Spider veins and varicose veins tend to creep up on people in Singapore the same way they do elsewhere, though our humid climate, long hours on our feet, and pregnancy patterns give the problem a local flavor. Some notice a fine web of reddish or bluish lines at the ankles. Others struggle with aching calves after a day at the hospital ward or sales floor. For a smaller group, the veins become ropey and tender, with swelling by evening and cramps at night. If you are weighing spider veins treatment in Singapore or trying to understand the difference between cosmetic spider veins and a genuine medical problem, you are not alone.
I treat these conditions often, and the conversation always begins with two questions. First, what are we dealing with? Second, what outcome do you want? Clearing a cosmetic cluster of spider veins is a very different job from fixing venous hypertension that causes pain, leg heaviness, skin discoloration, or ulcers. The right diagnosis prevents wasted money on the wrong procedure, and it reduces the risk of recurrence.
Spider veins vs varicose veins: what they signal
Spider veins resemble a delicate roadmap on the skin, typically red, purple, or blue, and sit very close to the surface. They measure a fraction of a millimeter to about 1 mm in diameter. Most are harmless and primarily a cosmetic concern. But they can sting, itch, or feel hot after a long day, especially in our heat.
Varicose veins are larger, https://sgvasculargrp.com/medical-condition/varicose-spider-veins/ often 3 mm or more, bulging, and tortuous. They reflect a deeper problem in the vein valves that are supposed to keep blood flowing up the leg. When valves fail, blood pools under gravity. This backflow builds pressure that gives you aching, heaviness, swelling around the ankles by evening, cramps, or restless legs. Over years, the skin over the ankles can darken and harden. In advanced cases, the skin breaks down into painful ulcers.
People sometimes present with spider veins but have symptoms that suggest an underlying leak in the saphenous system. I pay close attention to red flags: evening swelling that improves with elevation, calf cramps, itching around the inner ankle, a history of phlebitis, or a family history of venous disease. If any of these are present, I suggest a Doppler ultrasound before planning laser or injections.
Why spider and varicose veins show up here
Genetics sets the stage. If one parent had varicose veins, your risk climbs. If both did, it jumps further. Hormones also weaken vein walls and valves, which is why varicose veins in legs in Singapore are common around pregnancy. Rising progesterone relaxes tissues, blood volume increases, and the uterus compresses pelvic veins. Many pregnant women develop new varicose veins and spider veins. Some improve after delivery, but not all.
Lifestyle and work matter. Long standing shifts in retail, F&B, teaching, nursing, or security raise venous pressure. So do prolonged sitting marathons at desks. Heat and humidity promote vasodilation, which can make veins more visible and symptoms more noticeable. Weight gain adds pressure. Past trauma, previous clots, and surgery can reroute venous flow and create collateral veins that later dilate.
I see a pattern in sporty patients too. High-impact exercise is not the culprit by itself, but heavy lifting with bracing can spike abdominal pressure, which can worsen existing reflux. The goal is not to stop moving, it is to be smart with technique and recovery.
How diagnosis works in Singapore clinics
A careful history and leg exam usually point in the right direction. The keystone investigation is duplex ultrasound, performed with the patient standing. The sonographer maps the saphenous veins, checks valves with compression and release maneuvers, and looks for reflux timers, typically anything over 0.5 to 1 second is abnormal. We also assess tributaries and perforators, the veins that link the superficial and deep systems. The outcome is a map that guides treatment.
For isolated spider veins with no symptoms and a normal saphenous exam, you can head straight to sclerotherapy or surface laser. For painful veins in legs in Singapore that suggest reflux, treating the root cause first is crucial. If you inject surface veins while the main trunk is leaking, they will often return or new ones will appear.
Insurance and Medisave depend on this differentiation. Cosmetic spider veins are generally not claimable. Symptomatic varicose veins with documented reflux that impair function, cause skin changes, or bleeding are more likely to qualify for coverage. Expect clinics to document photographs, CEAP classification, and ultrasound findings.
