Quick answer. Varicose veins are twisted, enlarged surface veins caused by faulty one-way valves that let blood pool in the legs. In Singapore, treatment options range from compression stockings and lifestyle measures to minimally invasive procedures such as endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided sclerotherapy, and medical adhesive (VenaSeal), with traditional surgery (ligation and stripping) reserved for selected cases. Many people seek treatment for cosmetic reasons, but when a duplex ultrasound confirms venous reflux and there are symptoms or complications, treatment is medically indicated and MediSave may be used for approved day-surgery procedures. This is general information, not medical advice.
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Varicose veins are bulging, rope-like veins that appear most often on the legs and ankles. They form when the tiny one-way valves inside leg veins weaken, allowing blood to flow backwards (reflux) and pool. While many people are bothered by their appearance, varicose veins can also cause aching, heaviness, swelling and, over time, skin changes or ulcers. This guide explains the causes, the treatment options available in Singapore, the difference between cosmetic and medically indicated treatment, and when MediSave may help with costs.
At a glance
| Treatment | How it works | Typical price range (per leg, private) |
|---|---|---|
| Compression stockings | Graduated pressure supports veins and reduces pooling; first-line for symptom relief | Low cost (retail) |
| Endovenous laser ablation (EVLA) | Laser fibre heats and seals the faulty vein from inside; day procedure | S$4,900-S$7,300 |
| Radiofrequency ablation (RFA) | Radiofrequency energy heats and closes the vein; similar to EVLA | S$4,900-S$7,300 |
| Ultrasound-guided sclerotherapy | Foam or liquid injected to scar and close smaller veins | S$1,900-S$4,300 |
| Ligation and stripping (surgery) | Faulty vein is tied off and removed under anaesthesia | Varies; usually higher, inpatient |
What causes varicose veins?
Healthy leg veins use one-way valves to push blood upward against gravity back to the heart. When these valves weaken or fail, blood flows backwards and pools, stretching the vein wall until it becomes twisted and enlarged. According to HealthHub, contributing factors include genetics (a family history), advancing age, hormonal changes, pregnancy, being overweight, and jobs that involve prolonged standing or sitting. Women are affected more often than men, partly due to hormonal influences.
Symptoms and possible complications
Varicose veins are often visible as dark blue, swollen, twisted veins. Symptoms can include aching or heaviness, leg tiredness, swelling, throbbing and night cramps that worsen after long periods of standing. Left untreated, more advanced chronic venous insufficiency can cause skin darkening, dry or thickened skin, and open sores (venous ulcers), usually near the ankle. Less common complications include superficial blood clots (thrombophlebitis) and bleeding from a vein close to the skin. New skin changes, a non-healing ankle ulcer, or a hot, hard, tender vein should prompt a medical review.
Treatment options available in Singapore
Treatment is tailored to the size and pattern of the veins and the degree of reflux found on duplex ultrasound. Conservative measures (compression stockings, leg elevation, exercise, weight management) are first-line for mild symptoms. Minimally invasive endovenous therapies are now standard of care: EVLA and RFA use heat to seal the faulty truncal vein, while non-thermal options such as medical adhesive (VenaSeal) and mechanochemical ablation (ClariVein) avoid heat. Ultrasound-guided foam sclerotherapy treats smaller veins, and mini-phlebectomy removes bulging segments through tiny punctures. Traditional surgical ligation and stripping is now reserved for selected cases. Endovenous procedures are typically day procedures with quicker recovery and earlier return to work.
Cosmetic versus medically indicated treatment
The distinction matters for both clinical priority and funding. Treatment is considered medically indicated when there are symptoms (pain, swelling, heaviness) or complications (skin changes, ulcers, bleeding, superficial clots) and a duplex ultrasound confirms underlying venous reflux. Where veins are treated purely to improve appearance without symptoms or proven reflux, it is regarded as cosmetic. Spider veins treated only for looks are usually cosmetic and not subsidised.
MediSave and costs
When varicose vein treatment is medically indicated (symptoms plus duplex-confirmed reflux), MediSave may be used to help pay for approved surgical or day-surgery procedures such as RFA, EVLA, VenaSeal, ClariVein, ultrasound-guided sclerotherapy or phlebectomy, subject to procedure type and MediSave withdrawal limits. Coverage and out-of-pocket costs depend on whether you are treated in a public (subsidised) or private setting, and on your specific case. Prices quoted here are indicative private ranges only; confirm exact fees, MediSave use and any insurance coverage directly with the treating clinic before proceeding.
What to expect and prevention
Most endovenous procedures are done under local or tumescent anaesthesia, allowing you to walk soon after and return to light activities quickly; compression stockings are usually worn for a period afterwards. No treatment guarantees that new varicose veins will never form, so maintaining a healthy weight, staying active, avoiding prolonged standing where possible and using compression when advised can help reduce recurrence and symptoms. Discuss the most suitable option, success rates and risks with a vascular surgeon or accredited vein specialist.
What to expect on the day of a procedure
Most endovenous treatments for varicose veins are done as day procedures, so you arrive and go home the same day. Before the procedure, the vein is mapped again with ultrasound, and local or tumescent anaesthesia is used to numb the area. You are usually awake throughout and may feel some pressure but little pain. Afterwards, a compression stocking or bandage is applied, and you are encouraged to walk soon after to keep the blood moving. Many people return to light activities and desk-based work within a day or two, though your doctor will advise on when to resume exercise, flights or heavier work. Some bruising, tightness along the treated vein or mild discomfort for a week or two is normal.
Questions to ask before treatment
- Has a duplex ultrasound confirmed venous reflux in my case?
- Is my treatment considered medically indicated or cosmetic, and how does that affect funding?
- Which technique do you recommend for my veins, and why?
- What are the success rates and possible risks or side effects?
- Can I use MediSave, and what will my likely out-of-pocket cost be?
Common questions
Will the veins come back after treatment?
Treated veins are usually closed for good, but no procedure prevents new varicose veins from forming elsewhere over time. Staying active, keeping to a healthy weight and using compression when advised can help reduce recurrence.
Are compression stockings enough on their own?
For mild symptoms they can give good relief, but they manage rather than cure the problem. Where ultrasound confirms significant reflux and there are symptoms or complications, a procedure may be recommended. Discuss the options with an accredited vein specialist.
Related guides
- Best Vascular & Vein Clinics in Singapore — our editorial shortlist
- DVT
- PAD
- Leg swelling and spider veins
Sources
- HealthHub – Varicose Veins
- SingHealth – Varicose Veins and Chronic Venous Insufficiency
- MOH Singapore
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