Guide To Varicose Veins In Singapore

Varicose veins are enlarged, twisted veins that usually appear in the legs and feet. They occur when the valves in the veins become weak or damaged, causing blood to pool and veins to enlarge. While often considered a cosmetic issue, they can cause discomfort and lead to more serious health problems.

Varicose Veins Singapore Statistics

Varicose veins are quite common in Singapore, reportedly affecting more than 1 in 3 people in Singapore. Women are more susceptible, with around 35% of women experiencing the condition compared to 20% of men. It is also more prevalent among older adults and those with jobs requiring prolonged standing or walking.

Causes And Risk Factors

Varicose veins may be caused by:

• Weakened Valves: Blood flows towards the heart in the veins. In the veins are one-way valves that prevent backflow of the blood. When the valves become weakened or are damaged, blood can collect in the veins, causing the veins to become enlarged.
• Prolonged Standing: Standing for extended periods can result in blood pooling in the veins in the leg. This causes increased pressure within the veins – stretching them, weaken the walls of the veins, and damage the valves.

Risk factors for developing varicose veins include:

• Obesity.
• Older age.
• Female.
• Inactive lifestyle.
• History of leg injury.
• Pregnancy.
• Smoking.
• Taking oral contraceptive pills or on hormone replacement therapy.

Symptoms Of Varicose Veins

Varicose veins are characterised by twisted, enlarged veins that often appear on the legs. They result from weakened valves within the veins that impede proper blood flow, causing blood to pool and veins to swell. The symptoms may include:

• Visible Veins: Prominent, dark blue or purple veins that are easily noticeable under the skin.
• Swelling and Heaviness: Legs may feel heavy, especially after standing or sitting for long periods.
• Pain and Discomfort: Aching or throbbing pain in the legs, often accompanied by burning or itching sensations.
• Skin Changes: The skin around varicose veins might become dry, itchy, and discolored. In severe cases, ulcers may develop.
• Muscle Cramps: Frequent leg cramps, particularly at night.

These symptoms can range from mild to severe and may worsen over time, highlighting the importance of early detection and treatment.

Screening & Prevention

Routine medical exams can help identify varicose veins early. Diagnosis typically involves a physical examination by a healthcare professional, who will assess the affected area while you are standing to check for swelling and visible veins. Further diagnostic procedures may include:

• Ultrasound: A doppler (duplex) ultrasound is a common non-invasive test that uses sound waves to visualize blood flow and check for any clots or blockages.
• Venogram: In rare cases, a venogram might be used. This involves injecting a contrast dye into the veins to provide detailed X-ray images of the veins in the legs.

Learn More: Varicose Veins Screening >>

There are actions that can be taken to prevent or lessen the worsening of existing varicose veins:

• Avoid prolonged periods of sitting or standing.
• Regular physical activity improves blood circulation.
• Elevating your legs when resting can reduce swelling.
• Wearing compression stockings can help improve blood flow.
• Maintaining a healthy weight reduces pressure on veins.

Varicose Veins Treatments

There are several effective treatment options available in Singapore, ranging from minimally invasive procedures to more traditional surgical methods:

• Compression Stockings: These are the first line of treatment for varicose veins. They apply gentle pressure to the legs, helping to improve blood flow and reduce swelling. Compression stockings are often recommended for mild cases and can be used as a preventive measure.
• Lifestyle Changes: Simple lifestyle modifications can help manage varicose veins. Regular exercise, maintaining a healthy weight, and avoiding prolonged periods of standing or sitting can all contribute to better vein health.
• Venotonic Medications: Certain drugs can be taken to improve vein health and symptoms.
• Sclerotherapy: This minimally invasive procedure involves injecting a solution into the affected veins, causing them to close. Sclerotherapy is commonly used for smaller varicose veins and spider veins.
• Echotherapy: This non-invasive treatment uses high intensity focused ultrasound to heat and seal off the veins. This procedure is performed under local anesthesia and typically involves a quick recovery time.
• Endovenous Laser Ablation (EVLA): EVLA uses laser energy to heat and close off the affected veins. This procedure is also performed under local anesthesia.
• Endovenous Radiofrequency Ablation (RFA): Similar to EVLA, RFA uses radiofrequency energy to heat and seal the veins.
• MechanicO-Chemical Ablation (MOCA): This treatment option combines the mechanical action of a small catheter (tube) placed in the varicose vein and the chemical action of a sclerosing agent, to seal off veins.
• Surgical Options: In more severe cases, surgical procedures such as microphlebectomy, saphenofemoral junction ligation, or great saphenous vein stripping may be necessary. These procedures involve removing or tying off the affected veins and are typically reserved for larger or more problematic veins.

Health Implications Of Untreated Varicose Veins

While many people seek treatment for varicose veins due to their appearance, ignoring this condition can lead to serious health issues. Potential complications include:

• Swelling: Untreated venous disease manifested as varicose veins often cause generalised swelling of the limb affected. This can create heaviness in the leg, poor skin quality, uneven limb size, increased blood pressure, pain and significant discomfort. Many symptoms will manifest towards the end of the day when pooling and gravity has made it difficult for the body to manage the swelling.
• Decrease in skin quality: Prolonged swelling may lead to significant degradation of the skin. The swollen tissue can restrict oxygen and nutrient flows that are needed for normal healing process. This results in the surrounding skin becoming less likely to heal from minor injuries in the area.
• Skin Ulceration: Persistent swelling and skin deterioration due to varicose veins can result in non-healing ulcers. Wounds that would otherwise heal through blood flow normally, can turn into skin ulcers that are difficult for the body to heal.
• Superficial Thrombophlebitis: This inflammatory process causes blood to clot within the vein and forming a blockage. When this happens to superficial veins near to the skin’s surface, it results in a condition called superficial thrombophlebitis. Symptoms of superficial thrombophlebitis usually include pain in the affected area and hardening of the vein. The affected area is also warmth to the touch.
• Deep Vein Thrombosis: This happens when a blood clot is created in the deep veins and creates a blockage. DVT is a serious medical condition and always requires medical attention. There is a danger that a part, or all of, the blood clot breaks off and travel to the lungs, resulting in a pulmonary embolism, which is life threatening.

Costs of Screening and Treatment

The cost of screening and treatment for varicose veins can vary:

• Screening: A duplex ultrasound to diagnose varicose veins typically costs around S$250.

The cost of varicose vein treatment in Singapore varies depending on the type of procedure and the severity of the condition. Here are some estimated costs:

• Compression Stockings: Prices range from S$30 to S$50 a pair, depending on the type and brand.
• Surgical Options: The surgeon’s fee for vein stripping and ligation ranges from S$3,000 to S$5,000, not including facility or equipment fees.

Learn More: Varicose Veins Treatment Costs In Singapore >>

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FAQs

Are varicose veins dangerous?

While often not dangerous, varicose veins can cause discomfort and lead to complications like skin ulcers and blood clots.

Can they be prevented?

Yes, through regular exercise, maintaining a healthy weight, and avoiding prolonged periods of standing or sitting.

What are the treatment options for varicose veins?

Treatment options include lifestyle changes, compression stockings, sclerotherapy, endovenous laser therapy, and surgery.