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Not all visible leg veins are the same, and identifying the type is the first step in choosing the right treatment.
For many people, spider veins are mainly a cosmetic concern. For others, they can be accompanied by aching, heaviness or itching, or may sit alongside larger reticular or varicose veins.
As vascular and endovascular surgeons, our usual approach is to look at the whole picture before treating the surface. Where clinically appropriate, we assess whether there is any underlying venous reflux, where vein valves are not working efficiently and blood pools in the leg, that may be contributing to visible veins. A focused assessment, which can include a duplex ultrasound scan, helps us recommend treatment that addresses the cause where one is present, not only the appearance. In many cases no significant underlying problem is found and treatment can focus purely on the cosmetic result.
Various factors contribute to the development of spider veins. Primarily, they occur when valves within the veins weaken, leading to blood pooling and vein dilation. Several factors enhance the risk of developing spider veins, including:
Understanding these factors is important in preventing new spider veins and deciding the appropriate treatment option.
Spider vein treatments in Singapore address cosmetic enhancement and physical discomfort associated with the condition. Indications for treatment include:
Many people seek treatment to improve the appearance of spider veins, which can be prominent in visible areas like the legs and face.
Insurance providers in Singapore typically don’t cover spider veins treatments as they are considered cosmetic procedures aimed at improving appearance rather than addressing medical concerns.
Symptoms such as aching, throbbing, itching, or burning sensations in the affected areas can prompt the need for treatment.
Treating spider veins can help prevent the development of more significant venous issues.
Micro-sclerotherapy is a leading treatment for spider veins and small varicose veins. It uses a sclerosing solution to close off these unsightly vessels. The technique involves injecting a sclerosing solution directly into the affected veins using a very fine needle. This causes the walls of the veins to stick together, eventually turning the vein into scar tissue that fades over time.
We specifically use a special Varixo microfoam technique that allows us to inject very fine low concentration sclerosant microfoam and sometimes combine this with activation of the veins with blue light for better sclerosant action. This reduces the risk of complications and provides a better cosmetic result.
The micro-sclerotherapy procedure is designed to provide a minimally invasive solution for spider vein removal.
Although micro-sclerotherapy is deemed safe, some people may experience minor side effects, such as:
These effects are typically temporary, fading within a few days to weeks. Most patients can return to their daily routines immediately, with minimal downtime.
Needle phlebectomy, also known as microphlebectomy or ambulatory phlebectomy, is a minimally invasive surgical technique for removing larger spider veins. Unlike micro-sclerotherapy, which involves injecting a solution into the veins, needle phlebectomy involves physically removing the veins through tiny needle-point punctures in the skin.
This procedure is particularly effective for veins that are too large for sclerotherapy but too small for more invasive surgical treatments. It’s performed under local anaesthesia, and the patient can usually return to normal activities shortly after the procedure.
The needle phlebectomy procedure is a detailed method aimed at removing problematic veins with precision and minimal discomfort. This is usually performed in combination with an endovenous procedure, but also sometimes in the out-patient setting under local anaesthesia.
Possible side effects of needle phlebectomy include:
These side effects typically resolve on their own within a few weeks. The procedure’s efficacy improves the appearance of the skin and can alleviate symptoms associated with venous insufficiency.
Preparing for either micro-sclerotherapy or needle phlebectomy involves several steps to ensure the safety and effectiveness of the procedure.
Micro-sclerotherapy and needle phlebectomy are both effective treatments for spider veins and small varicose veins, but they have distinct differences in their approach, suitability, and recovery process.
The recovery process for both micro-sclerotherapy and needle phlebectomy is generally straightforward, with patients able to resume most normal activities shortly after treatment. However, there are specific aftercare instructions that help ensure optimal healing and results:
Spider veins are fine vessels just under the skin’s surface, usually in a web or branching pattern. Varicose veins are larger, raised, often rope-like veins and are more likely to be associated with an underlying vein-valve problem. Reticular veins sit between the two in size. A consultation helps confirm which type you have and whether they are linked.
Not always. Many spider veins are a surface, cosmetic finding. An ultrasound, such as a duplex ultrasound scan may be recommended when there are leg symptoms, larger or feeding veins, or signs that suggest underlying venous reflux. Your surgeon will advise whether it is needed in your case.
This varies with the number, size and distribution of the veins. Some people see good improvement after one session, while others need more, spaced a few weeks apart. A clearer estimate is possible after your initial assessment.
Most people describe only mild discomfort, often a brief stinging sensation as the fine needle and sclerosant are used. Because the needle is very fine, anaesthetic is usually not required for the injections themselves.
Spider veins generally fade gradually rather than disappearing immediately. Improvement is often visible over several weeks and may continue over a few months. Some bruising or discolouration in the early weeks is normal and usually settles.
Treatment can fade or remove the veins that are treated, but it does not stop new veins from forming. Factors such as genetics, hormonal changes and prolonged standing can contribute to new veins over time, which is why some people choose periodic top-up sessions.
Cost depends on the number and size of veins treated, whether one or both legs are involved, the treatment type, the number of sessions, whether an ultrasound is needed, and whether the treatment is cosmetic or medically indicated. A consultation allows for a personalised estimate.
There is no single best treatment for everyone. The most suitable option depends on the type and size of the veins, your symptoms, and whether any underlying venous reflux is found. Micro-sclerotherapy is commonly used for leg spider veins, while very fine vessels may respond better to surface laser or ohmic thermolysis, and larger veins may be better suited to phlebectomy. Your surgeon will recommend an approach tailored to you.
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