Quick answer. Varicose veins are enlarged, twisted leg veins caused by faulty vein valves; many cases are cosmetic, but symptomatic or complicated veins can be treated with minimally invasive options like RFA, EVLA or sclerotherapy, often with MediSave support when medically indicated.
Varicose veins are bulging, rope-like veins that usually appear on the legs when the one-way valves inside leg veins weaken and blood pools backwards (venous reflux). They are very common, especially with age, pregnancy, prolonged standing and a family history.
Many varicose veins are mainly a cosmetic concern, but some cause aching, heaviness, swelling, itching, skin changes or, in advanced cases, ulcers. A vascular surgeon will usually confirm the diagnosis with a duplex ultrasound scan before recommending treatment.
At a glance
| Treatment | How it works | Indicative surgeon fee (per leg) |
|---|---|---|
| Sclerotherapy (incl. ultrasound-guided) | Solution injected to close small/medium veins | About S$1,900-S$4,300 |
| Endovenous laser ablation (EVLA) | Laser fibre seals the faulty vein from inside | About S$4,900-S$7,300 |
| Radiofrequency ablation (RFA) | Heat energy closes the faulty vein from inside | About S$4,900-S$7,300 |
| Open surgery (ligation/stripping) | Faulty vein tied off and removed | About S$2,600-S$4,300 |
What causes varicose veins?
Varicose veins develop when the valves in your leg veins stop closing properly, so blood flows backwards and pools, stretching the vein walls. Risk factors include:
- Increasing age and a family history of varicose veins
- Pregnancy and female sex (partly hormonal)
- Jobs involving prolonged standing or sitting
- Being overweight and lack of physical activity
- Previous deep vein thrombosis (DVT) or leg injury
When should varicose veins be treated?
Not every varicose vein needs treatment. Treatment is more strongly considered when there are symptoms or complications rather than for appearance alone. See a doctor if you have:
- Persistent aching, heaviness, throbbing or night cramps in the legs
- Ankle or leg swelling that worsens through the day
- Skin discolouration, eczema or hardening around the ankle
- Bleeding from a vein, or a painful hard lump (possible superficial clot)
- A leg ulcer that is slow to heal
Skin changes and ulcers are signs of more advanced venous disease and should be assessed promptly.
Treatment options explained
Most varicose veins today are treated with minimally invasive, walk-in-walk-out techniques:
- Endovenous thermal ablation (EVLA/RFA): A thin catheter delivers laser or radiofrequency heat to seal the faulty vein. Usually done under local anaesthesia with quick recovery.
- Sclerotherapy: A solution is injected to close smaller veins or spider veins; ultrasound-guided foam sclerotherapy can treat larger veins.
- Open surgery (ligation and stripping): The traditional operation to tie off and remove the affected vein, now used in selected cases.
- Newer non-thermal techniques (e.g. medical glue) are also available at some centres.
What do treatments cost in Singapore?
Costs vary widely depending on the technique, the number and complexity of veins, whether one or both legs are treated, and the choice of public or private care. The figures in the table reflect MOH surgeon-fee benchmarks for the private sector and exclude facility, anaesthetist, equipment and GST charges, so your total bill will be higher.
Always ask for a written, itemised estimate before proceeding. Prices vary between providers, and benchmarks are a reference, not a cap.
Can I use MediSave or insurance?
When varicose vein treatment is medically indicated, for example symptomatic disease with venous reflux confirmed on duplex ultrasound, it may qualify as a claimable day-surgery procedure. In these cases, MediSave can typically be used to offset part of the cost, and Integrated Shield plans may cover eligible cases.
Purely cosmetic treatment of spider veins is usually not claimable. The exact MediSave withdrawal limit depends on the procedure and current MOH rules, so confirm eligibility with your surgeon and insurer beforehand.
Can varicose veins be prevented?
You cannot always prevent varicose veins, but you can reduce symptoms and slow progression:
- Stay active and maintain a healthy weight
- Avoid standing or sitting still for long periods; move and elevate your legs regularly
- Wear graduated compression stockings if advised by your doctor
- Treat early skin changes promptly to avoid ulcers
Compression and lifestyle measures help symptoms but do not make existing varicose veins disappear.
What to expect at your appointment
Your first visit usually begins with questions about your symptoms, how long you have had them, and any family history or previous clots. The doctor examines your legs while you stand, as veins are more obvious under the pull of gravity. The key test is a duplex ultrasound scan, a painless examination using a probe and gel that maps the leg veins and shows where the valves are leaking. This guides whether treatment is needed and which technique suits you. It helps to wear loose clothing so your legs are easy to examine, and to come with a list of your symptoms and any questions.
Recovery and self-care after treatment
Most minimally invasive procedures are done as day cases, and many people walk out the same day. You will usually be encouraged to walk regularly soon afterwards to keep blood moving, while avoiding very strenuous activity or heavy lifting for a short period as advised. Compression stockings are often worn for a set number of days to support healing and reduce swelling and bruising. Some aching, tightness or bruising along the treated vein is normal and settles over days to weeks. Follow your surgeon’s specific instructions, and report increasing pain, redness, warmth or a swollen calf, as these need review.
How to ease symptoms day to day
- Move regularly rather than standing or sitting still for long stretches; flex your ankles and take short walks.
- Elevate your legs above heart level for short periods to help blood drain.
- Wear graduated compression stockings if your doctor recommends them.
- Maintain a healthy weight and stay active to support your circulation.
- Look after the skin around your ankles and treat any early changes promptly.
Special situations: pregnancy
Varicose veins often appear or worsen during pregnancy because of hormonal changes and the extra pressure on pelvic veins. Many of these veins improve in the months after delivery, so doctors generally recommend conservative measures such as compression stockings and leg elevation during pregnancy, and reassessing afterwards rather than treating straight away. If you develop a hot, tender, swollen area or a painful swollen calf, seek medical review, as this needs to be checked.
Common questions
Will varicose veins come back after treatment?
Treatment closes the faulty veins that are present, but new varicose veins can develop over time, especially if you have strong risk factors. Staying active, managing weight and wearing compression as advised can help reduce the chance.
Are varicose veins dangerous?
Many are mainly a cosmetic or comfort issue, but skin changes, ulcers, bleeding or a painful hard lump suggest more advanced disease that should be assessed. A sudden painful, swollen calf needs prompt medical attention.
Related guides
- Best Vascular & Vein Clinics in Singapore — our editorial shortlist
- Diabetic foot
- Leg swelling
- Aortic aneurysm
Sources
- MOH Fee Benchmarks – Varicose Veins / Endovenous Laser
- SingHealth – Varicose Veins
- HealthHub Singapore
- NHS – Varicose veins overview
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