Varicose Veins Archives

Surgery free, walk in and walk out

Non-Invasive Treatments


Do Varicose Vein Treatments Work?

Understanding the Playing field

Hi, Dr Gan from Doctor Vein Medical and Cosmetic. Today I’m going to be addressing a very common question that comes up. It is probably a comment that pops up a lot when you’re at dinner tables and when you talk about any treatment for varicose veins. That is, “Will my varicose veins come back after I’ve had treatment.” Now the reason this pops up a lot is because in the past, the passing statement that usually follows is, “Why bother having treatment because it all comes back anyways.” Now today, I’m going to address this because there might be some truth to that comment, but more importantly I think it’s important to address that comment by itself because there are multiple factors here.

Different Treatments for Varicose Veins

And so the first and most important question you need to ask when you hear such a comment is, “What type of treatment did you have?” Now in the past, the only way of treating varicose veins was by surgery and specifically a type of surgery known as stripping. Here the vein was basically pulled out after you’ve had general anesthetic and it was pulled out from the inside out and the chances of a new vein developing in that area where it was treated was very high. And what I mean by that is that in a year, in two years, in five years, there could be a high possibility that you develop more abnormal veins in that region, which was treated. Now in comparison with the newer treatments, and I’m specifically talking about endovenous laser ablations, and to a certain degree radiofrequency ablations, the chances of any new vein development after it has been treated is close to 0%. That means that when you’ve had that vein treated, the chances of it coming back is almost nil.

Endovenous Laser Ablation for Varicose Veins

So we sort of guarantee that we are up to 99.8% which is almost a hundred percent sure that that treated vein will be gone once it has been treated. Now an important point to remember is that sometimes you can get abnormal veins, or maybe I should put it this way. Sometimes you can get veins that are normal currently, so if you’ve come in for an assessment and I’ve had a look at your veins on the ultrasound, I usually mention to most of my patients that these are veins in this location, this area, are completely normal now. Now in three years, in five years, in 10 years, if that vein becomes abnormal, then sometimes it can pop out on the skin and come across the area where you used to have a vein and it can almost feel like that vein has reappeared.

But if you’ve had the newer treatment, I can often guarantee that that vein that we’re seeing pop up is a new vein. And with most of my patients, I usually show them their normal veins and I usually tell them, “This vein is completely normal.” And I show them the abnormal veins as well so that they know exactly which veins I’m actually treating. So in that way, they’re crystal clear that the vein that is affected them causing them the symptoms, causing them the signs that they see on their leg are treated. Now another important factor too to note is that if you produce veins often (and you usually know which patients these are, because you often get veins at a very early age), there could be a high chance that you can develop more veins as you get older. We tend to call them the vein makers because they keep making veins.

Following Up Treatments

We can always treat the veins and we can guarantee those veins are gone, but then there’s a high likelihood you’re going to create new veins. So coming back to the first comment about, “It’s going to come back anyways.” It’s not completely true, especially for the new treatments because when we treat these veins, we can guarantee they’re gone. The last point I want to make is if you’ve had a vein treated, for example, there’s a vein on your leg that has annoyed you for longest time and you’ve had it treated and you’ve gone through the entire procedure and you find that vein hasn’t disappeared or it has kind of gone down, but it has popped up again in the same location, then there’s a high likelihood that that vein wasn’t treated in the first place. There could be multiple reasons why that’s happened, and I’ve always told patients that if this happens to you or if it’s happened with me, I often want to be the first person to know about it so I can have a look at it.


But more importantly, I think if you’ve had treated with someone and it’s come back, you may want to get a second opinion and here at Doctor Vein, we’re quite happy to have a look and let you know whether or not that vein has been treated. Part of my practice, is that I actually make sure that I follow up every patient to ensure that vein that we’ve treated is gone. Because if I haven’t done my job, I’m completely transparent in patients that it hasn’t closed, and we may have to do a different form of treatment to close it because it may be a little bit resistant. But oftentimes the most important thing to ensure is to make sure that the vein that would be where we’re actually targeting and treating is treated. Hope this gives you an idea about veins coming back after treatment. And more importantly, if you’re having a dinner meeting with a whole bunch of friends, you can kind of tell them that it’s not true. Varicose veins can get treated and they can be gone forever.

Flying and Varicose Veins

We all know, through media or even through the news, that when you fly on a plane, there is always a risk of developing a deep vein thrombosis or DVT. That is why they encourage everyone flying to move around the cabin and do plenty of stretching exercises. Many of my patients are also worried about flying on a plane when they have varicose veins. In this video, I discuss the risk involved and answer the question based on current research, what the dangers are and whether it is acceptable to fly with varicose veins.