Treatment options, from least to most involved
There is no single best method. The right choice depends on vein size, depth, symptoms, and cosmetic goals. I counsel patients on both outcomes and maintenance. Veins are a chronic condition, not a one-time event, especially if there is a genetic load.
Conservative measures play a role even when you proceed with a procedure. Medical-grade compression socks and lifestyle adjustments reduce recurrence and help symptoms. They do not erase veins, but they often buy time and improve comfort during pregnancy or while you plan a procedure.
Sclerotherapy for spider veins and small reticular veins
Sclerotherapy is the workhorse for spider vein treatment. A tiny needle introduces a sclerosant that irritates the vein lining, causing it to collapse and seal over weeks. The body gradually absorbs it. In Singapore, we commonly use polidocanol or sodium tetradecyl sulfate in liquid form for fine veins, and sometimes foam for larger reticular veins.
What to expect during the session: a series of small injections, each lasting seconds. Most patients rate the discomfort as mild. You might feel a brief sting or crampy sensation along the vein. The treated veins darken and can look worse for a few weeks before they fade. You wear compression stockings for 1 to 2 weeks. Pigmentation can linger, especially in darker skin types, so treatment planning and aftercare matter.
Results usually require several sessions spaced 4 to 6 weeks apart. For an ankle web with 30 to 50 visible spider veins, two to three sessions is common. New veins can appear over time, and touch-ups every year or two are normal. If you have underlying reflux, combining sclerotherapy with upstream treatment gives better longevity.
Surface laser and intense pulsed light for very fine spiders
Very fine, blush-like telangiectasias sometimes respond better to vascular lasers or IPL. Not all clinics carry the right wavelength. The technology works by targeting the hemoglobin in small vessels, heating and collapsing them. It is non-invasive, but pain can be a sharp snap, often mitigated with cooling.
I use laser for those tiny matting clusters that do not accept a needle easily, or when a patient prefers no injections. Slight redness and swelling follow for a day or two. In darker skin types, cautious parameters are essential to prevent post-inflammatory hyperpigmentation. Realistic expectations are key. Laser complements sclerotherapy rather than replaces it for most patients.
Endovenous thermal ablation for symptomatic varicose veins
When reflux in the great or small saphenous vein drives your symptoms, heat-based closure is often the mainstay. Endovenous laser ablation and radiofrequency ablation achieve the same goal, they seal the faulty vein from within under tumescent local anesthesia. Through a tiny puncture, a fiber is threaded into the vein, the area is numbed with dilute anesthetic, then heat collapses the vein. The body reroutes blood to healthier veins.
Compared to older stripping surgery, thermal ablation has smaller punctures, faster recovery, less bruising, and similar or better long-term success. Many patients walk out the same day, back to desk work within 24 to 72 hours, and resume workouts after one to two weeks depending on bruising and comfort. Compression stockings are worn for 1 to 2 weeks. Follow-up ultrasound checks for closure and rules out complications.
Non-thermal closure options
Adhesive closure systems use a medical-grade cyanoacrylate glue to seal the vein without tumescent anesthesia. Sclerotherapy foam can also be used to treat longer segments of refluxing veins in selected cases. These techniques are helpful when heat is relatively contraindicated, for example in very superficial veins, but they require careful selection and operator experience. Each has its own profile of side effects, including inflammation, phlebitis-like reactions, or, rarely, allergy.
Microphlebectomy for bulging tributaries
Large, ropey surface veins sometimes persist even after the main trunk is sealed. Microphlebectomy removes them through 2 to 3 mm punctures with a specialized hook, leaving tiny marks that usually heal well. Under local anesthesia, it is straightforward and gives immediate contour improvement. Bruising lasts a week or two.
When is surgery still used?
Varicose veins surgery, meaning traditional high ligation and stripping, is less common now but remains an option if endovenous access is difficult, the vein anatomy is unusually tortuous, or resources are limited. Recovery is longer with more bruising. It is still a legitimate choice in selected scenarios and can be combined with phlebectomy.
Costs to expect in Singapore
Numbers vary with clinic setting, technology, and whether treatment is cosmetic or medically indicated. Use the ranges below as a planning tool, not a quote.
