Facial & Leg Vein Treatments

TREATMENT OF UNWANTED FACIAL VEINS

The appearance of unsightly vascular lesions (port wine stains, hemangiomas, spider veins or "broken blood vessels") on the face, or elsewhere on the body, can now be safely treated with a variety of lasers used by Dermatologic Surgeons. These lasers work by emitting a flash of light that passes through normal skin and is absorbed (in this case) by hemoglobin found in the blood that runs through these "unwanted" blood vessels. This seals off the blood vessels, which are then naturally dissolved by the body. Temporary side effects can include bruising and crusting which resolve after a few days or so.

SCLEROTHERAPY: TREATMENT OF SPIDER VEINS AND VARICOSE VEINS OF THE LEGS

Spider veins are dilated small blood vessels that have a red or bluish color. They can be short, unconnected lines each about the width of a hair, or connected in a scraggly, sunburst-type pattern. The may also look like a tree with branches. Sometimes, they occur in a small area and aren’t very noticeable, or they can cover a large area of skin and be quite unattractive.

Large dilated blood vessels called varicose veins may be raised above the skin surface. They may occur along with spider veins. Some people with unwanted blood vessels can have pain, ranging from a dull throbbing to a burning sensation. Varicose veins are more likely to cause discomfort.

Although all unwanted blood vessels carry blood, the great majority of them, especially spider veins, are not necessary. If these veins are unsightly or uncomfortable, they can be treated by injection of a solution that will cause them to disappear or become much smaller. There is about a 50-90 percent chance for a greatly improved appearance.

The cause of spider veins is not known. They seem to run in families. They can occur in both men and women, but women have them more frequently. Hormones (estrogen and progesterone) may play a role in their development. Spider veins can be associated with puberty, pregnancy, birth control pills or hormone replacement therapy. They also can appear after an injury, or as a result of wearing too tight girdles or hosiery held up with tight bands. Spider veins can also occur with varicose veins.

Spider veins can’t always be prevented. Wearing support hose may prevent some unwanted blood vessels from developing. Keeping ones weight at a normal level, exercising regularly, eating a high-fiber diet, and wearing low-heeled shoes may also is helpful.

In the majority of cases, a procedure called sclerotherapy is used to treat unwanted blood vessels. One of several kinds of sclerosing solutions is injected with a very fine needle directly into the blood vessel. Sclerotherapy has been used to treat unwanted veins since the 1930s. The solution irritates the lining of the vessel, causing it to swell and stick together and the blood to clot. Over a period of weeks, the vessel turns into scar tissue that fades, eventually becoming barely noticeable or invisible. Varicose veins can also be treated in this same manner, or by other means (stripping, legation, or ambulatory phlebectomy).

After one, or possibly several treatments, most patients can expect a 50-90 percent improvement. However, fading is gradual. Disappearance of spider veins is usually achieved, but similar veins may appear in the same general area.

Even with a highly experienced physician performing sclerotherapy, there are some possible side effects. They include:

• stinging at the site of injection (lasts 5-10 minutes)
  
• muscle cramping (lasts 5-10minutes)
  
• pigmentation at the sites of treated blood vessels (occurs in 30-50% of cases, but usually clears by a year)
  
• new fine blood vessel formation (occurs in 30% of cases, can usually last for several months)
  
• ulceration at the injection site (occurs in about 1% of treated varicose veins)
  
• clotting of larger vessels (these can be drained by the doctor)
  
• rare allergic reactions to some sclerosing solutions.

New lasers may hold promise for treating blood vessels, but currently vessels in the legs do not respond uniformly to laser treatment, and results vary widely.

After sclerotherapy, the physician may have the patient wear compressive bandages and possibly support hose to help the seal the treated vessels. Follow up in one to two weeks after treatment is routine. Further treatments may be necessary, usually a two to four month intervals.