Varicose Veins and Spider Veins
At the Supreme Vascular and Interventional Clinic, we specialize in cutting-edge treatments with advanced diagnostics for varicose veins. Our compassionate vascular specialist, Dr. Manish Taneja, is here to provide personalized care and tailor-made solutions just for you. Don’t let varicose veins hold you back any longer.

Overview
Blood circulation to the legs involves two systems broadly. First is the arterial system taking blood to the legs from the heart carrying oxygenated blood. Second is the venous system taking deoxygenated blood from the legs to the heart. This venous system comprises two parts: superficial venous system under the skin and deep venous system next to the bones and the deep muscles.
Varicose veins is a condition that affects these superficial veins under the skin. Normal healthy veins have valves inside that help to maintain continuous blood flow to the heart. These valves can get damaged or diseased leading to venous reflux disease. Varicose veins develop as a result of venous reflux disease.
The Two Types of Varicose Veins
They are most commonly seen in the legs. There are two types of varicose veins seen commonly seen in practice.
- Swollen enlarged bulging veins under the skin
- Spider veins that look like a fine network of red or blue lines just under the skin.

Symptoms of Varicose Veins
These are simply not a cosmetic issue. Varicose veins and venous reflux disease can lead to significant physical problems. These include heaviness, fatigue, aches and pains, and cramps in the legs. These can also lead to swollen legs. In more severe cases, these can cause skin changes such as dermatitis/ eczema and ulcers affecting the legs, besides causing recurrent infections.
Some patients with varicose veins present with acute pain, tenderness and redness overlying the veins that is called as thrombophlebitis (acute inflammation and clotting of the varicose veins).
Spider veins can cause itching and aching pain in the affected part that can be quite significant.
Causes and Risk Factors
Spider veins develop when the valves inside veins weaken or sustain damage. Once the valves become defective, blood may have difficulty flowing in the correct direction and may back up in the veins. This creates pressure in the veins, which is transferred to the small branches, causing them to weaken, expand and show through the skin. While it is not clear why this happens, some known causes include:
- Hormonal changes
- Connective tissue diseases
- Genetic syndromes
- Injury or trauma
Spider veins do not typically cause any symptoms. However, in rare cases, the condition may cause:
- Itching
- Burning
- Cramping
- Legs that feel tired
- Pain
How Is a Varicose Veins Diagnosed?
Varicose veins are diagnosed through a combination of clinical assessment and duplex ultrasound, which is considered the gold standard for evaluating venous disease.
Your consultation may include:
- A review of your symptoms and medical history
- Discussion of your occupation, activity levels, and lifestyle
- Examination of the affected veins
- Assessment of your circulation
- Duplex ultrasound to evaluate blood flow and identify venous reflux
Rather than focusing only on the veins that are visible on the surface, duplex ultrasound helps identify the underlying source of the problem. Understanding which veins are affected and how blood is flowing allows your vascular specialist to recommend the most appropriate treatment strategy.
Varicose Veins Treatment Options
There are various techniques available to treat varicose veins depending on clinical presentation such as minimally invasive treatment options. We offer specialized care for varicose veins treatments at the Supreme Vascular and Interventional Clinic in Singapore.
Non-Procedural Management
- Conservative medical management / compression
Endovenous Treatments
- EVLT
- RFA
- ClariVein®
- VenaSeal™
- Microwave Endovenous Ablation
Surgical / Vein Removal
- Open surgery
- Venous avulsions / ambulatory phlebectomy
Injection-Based Treatments
- Sclerotherapy
- Cryolaser & cryosclerotherapy
Prevention of Varicose Veins
Chances are you or someone you know may develop varicose veins or already have them. Knowing how to prevent them is essential. If you already have varicose veins, you may want to learn how to prevent them from getting worse. This will help you to avoid the discomfort, pain and complications associated with them. To keep your legs healthy, it is important to understand how varicose veins occur, whether they are preventable and the best treatment options.
If questions like “How can you stop getting varicose veins?” or “Can you fix varicose veins?” are going through your mind, read our “How to Prevent Varicose Veins: Best Practices to Follow” blog post where we’ve curated some of the best practices to follow, exercises to reduce varicose veins, slow the condition’s progression, and answers to important questions.