- Spider veins removal in Singapore via sclerotherapy: about SGD 300 to 600 per session for a limited area, up to SGD 800 to 1,200 for extensive areas. Most people need two to three sessions per leg. Laser or IPL for spider veins: roughly SGD 300 to 700 per session, often as an adjunct for fine vessels after sclerotherapy. Endovenous ablation of a saphenous vein: commonly SGD 3,000 to 6,500 per leg in private practice, including facility, consumables, and ultrasound guidance. If both great and small saphenous veins need treatment, costs rise. Microphlebectomy for bulging veins: SGD 1,000 to 2,500 depending on extent and number of segments. Follow-up ultrasounds and compression stockings add a few hundred dollars.
Varicose veins treatment Singapore cost and coverage hinge on documentation. When reflux is proven and symptoms interfere with daily life or there are skin changes, portions may be claimable through insurance or Medisave in certain settings. Cosmetic spider vein treatment is usually out-of-pocket. Always ask for a written estimate and clarity on what is included, such as ultrasound, consumables, stockings, and follow-up.
Pain, recovery, and what it really feels like
Sclerotherapy is a series of quick pinpricks. Most tolerate it with no numbing. You might feel a warm or crampy thread along the injected vein for minutes. Walking after the session helps. Expect temporary darkening of the treated lines, sometimes with small scabs where injections were made. The cosmetic payoff arrives at the 4 to 8 week mark. If you are planning a beach holiday, do your final session at least a month before.
Endovenous ablation uses local anesthesia. The tumescent fluid is the main source of pressure sensation during the procedure. Once the vein is sealed, patients usually walk out comfortably. Aching along the treated track can persist for 3 to 10 days, often described as a pulled-muscle feeling. Over-the-counter pain medication and walking help. I limit heavy leg workouts for one to two weeks and recommend compression during waking hours for the first week. Bruising varies. Most return to normal routine quickly. Very active patients are often surprised by how manageable recovery is.
Complications are uncommon but not zero. Superficial phlebitis, small skin burns with laser if parameters are off, pigmentation, matting (a blush of new fine vessels) after sclerotherapy, and rarely, deep vein thrombosis. Choosing an experienced practitioner and following instructions reduce risks. If you develop increasing calf pain, swelling, or shortness of breath after any vein procedure, seek assessment promptly.
Pregnancy and veins: timing matters
Varicose veins pregnancy Singapore cases are common in obstetric clinics. During pregnancy, we focus on symptom relief: daily walking, left-side sleeping, elevation, and compression stockings. Sclerotherapy is usually deferred until after delivery and the end of breastfeeding. Some surface spider veins fade within three to six months postpartum as hormones normalize and blood volume decreases. Persistent or symptomatic veins can be mapped and treated once you are ready. If you plan more pregnancies, treating significant reflux between pregnancies can reduce symptoms in the next one, though new veins can still form.
How to pick the right clinic and operator
Complexity in vein disease treatment sits less in the device and more in the planning. The best outcomes come from practitioners who do a thorough ultrasound map, discuss a staged plan if needed, and do not oversell quick fixes.
A practical mini-checklist helps:
- Ask who performs the duplex ultrasound and whether it is done standing. Request to see a map or report that identifies segments with reflux and valve times. Clarify whether you have only surface spider veins or deeper reflux that needs endovenous treatment first. If you are quoted multiple sessions of sclerotherapy without an ultrasound despite symptoms, consider a second opinion. Enquire about exact sclerosant or device types, expected number of sessions, and the plan if matting or pigmentation occurs. Get an all-in cost range including stockings, follow-up ultrasound, and any touch-up policy. Review before-and-after photos of similar skin tones and vein patterns, not just ideal cases.
The operator’s experience matters. Most complications I see in second-opinion cases stem from either not treating the root reflux or being too aggressive in fragile, superficial veins near the ankle where nerves and skin are sensitive.
