Frequently Asked Questions
Varicose Veins, Spider Veins and Venous Reflux
Varicose veins are enlarged, twisted veins that are visible under the surface of the skin. They often appear in the legs and can cause discomfort, pain, or swelling.
Spider veins are smaller, more superficial veins that often appear as blue, purple, or red lines on the skin surface. They are typically not painful but can be cosmetically bothersome to some individuals.
Several factors contribute to the development of varicose and spider veins, including age, genetics, hormonal changes, pregnancy, obesity, and prolonged periods of standing or sitting.
While spider veins are generally harmless, varicose veins can sometimes lead to complications such as bleeding, blood clots, and ulcers. It is advisable to consult with a healthcare provider for diagnosis and treatment options.
Approximately half of the population has some form of venous disease while varicose veins affect one out of two people age 50 and older, and 15-25% of all adults. On average 18% of men and 25% of women develop varicose veins. Varicose veins are one of the most common venous issues affecting the world today.
Anyone can develop spider or varicose veins, but they are more common in those above 50 years old, females, individuals with a family history, and those with certain lifestyle factors like a high BMI, desk-bound work environments, or in occupations which require you to stand for long periods of time.
Here are some physical symptoms of varicose veins that make them easier to diagnose:
- Itchy or flaky skin around the affected vein, sometimes accompanied by a burning sensation,
- Feeling of heaviness or ache in the lower legs after standing or sitting for long periods of time (usually worse at end of day, with comparative relief in the morning),
- Muscle cramps or pain in the lower legs, and,
- Swelling around the ankles – the ankle area appears puffy and swollen, and the ankle bone may not be visible
Not all of these symptoms are present in the same person. However, if you fit the above description, or if you have one or more of these symptoms, it is likely you have varicose veins. These symptoms can take a toll on your quality of life, making it hard to do things like walking or even standing for long periods.
Fortunately, modern minimally-invasive surgical methods have made the treatment of varicose veins quick and easy. Feel free to reach out for a personalised assessment and consultation should you have any of the above concerns.
While not all people present with severe symptoms, varicose veins generally worsen over time. Initially, slight heaviness and discomfort in the affected leg will be felt. If untreated, this pain may increase and result in limitations in walking and cramping during the night. Eventually, varicose veins can lead to skin discolouration or open wounds (ulcers) around the ankles.
Your healthcare provider will usually diagnose these conditions based on a physical examination. Additional tests like ultrasound may be recommended to assess the presence of venous incompetency (reflux), and rule out other issues.
An ultrasound is the most common diagnostic test for varicose veins. Some patients may require a CT (Computed Tomography) scan of your abdomen may be indicated to evaluate for compression of your pelvic veins.
Treatment options may include lifestyle changes, compression stockings, minimally invasive procedures like sclerotherapy, radiofrequency ablation therapy, and surgical interventions like vein stripping.
Generally, spider veins are treated with less invasive methods like injection sclerotherapy or radiofrequency treatment. Spider veins usually require a few sessions of sclerotherapy to resolve.
Varicose veins may additionally require more extensive treatment like mini-stab avulsions (for removal) depending on their extent and severity.
Coverage varies by insurance provider and plan. It is essential to consult your insurance to determine what treatments are covered, especially since some treatments may be considered cosmetic.
Clinical results have been published documenting the success of Endovenous Radiofrequency Ablation, ClariVein and VenaSeal at above 90% and Sclerotherapy between 60-80%.
As with any medical treatment, each method has its own risks and benefits. Your surgeon will explore the most suitable treatment option, after a thorough assessment of your condition.
Sclerotherapy is commonly used to treat spider veins (small superficial veins) and has been used with safety and success since the 1930’s. This treatment is a non-surgical procedure, and can be performed in the outpatient clinic.
Using a very fine needle, a solution is injected into the vein. This solution causes the vein walls to stick together and eventually close. The obliterated vein is absorbed by the body over time.
Following sclerotherapy, there is very little to no downtime. Patients will be required to wear a compression stocking for the next week. They can return to work or carry on with normal activities straight away. Some patients may experience gentle bruising at the treated area, especially those with thin and lighter skin.
Patients should wait at least three months after pregnancy before being treated for venous insufficiency. Patients who have suppressed immune systems, deep vein thrombosis, and patients who are immobile (ie cannot walk or move around), are generally not good candidates for treatment and will require further evaluation to assess their suitability.
Recovery depends on the treatment method used. Minimally invasive treatments usually have shorter recovery times. Most patients will be able to walk on the same day after their surgery. Traditional open surgical treatments (eg open stripping of vein) may require a longer period for full recovery.