Frequently Asked Questions
When should you see a Varicose Vein specialist in Singapore?
Visible varicose veins are not always a medical emergency, but persistent symptoms should not be ignored.
You should consider seeing a vascular specialist if you experience:
Aching or heavy legs, particularly after prolonged standing
Swelling around the ankles or lower legs
Throbbing, burning, or itching over visible veins
Night cramps or restless legs
Skin discolouration or eczema around the ankles
Bleeding from varicose veins
Slow-healing wounds or venous leg ulcers
Recurrent inflammation of superficial veins (superficial thrombophlebitis)
Progressive enlargement of varicose veins
Symptoms that interfere with work, exercise, or daily activities
Many people assume these symptoms are simply part of ageing or prolonged standing. However, they may indicate chronic venous insufficiency, where damaged vein valves allow blood to flow backwards (venous reflux), increasing pressure within the veins.
Early assessment can help determine the cause of your symptoms and whether treatment or ongoing monitoring is appropriate.
Do I really need treatment for Varicose Veins?
One of the most common questions patients ask is:
“Do I actually need treatment?”
The answer depends on several clinical factors rather than appearance alone.
Your vascular specialist will consider:
Your symptoms and how they affect daily life
Duplex ultrasound findings
The severity of venous reflux
The size and location of the affected veins
Whether skin changes or complications have developed
Previous vein treatments
Your overall health and medical history
Your lifestyle and treatment goals
For some patients, conservative measures and observation may be appropriate. Others may benefit from minimally invasive treatment to relieve symptoms, improve circulation, and reduce the risk of disease progression.
The goal is to recommend treatment only when it is likely to provide meaningful clinical benefit.
What are the treatment options for Varicose Veins?
Modern varicose vein treatment has evolved considerably, with many patients now suitable for minimally invasive procedures that do not require traditional vein stripping surgery.
Treatment options may include:
Conservative Management
Lifestyle modification, regular exercise, leg elevation, weight management, and compression stockings may help relieve symptoms and slow the progression of venous disease for selected patients.
Endovenous Laser Treatment (EVLT)
EVLT uses laser energy delivered through a small catheter to seal the affected vein. Blood is naturally redirected into healthier veins, improving circulation and relieving symptoms.
Radiofrequency Ablation (RFA)
RFA uses controlled heat generated by radiofrequency energy to close the diseased vein. It is another well-established minimally invasive treatment for venous reflux.
Medical Adhesive (Vein Glue)
Vein glue uses a specialised medical adhesive to close the affected vein without the need for heat. This option may be suitable for selected patients depending on their vein anatomy.
Ultrasound-Guided Foam Sclerotherapy
Foam sclerotherapy involves injecting a specialised medication into affected veins, causing them to collapse and gradually be absorbed by the body.
There is rarely a single “best” treatment. The most appropriate option depends on your ultrasound findings, vein anatomy, symptoms, and individual treatment goals.
Can Varicose Veins be left untreated?
Yes, in some cases. Not every patient requires immediate intervention, particularly if symptoms are mild and ultrasound findings do not suggest significant venous disease.
However, untreated varicose veins may gradually progress over time.
Possible complications include:
Persistent leg swelling
Skin pigmentation changes
Venous eczema
Lipodermatosclerosis
Bleeding from superficial veins
Venous leg ulcers
Recurrent superficial thrombophlebitis
Regular review helps determine whether conservative management remains appropriate or whether treatment should be considered.
What should you expect after Varicose Vein treatment?
Recovery following minimally invasive varicose vein treatment is often quicker than many patients expect.
Most patients are encouraged to walk soon after treatment and can gradually resume normal daily activities according to their specialist’s advice.
Your recovery plan may include:
Wearing compression stockings if recommended
Walking regularly to encourage healthy circulation
Avoiding strenuous activities for a short period if advised
Attending follow-up appointments
Monitoring for symptom improvement
Although treated veins usually do not return, varicose veins are part of a chronic venous condition, and new veins may develop over time. Maintaining a healthy lifestyle and attending follow-up reviews help support long-term vein health.
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