point to it, the faulty vein is closed from inside or removed.
Which of these suits you depends on your symptoms, the scan, your general health and your own choice.
Varicose vein treatments Dr Ooi offers
Closing the faulty vein from inside, through a needle puncture, is now the usual first choice: it needs no cut and no general anaesthetic, and people return to work sooner. Most of these treatments are day procedures.
Dr Desmond Ooi is a General Surgeon whose clinical interest is vascular surgery
BM (Southampton), MMed Surgery (NUS), FRCS (Edinburgh)
He received specialised vascular and endovascular training in the UK, and was formerly Patient Safety Officer at Khoo Teck Puat Hospital.
Costs, MediSave and insurance for varicose vein treatment
For varicose vein day surgery that is medically indicated, MediSave may help, and an Integrated Shield Plan may also cover it, subject to your plan and panel.
Corporate
Personal
Vascular clinics at Mount Elizabeth and Mount Alvernia
Advanced Vascular Centre, Mount Alvernia
Medical Centre D, #07-58, 820 Thomson Road
+65 6265 8820
Questions patients ask about varicose veins
Most are not. Some lead to skin changes, an ulcer near the ankle, a painful inflamed vein or bleeding.
If your legs ache, swell or change colour, a scan shows whether the veins are the cause.
Some causes, such as your genes and your age, cannot be changed.
Walking, raising your legs when you rest and compression stockings can ease the aching and swelling.
Compression stockings ease the aching, heaviness and swelling while you wear them, and they are often tried first.
They do not repair the faulty valves, so the veins remain.
Spider veins are a different, smaller kind: tiny red or blue veins in the skin, up to about 1 mm across.
They are usually treated for how they look.
After radiofrequency ablation or endovenous laser treatment, two of the minimally invasive vein treatments, patients usually walk straight away and go home the same day.
Open surgery takes longer to recover from, so ask about yours at the consultation.
For varicose vein day surgery that is medically indicated, MediSave may help, and an Integrated Shield Plan may also cover it, subject to your plan and panel.
Start with a question
If you are unsure whether your veins need a scan, message the clinic.
You can ask before you arrange anything.
Family members can also message on a patient's behalf.