What Causes Varicose Veins?

What Causes those Unsightly Varicose Veins? Why are you affected more than other people of the same age or even your friends and family. In this video, I break down the commonest causes as to why you develop varicose veins.

Simplifying Varicose Veins – The 3 Levels

Simplifying Varicose Veins into the 3 Levels. Varicose veins and spider veins are a very common condition that many patients have. In this video, I break down the different types of veins and how each one is connected. More importantly, I highlight what type of treatment is required for each level.

What is Sclerotherapy for varicose veins and spider veins?

Sclerotherapy (Pronounced skle-ro-therapy), has been around since the 17th century.  It was not until 1916, when the use of modern sclerotherapy treatment for varicose veins was founded. The word “Skleros” itself comes from the Greek word to make hard. Different solutions and sclerosants have been created since then, that are not only safe but highly effective in removing varicose and spider veins.

What is it?

Sclerotherapy is a medical procedure, whereby a “sclerosant solution” is injected directly into the vein. This then irritates the inner lining of the vein wall causing it to harden and then get absorbed by the body. The absorption by the body is similar to what happens when you develop a bruise after a fall. It eventually disappears.

It is commonly used for varicose veins and spider veins but can also be used for vascular and lymphatic malformations, hemorrhoids (dilated veins in the anal canal) as well as for hydroceles (fluid in a body cavity).

How is it performed?

Sclerosant solution is injected using very small needles either directly into the vein or by using ultrasound guidance for veins that are not visible.

The solutions can be injected directly as a liquid or as a foam. Both are as effective for spider veins, but foam is generally found to be more effective for bigger veins hiding under the skin.

Is it painful?

This is a very common question and the simple answer is no. Some solutions used for sclerotherapy can cause stinging when first injected and others cause some slight itchiness during the procedure. The solution I use has an anaesthetic property as well that further reduces any pain. It is important to note that the needles used are tiny and not ordinary sized needles. Generally, it is very well tolerated by most people. Many who do get treated are often surprised how little discomfort there is.

Recovery time?

Most patients who get sclerotherapy can be treated and go straight to work or any other day to day activities. It is often recommended to not do heavy exercise or weight lifting for the first 5 days after sclerotherapy.

It is also advisable to walk daily for 30 to 45 minutes each day after treatment and wear medical compression stockings during that period.

How many treatments will I need?

This is challenging to answer without examining a patient and doing a duplex ultrasound. Most patients generally need at least 3 treatments of sclerotherapy. Some patients have multiple spider veins scattered everywhere and, in that case, more treatments may be needed. Also, some treatments may need a combination of different procedures with sclerotherapy just being one of them. I advise patients as to what will be required during their initial consultation.

Is it effective?

Treatment of spider and varicose veins using sclerotherapy can be very effective. Even after the first few weeks post treatment considerable changes in the appearance of varicose and spider veins can be seen. The final results will be visible 6 months post treatment.

I personally treat all my patients and at Doctor Vein, our focus is only on veins. We strive for the best outcomes and endeavor to deliver the best results.

If you have any questions about Sclerotherapy, please send me an email to

Busting Varicose Vein Myths

This is an age-old question, often surrounded by myths. The usual adage being, “Oh no, I have my mothers or fathers legs”. We do know that one third of the population suffer from varicose veins in one form or another. Some believe this number is actually higher, especially as many men tend to not seek treatment and therefore often do not contribute to the total. Studies conducted in the UK through the NHS, have highlighted that up to 56% of men and 60% of women have varicose veins.

This article breaks down the common causes and risk factors that increase the chances of developing varicose veins. In order to give you some insight into why it occurs in the first place.

Varicose veins are those bulging veins that are seen on lower limbs, especially the legs and thighs. They can occur because of weakening of the valves, absence of valves in some people, or even damage to the valves of the veins in the limb.

The most common cause for damage of the valves is following a deep vein thrombosis, whereby there is a clot in the deeper veins. This damages the wall of the vein, affecting the valves and impairing blood flow through the veins.

One way to think about it is to imagine a rubber pipe watering system with valves, that allow water to flow in one direction when opened and stops water from travelling when closed. If this valve stops working, it then allows water to travel in both directions, without any control. Eventually if the pressure is too great, this will cause the rubber pipe to expand or swell up and affect other valves up or down the pipe. When this happens, more valves in various locations along the path of the pipe stop working as well. As the pipe becomes bigger than the original valve, this allows water to leak through in other places, despite having a normal valve.

Similarly, when the valves in veins are abnormal or damaged, the veins can get distended along the length of the vein and not function properly. This then gets carried to other areas of the vein that may have had a well functioning valve in the first place. Almost like a domino effect.

