The reason varicose veins developed is not fully understood. The basic problem appeared to be that of damaged valves. Normally, the veins transport blood from the leg to the heart. In order for this to be possible, it has one-way valves to allow blood to travel in only one direction. In varicose vein, these valves have failed. Without the proper valve function, the blood tends to flow down (leaky), giving rise to blood pooling in the leg, thus causing the vein to bulge.

People who have varicose veins often have an inherited weakness of this valve. They may also give history of prolonged standing at work or multiple pregnancies, situations that will cause significant stress on the veins in the leg. These ultimately cause the veins to stretch and the valves to fail.

^ Back to Top

These can be grouped into:

• • • Asymptomatic-some patients has no symptoms at all apart from the veins being unsightly. They are usually very active physically and their active leg muscles compensate for the weakness of the vein function.
    • Mild symptoms-aching and cramps in the leg, itchiness near the area of the veins and swollen ankle. All these are worse with prolonged standing.
    • Severe symptoms and complications – leg ulcers, bleeding and thrombophlebitis.

^ Back to Top

This may not always be possible; however some simple measures and changes in our lifestyle can potentially delay the onset of varicose veins.

• • • Regular exercise will improve circulation and strengthen the veins. Focus on exercises that work your legs, like walking or running.
    • Watch your weight. Obesity can put a lot of pressure on the legs and is known to cause spider veins.
    • Do not cross your legs when sitting.
    • Elevate your legs when resting or sleeping.
    • Try not to sit or stand for long periods of time. When you have to sit for a long time, get up and take a walk every now and then.
    • Wear elastic support stockings as much as you can.
    • Avoid wearing tight clothing and high heel shoes.
    • Eat a well balanced diet with sufficient fibres and cut down on salt intake.

^ Back to Top

Varicose veins are not only an appearance issue, untreated it can progress and give rise to other medical problems. There are many reasons why you should seek treatment if you have varicose veins.

• • • Progressive Disease: Varicose veins are a progressive problem, it will not go away. No amount of cream or medication can cure it. Stocking and leg elevation will relieve the symptoms and slow the progression but they don’t cure your veins.
    • Pain and Aches: Varicose veins can be initially asymptomatic, as it progresses, you will begin to experience significant discomfort in the form of aches, cramps and swollen ankle.
    • Leg Ulceration: If you see pigmentation and spider veins around the ankle, it may means that your varicose veins are fairly advance and there are significant risk that it may developed into leg ulceration.
    • Current Treatment is non-invasive: In the last 10 years, treatment of varicose veins has evolved from one where you need to undergo major invasive surgery to one where you can walk into the clinic, have the treatment under local anaesthesia and walk out 1-2 hours later without so much of an incision scar.
    • Insurance cover: Varicose Veins are a medical condition and should be covered by your insurance if you have one.

^ Back to Top

There are basically four types of treatments offered by different practitioners:

• • • Stripping surgery: Under General Anaesthesia a few incisions are made to isolate the vein and the whole vein is yanked off. This is no longer popular because it is considered to be very invasive and carries significant complication rate.
    • Ultrasound Guided Foam Sclerotherapy: Here, instead of removing the varicose veins, a strong chemical foam is injected into the varicose veins to try and close it. This method is attractive because it is cheap and not invasive. However it requires many treatment session and it has very high recurrence rate.
    • Local avulsions: The varicose veins are avulsed under local anaesthesia using small incisions. This method only treat the visible veins and does not address the deeper varicose veins. They will invariably recur within a few months.
    • Endovenous Laser Treatment: With this one time treatment, a fine laser wire is inserted into the veins under Ultrasound Guide. Laser pulses are fired to constrict and close the varicose veins . This treatment eliminate the veins without any surgery, general anesthesia or hospitalisation. Patient can walk immediately after that and there are no visible scars once the needle marks have healed.
    • VNUS closure: This is fairly similar to EVLT, except instead of using laser wire, Radiofrequency is used instead.

^ Back to Top

The Varicose Veins you see on your legs are just the tip of the iceberg. There are usually 1 or 2 deeper varicose veins that is the source of all your problems. These usually run from the groin to the ankle and are usually not visible because they are very deep. To achieve a proper and complete treatment, these deeper varicose veins must be addressed.

Therefore for effective treatment, an Ultrasound examination is necessary to identify and map out these hidden veins. This examination is painless and can be performed in less than 10-15 minutes.

During consultation, Dr. John Tan will assess your varicose veins and if necessary, he will performed the Ultrasound examination during the same consultation and explain the finding to you realtime.

Base on clinical examination and Ultrasound finding, he will decide on an individualize treatment regime that is best suited to your conditions. This usually involve combinations of Endovenous Laser Treatment or VNUS Closurefast and Needle Phlebectomy or Foam Sclerotherapy.

In THE VEIN CLINIC, we have been treating varicose veins with good result and has experience no significant complications.

Read more about Endovenous Laser Treatment.

^ Back to Top