Every week, Associate Professor Tan Seck Guan, Senior Consultant, Department of General Surgery, Singapore General Hospital, sees six to 10 new cases of varicose veins at his clinic. Although these visibly enlarged and twisted veins do not usually pose serious health problems, more patients are seeking treatment for the condition, said A/Prof Tan.
Women who have had children or are middle aged are more likely to have the condition, with men representing just one in five patients.
Understanding varicose veins
Veins are blood vessels that return deoxygenated blood from the outer parts of the body back to the heart and lungs. Valves ensure the blood flows one way – towards the heart – but when these valves become weak or damaged, blood flows backwards and pools in the veins, causing them to swell.
Varicose veins seldom occur anywhere other than the legs and thighs. These enlarged veins may cause mild swelling of the ankles, especially after long hours of standing or walking. Other symptoms can include throbbing in the legs, aches and pains, darkening of the skin, rashes and even ulcers on the ankles.
Not all patients with varicose veins suffer from these symptoms. Some have no medical complaints even after decades of having them.
“Varicose veins are not considered a serious problem as they seldom lead to limb loss and do not affect general health. They can be an aesthetic issue, and patients who are bothered by their ugly appearance can seek treatment,” said A/Prof Tan.
Treatment for varicose veins
- Stripping (early surgical procedure)
One early surgical procedure to treat varicose veins is known as stripping, which involves general or half-body anaesthesia. The faulty veins are removed and blood flow directed through functioning veins. Stripping requires incisions to be made at the groin, inner thigh and calf. Patients typically are given up to two weeks of leave for recovery, during which they are encouraged to walk.
- Endovenous laser therapy
Endovenous laser therapy uses a laser to burn the vein under local anaesthesia, allowing patients to literally walk home immediately after treatment.
- Injection of foamed sclerosants
Another popular alternative is the injection of foamed sclerosants – liquid chemicals in bubble form – into the inner thigh to harden the vein. This minimally invasive and relatively painless procedure is also performed under local anaesthesia.
All the patient needs to do after undergoing either sclerosant injection or endovenous laser therapy is to take a few painkillers and wear graduated compression stockings for 30 days to aid recovery. These prescription tight-fitting below-the-knee, above-the-knee or pantyhose stockings create a gentle pressure on the legs which prevents blood from pooling in the veins and improves the results of minimally invasive treatments.
Endovenous laser therapy typically sets private patients back $5,000 to $7,000 per leg, while foamed sclerosants cost slightly less. Of course, prices also depend on the ward class patients opt for.
Results for either treatment have been encouraging. Post-treatment, most patients will find their varicose veins reduced in size and symptoms relieved. In 25 per cent of cases, varicose veins eventually completely disappear, said A/Prof Tan.
“Although most women are bothered by varicose veins and find them unsightly, they should not affect self-confidence,” said A/Prof Tan. “There is no need to be resigned to them as they can be easily treated.”