The above is the predominant cause of varicose veins, but the question still remains: Why do some people have varicose veins and others do not?

This comes down to risk factors. Over the years, many studies have been done to show which are the highest risk as compared to those that may only cause a small risk or no risk at all after completing the study.

Busting the Varicose Vein Myths

Below are some of the high risk factors for developing veins in no particular order:

Genetic or family history

  • If you have a family member, mother or father specifically who have a history of having varicose veins, then you are going to be at risk as well.


  • Both progesterone and oestrogen play a major role, affecting the vein wall directly. This will explain why symptoms may be more prominent during the menstrual cycle for women.


  • During pregnancy as a result of hormonal changes as well as increased blood flow, veins tend to expand (dilate), but they do come back to almost normal after pregnancy. For those who have weak valves or who are genetically predisposed, their veins may be worsened by pregnancy. Repeated pregnancies increases the risk whether there is genetic predisposition or not.


  • Being overweight increases the risk of varicose veins, almost as an aggravating factor rather than a cause. Some people, more commonly in women have a condition called “lipoedema”, whereby there is a build of fat tissue and they have a higher risk of developing varicose veins.


  • Standing or sitting for long periods increases the risk, which possibly also explains the higher risk of varicose veins in developed and industrial nations.


  • As you get older, the elasticity of the veins reduces making it more susceptible to expand. This has been shown in multiple studies to date.


Smoking has been postulated to be a risk factor of varicose veins, but the evidence is lacking. We do however know it affects management, but probably does not affect veins directly.

There has not been any conclusive evidence regarding posture and sitting cross- legged as a trigger for varicose veins. However, isolated direct trauma may trigger varicose vein developments in affected regions.

If you are not sure what is causing your varicose veins, but have noticed them and want to find out how to get rid of them, do not hesitate to contact us at Doctor Vein, on 03 91908922. We will be happy to evaluate and manage all your varicose veins concerns.


What is the difference between Spider Veins and Varicose Veins?

Are you looking at your legs right now and asking yourself: do I have varicose veins or are they spider veins?

To understand the difference between varicose veins and spider veins in the lower leg and thigh region, we must look at what the purpose of veins is in first place:

  • Veins are integral to the circulatory system of the body, as the heart pumps oxygenated blood through the arteries and receives deoxygenated blood (blood with no oxygen and more carbon dioxide) through the veins. In the lower limbs (thighs, legs and feet) the same arterial and venous system exist supplying oxygen through arteries and taking away waste products through veins.
  • The largest superficial vein in the lower limb is the great saphenous vein and it starts in the feet and goes all the way to the groin. When the valves in these veins are damaged due to hereditary or hormonal causes, excessive stretching or even injury, they stop doing their job of pushing blood to the deep veins. Other veins take over the job, leaving this diseased superficial segment within the lower limb to continue to stretch and cause a build up of pressure in smaller veins coming out of it. These smaller veins or tributaries are what gives rise to those bulging varicose veins seen on the skin.
  • From these larger veins, smaller micro veins can form called spider veins. It is important to note that spider veins can develop in the absence of diseased larger superficial veins within the lower limb.

What are spider veins, really?

Spider veins also known as telangiectasias are small, twisted blood vessels that are visible through the skin. They may be red, purple or blue and most appear on the thighs, lower legs or face. Due to this twisting and bent appearance, they appear like a spider with a central region and multiple legs.

They do not cause any major structural problems or complications but patients often feel self-conscious due to their unsightly nature and often very prominent pattern.

What are varicose veins, really?

Varicose veins are large tortuous and abnormal blood vessels that are often seen bulging out of the skin. They can develop anywhere in the body, but usually sprout on the legs and ankles

They often appear on the lower limbs and become more prominent when standing and less so when lying down or lifting the legs up. They tend to cause many symptoms and complications, such as heaviness, aching, cramping, swelling, itchiness and ulcer formation as they progress.

In summary

Spider veins and varicose veins are venous disorders often seen in the lower leg and thigh region of individuals. Both types represent abnormal and diseased veins that are not functioning. This essentially means that they serve no purpose except to worsen symptoms already present and give rise to complications like scarring, discoloration and ulcer (wound) formation.

These conditions are more common in women but men do suffer from them as well. Men tend to seek treatment only when the disease has progressed and complications have set in. Doctor Vein can treat and eliminate both spider veins and varicose veins with ease and efficiency. Why not make an appointment today and find out how you can be relieved from this often painful condition.

If you have any further questions about the difference between varicose and spider veins, do not hesitate to contact us.