Yes. There is a possibility that new varicose or spider veins may develop over time even after successful treatment, particularly if underlying risk factors are not addressed. Risk of recurrence is usually around 5-10%.
This depends on the type of treatment you undergo. For minimally invasive treatments, most people can return to normal activities relatively quickly in a day or two. Vigorous exercise is usually not recommended till 2 weeks post-surgery. Traditional open surgical treatments may require a longer period for full recovery.
Most treatments aim to reduce the appearance and symptoms of varicose and spider veins significantly, but results can vary from person to person.
While many people seek treatment for cosmetic reasons, treatment can also alleviate symptoms like pain, swelling, and itching associated with varicose veins.
You can schedule a consultation by:
- Calling our clinic at +(65) 6694-2282,
- Leaving us a Whatsapp message +(65) 9727-0788,
- Emailing contact@drdarryllim.com, or
- Using our contact form [go to contact page]
During your first consultation, your vascular surgeon will examine your veins, discuss your symptoms, go over your medical history, and possibly recommend additional tests. A personalized treatment plan will then be discussed.
Peripheral Vascular Disease
Peripheral Vascular Disease (PVD) is a blood circulation disorder, where blood vessels outside the heart—usually the arteries—experience narrowing or blockage, often affecting the legs and feet. This typically occurs due to atherosclerosis, a build-up of fatty deposits (plaque) on the vessel walls, leading to reduced or obstructed blood flow.
Anyone can develop PVD, but it’s more common in people over 50, smokers, diabetics, and those with high blood pressure or high cholesterol. Early detection and treatment is the best way to slow down progression of the disease and reduce your chances of irreversible tissue loss.
If you’re experiencing leg pain while walking, numbness, or sores that aren’t healing, you might have PVD. But don’t worry – Dr. Lim is here to help diagnose and treat your condition, getting you back on your feet in no time!
To diagnose PVD, Dr. Lim might recommend a range of tests like an ultrasound, blood tests, or an angiogram. These are pretty straightforward and will help in crafting your treatment plan by identifying which blood vessels are blocked and how severe the blockage is.
Poorly healing wounds can be a sign of reduced blood flow due to PVD, especially in patients suffering from diabetes. Patients with diabetes also often have diminished sensation in their feet due to nerve damage (neuropathy), making them more likely to injure themselves. It’s crucial to get these issues checked by a professional as early as possible to reduce your chances of further issues like infection, gangrene and irreversible tissue loss.
While there’s no magic bullet to ‘cure’ PVD, it can be very manageable. Lifestyle changes, medication, or sometimes surgery can help control the symptoms and improve your quality of life.
If you have been recently diagnosed with PVD, do not be afraid. Dr. Lim will guide you through the best treatment options for your situation and help you gain control over your health and body.
Treatment plans depend on the severity of your symptoms, amount of tissue damage and the extent of infections (if any).
General treatment plans typical include lifestyle changes, medications to optimize the treatment underlying conditions, medications to improve blood flow, and sometimes procedures to open blocked vessels. Dr. Lim has a wealth of knowledge and experience with complex angioplasties to help you and your loved ones obtain the best possible outcomes.
Dr Lim also works closely with other doctors and allied health professionals, like endocrinologists, renal physicians, podiatrists and physiotherapists, to help his patients get back on their feet as soon as possible. Sometimes it may be necessary for patients to speak to a dietician or nutritionist to help design a sustainable meal plan.
It can be frightening to hear the word “amputation,” but there may be options like revascularization procedures to improve blood flow and promote healing. Dr. Lim specializes in these life- and limb-saving techniques and will explore every possibility to help you. Remember that early treatment for infections or tissue damage is usually your best chance of avoiding irreversible tissue loss and seek medical advice as soon as possible.
It’s tough when loved ones avoid medical advice. In our experience, one of the best ways to help a loved one who refuses to seek medical treatment is to understand their personal barriers to seeking care. This conversation may be difficult to initiate as your loved one may be worried about having their views ridiculed or dismissed. Take their concerns seriously and show them that you understand and are hearing them. You can also take some time to understand their diagnosis to the best of your ability, in case they do not understand it and need it to be explained to them again.
Some reasons patients may avoid medical advice or treatment are 1) Fear of bad news, 2) Poor understanding of the disease or diagnosis and 3) Worries about being a ‘burden’ to their family (financially, physically etc.).
A lower limb angioplasty is a procedure to open up narrowed or blocked blood vessels in your legs, improving blood flow. It can relieve pain and help heal wounds. This is a minimally invasive procedure that requires a ‘puncture’ (injection) in your groin. Dr. Lim has successfully performed many of these procedures, helping patients regain their mobility and quality of life.
