| Dr. Lily Talakoub is a Diplomat of the American Board of Dermatology. Here the Doctor has answered some of the common questions bizymoms visitors have about Cosmetic Dermatology.
Q. How long have you been in this field?
I have been in this field for 4 years.
Q. What causes spider veins on face and legs?
Spider veins are small superficial blood vessels that appear red or blue in the skin. They commonly occur on the legs, but are also found on the face or other areas of the body.These dilated blood vessels appear with age and can be noticed if the skin is sundamaged or thin. Larger dilated blood vessels called varicose veins may be raised above the skin surface. They may occur with spider veins.
Patients can have pain that ranges from dull and throbbing to a burning sensation. The larger vessels are more likely to cause discomfort, although smaller blue veins have been shown to cause pain as well. If spider veins are bothersome, they can be treated with laser or by injection of a special solution that can destroy them. They can disappear or become much smaller. There is about an 80 - 90 percent chance for a greatly improved appearance.
The cause of spider veins is not completely known. They tend to run in families. These veins can appear however in people that stand up for long hours or have leaky valves in their larger leg veins.
Spider veins appear in both men and women, but more frequently in women. Female hormones may play a role in their development. Puberty, birth control pills, pregnancy, or hormone replacement therapy may contribute to them. They may also appear after an injury or as a result of wearing tight girdles or hosiery held up with elastic bands. Varicose veins occur mainly from genetic susceptibility.
Spider veins on the nose or the cheeks of fair-skinned people can be related to sun exposure.
Spider veins cannot always be prevented. Wearing support hose may minimize unwanted blood vessels from developing. Keeping one’s weight at a normal level and exercising regularly may be helpful, as well as wearing low-heeled shoes. Sun protection is important to limit the number of unwanted vessels on the face.
The treatment for these small veins is called sclerotherapy. One of several kinds of solutions called sclerosing solution is injected directly into the blood vessel with a very fine needle. The solution irritates the lining of the vessel causing it to swell, stick together, and the blood to clot. Over a period of weeks, the vessel turns into scar tissue that fades, eventually becoming barely noticeable.
A single blood vessel may have to be injected more than once, some weeks or months apart, depending on its size. A number of vessels can be injected in any one-treatment session. The injection solutions available are slightly different, and the choice of which to use depends on several factors including the size of the vessel.
Occasionally, larger varicose veins are connected to them. In such cases, these vessels should be treated along with spider veins. This can be done by sclerotherapy, or endovenous laser ablation or laser therapy. There are several ways to treat spider veins on the face. Laser, electrodesication, and intense pulsed light have been used successfully.
Sclerotherapy is highly effective. Most patients notice an 80 - 90 percent improvement. Fading will gradually occur over months. Disappearance of treated spider veins is usually achieved, but similar veins may appear in the same general area, particularly if there are larger vericose veins in the area and these are not treated at the same time as the small veins.
Q. How does laser treatment help treat facial and spider veins?
Lasers have also been used for spider veins on the face and legs. Wavelengths of light are absorbed by the hemoglobin in the blood vessels to destroy them. Many types of lasers, pulsed dye, long-pulsed, variable-pulsed Nd-YAG, and Alexandrite may be used, as well as a non-laser intense pulsed light technique.
Q. How many laser treatments are required to effectively treat facial and spider veins.
Generally 1-3 treatments are needed. However many will see benefits with the first treatment.
Q. Are there any side effects of using laser treatment for facial and spider veins?
Some of the side effects include:
Stinging or pain at the sites of treatment.
Temporary redness, bruising.
Brown lines or spots on the skin at the sites of treated blood vessels.
Darkened areas may result when blood escapes from treated veins. These darkened areas are probably formed from iron in the blood and occur more often in patients who have larger veins treated or those patients that tan easily. In most cases, they disappear within a year, but they may last longer.
Burning with discoloration of the skin.
Q. Are the effects permanent?
Large vericose veins may recur even after surgical procedures. Spider veins may also recur. It may seem that a previously injected vessel has recurred when, in fact, a new spider vein has appeared in the same area.
To avoid recurrences, I recommned to patients to walk following the procedure. I also bandage the injected areas and instruct patients to "compress" the treated vessels by wearing support hose. This may help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. It also may reduce the number of treatments necessary, and the possibility of recurrence. Others put tape dressings on the areas and do not use compression unless the veins are large or in special locations. Between treatments, I recommend the use of compression or support hose. This may be recommended for people who spend a lot of time on their feet, or work in a standing occupation. |