Daily habits that support results
Veins respond to cumulative daily pressures. The boring basics work if you do them consistently. Patients often ask for a rigid rulebook. I prefer to tailor advice to how you live and work. Here is a compact plan that fits most schedules.
- Wear knee-high, graduated compression socks on long standing or sitting days, during flights, and for the first few weeks after any procedure. Aim for 15 to 20 mmHg for prevention, 20 to 30 mmHg if you have symptoms or travel often. Build calf-pump breaks into your routine. Every 45 to 60 minutes, stand, do 20 slow heel raises, and walk to refill your water. This takes one minute, and it pays off in the evening. Keep weight and waist circumference in check. Even a 3 to 5 kg reduction can lower venous pressure if you are currently overweight. Train legs smartly. Mix low-impact cardio like brisk walking, cycling, or rowing with strength work that emphasizes full-range calf raises and hip hinge patterns. If you lift heavy, exhale through effort and avoid prolonged Valsalva bracing. Elevate legs after work. Ten minutes with ankles above heart level reduces swelling and discomfort, especially in our climate.
These habits do not cure vein disease, but they reduce symptoms, slow progression, and preserve your results after treatment of varicose veins.
What success looks like several months later
For spider vein removal, success is measured in clearer skin and confidence to wear shorts without covering up. Realistically, many patients get 70 to 90 percent clearance of visible spiders after a few sessions. The residuals are often faint lines that you forget about. New clusters can appear as time passes, usually smaller than the original presentation. A brief touch-up every year or two maintains results.
For varicose vein treatment, we track symptom relief and ultrasound closure. Patients describe lighter legs, less evening swelling, fewer cramps, and better sleep within weeks. Skin changes take longer. Brown discoloration can lighten over months but may not vanish completely if it has been present for years. If there were bulging tributaries, the contours improve immediately after phlebectomy and continue to settle over a month or two. A six-month ultrasound establishes stability.
Recurrence is possible because vein disease is systemic and influenced by genes and life events like pregnancy. Recurrence does not mean failure. Most recurrences are smaller and easier to treat. Setting this expectation early prevents frustration later.
Special scenarios and edge cases
- Very superficial saphenous veins: Heat ablation risks skin burns if the vein lies too close to the surface. In these cases, a non-thermal adhesive closure or a carefully planned hybrid with foam has a safer profile. Ankle and foot spiders: These areas are sensitive to pigmentation and scabbing. I reduce sclerosant concentration, use the smallest volumes, and warn patients to expect slower clearance. Laser parameters must be conservative in darker skin. Previous DVT: Treating superficial reflux can still proceed with caution, but we coordinate with a vascular physician, time off anticoagulation if needed, and emphasize mobility after the procedure. Pelvic congestion: In some women with varicose veins that worsen around menses and persist despite leg procedures, pelvic venous insufficiency plays a role. Embolization of ovarian or internal iliac veins may be considered after thorough evaluation. Athletes and dancers: We prioritize scheduling around training and performances, often splitting treatments and carefully timing compression so it does not interfere with technique work.
A note on realistic marketing vs actual medicine
Search results for spider veins removal Singapore can be a thicket of before-and-after photos and claims of single-session miracles. Occasionally a small cluster responds in one go. Most of the time, more than one session is needed. Beware of any promise that ignores the need for ultrasound in symptomatic cases, or that downplays risks like pigmentation and matting in darker skin types. Good outcomes come from matching the treatment to your anatomy and goals, not from a particular brand of device.
Where to start if your legs hurt now
If you have aching, heaviness, evening swelling, or cramps, book a consultation that includes a duplex ultrasound. Clarify whether your issue is cosmetic or functional. If you are pregnant, use compression and symptom control, then plan post-delivery. If your concern is strictly cosmetic spiders with no symptoms, expect two to three sclerotherapy sessions and be patient with the timeline. If there is reflux, address it first, then tidy up the surface.
Singapore has no shortage of capable practitioners. The right fit is someone who takes the time to map your veins, explains trade-offs, and follows you through recovery. Done well, vein disease treatment is less about chasing lines on the skin and more about restoring comfort, function, and confidence that lasts.