Question: What’s the best treatment for leg veins?
Answer: It really depends on what type of leg veins you have as to what is the best treatment. For varicose veins that are large, cable-like veins, usually on the inner aspect of the leg, I would recommend seeing a vein specialist that can perform treatments with an endovenous catheter and either radio frequency or laser. For more superficial cosmetic veins, sclerotherapy is an excellent option and we typically use concentrated glycerin and this can be extremely successful at improving the appearance of the legs. Occasionally, we will use lasers for spot treating certain areas that are more difficult to treat with sclerotherapy and, therefore, a combination of different treatment options are frequently employed to give patients the best result possible.
Question: How is the pulse dye laser different from the fractional laser? Is one better than the other for improving spider veins on the face?
Answer: A pulsed dye laser is not a fractionated laser, but it is a laser that is absorbed by hemoglobin or blood and, therefore, is quite effective at treating vascular lesions on the face. A fractionated laser is any sort of laser that is broken up into small tunnels or dots that treat the skin. There are non-ablative fractional lasers that simply heat up tunnels in the skin and create denaturation of collagen. This then allows the healing process to increase the collagen and improve the skin quality. Ablative fractionated lasers actually vaporize tunnels into the skin. This creates a much more intense healing process with more intense collagen deposition and, therefore, overall will be much more effective than the non-ablative modalities, but there is a downtime associated with these types of lasers. Overall, fractionated lasers are not typically used for spider veins, so I would recommend consideration of the pulsed dye laser though I personally feel that the YAG laser or even broadband light can be just as effective or even more effective than a pulsed dye laser and they seem to have a lower propensity for bruising. Ultimately though, I really think it is your provider who will be able to make recommendations since they would be the ones who have experience with the specific laser that they have available.
Question: I have spider veins but am deeply afraid of lasers. Are there any natural or less invasive treatments for spider veins?
Answer: I know of nothing topical that can be applied to the skin that will help get rid of spider veins. Lasers are extremely successful at treating these unsightly vessels, and I think that after you have a chance to discuss the lasers with our medical professionals at the Quintessa Aesthetic Center, you will realize that there is very little to be afraid of regarding laser treatments of spider veins. However, if the lasers are still too scary, you may want to consider sclerotherapy, which involves using extremely small needles and injecting sugar solution into the vein to help it collapse and disappear. Ultimately, these are the only two reliable methods I know of to help rid a patient of these unsightly vessels.
Question: I have read that the solution that treats varicose and spider veins can sometimes travel throughout the body. What are the implications of this and is this procedure safe?
Answer: The solution that is used to treat varicose veins is safe as long as relatively small doses are administered. Obviously you will want to see a well-experienced injector to make sure that you not only get the result that you want, but that it is performed in a safe manner. At Quintessa Medical Spa we only treat smaller spider veins through sclera therapy and if someone has large, knotty varicose veins we will recommend a vein specialist, most of whom perform laser catheterization for treatment of these larger vessels.
Question: I am 52, male, with spider veins on my nose. They look really awful, and I would like to get rid of them. I have heard that laser vein treatments are a fairly simple procedure. How long do laser vein treatments typically take for spider veins on the nose?
Answer: We can typically treat spider veins on the nose in a matter of minutes with a pencil-tip style laser. This can be extremely effective but I would caution that, in some patients, these veins can be very stubborn and require multiple treatments for adequate eradication. The treatments themselves, however, are very quick, and we would tend to wait several weeks between treatments to allow the damaged vein to heal and determine whether any repeat treatments would be necessary.
Question: I am a 62-year-old woman with varicose veins on my legs. I am very interested in laser vein therapy. I know there are two types of laser vein treatments, one that is external and one that is internal to some degree (for heavier veins, I think). Is the external option available for treating varicose veins or just spider veins?
Answer: In my opinion, the external-type option is only good for treating the spider-type leg veins, and it is very ineffective at treating the larger varicose-type veins, simply due to their much larger size and larger blood volume within the vein. The external laser is extremely good at treating small veins, up to maybe 2 mm across but, once you get larger than that, it starts to become quite inefficient, and we will therefore tend to recommend an external approach to these types of leg veins and would refer you to a leg vein specialist. We would be happy to treat any residual spider veins for you with the external option though.
Question: I have been looking into different treatments for my spider veins for some time. I got a little scared off by the possibility of muscle damage from vein treatments though, so I am interested in laser vein treatments. Can laser vein treatments also result in muscle damage?
Answer: You should not be able to damage any muscle doing laser vein treatments, as the laser is only going to penetrate a short distance and only injure the visible veins that are being treated. With that said, laser vein treatments are typically limited to relatively small spider-type veins on the legs and, if you have larger varicose bulging veins, these would need to be treated with a different modality, and we would actually refer you to a leg vein specialist. If we are treating the cosmetic spider-type leg veins, we have a vast experience in treating these types of unsightly veins and have very high success rates. I would, however, not worry about any sort of muscle damage that can occur with these types of treatments.
Question: Do spider veins ever reappear after laser treatment? I noticed that my grandmother has tiny veins lining her leg muscles again, and I thought they were supposed to have been eradicated.
Answer: After laser vein removal, patients definitely can have recurrence of some of their spider veins, depending on the cause of the spider veins in the first place. If the cause is due to deeper vein abnormality such as varicosities, then the increased venous pressure in the legs can contribute to the recurrence of spider veins. Many of our patients ended up with spider veins secondary to pregnancy, and they otherwise have healthy leg veins today. When we treat the spider veins on those patients, they typically will not recur due to the fact that they otherwise have good venous pressure in their legs and will, therefore, not tend to make new spider veins after the laser vein treatment. I recommend you have your grandmother see her professional who treated her so that a thorough evaluation can be performed. If she has deep venous insufficiency, then they may want to refer her to a leg vein specialist who can provide ultrasound diagnostics and appropriate deep vein treatment to prevent the recurrence of these superficial visible veins.
I am 65 years old, but many think I am in my early 50’s – could I still be a candidate? And do you offer some type of a guarantee? I also have minimal spider veins on the face – does the procedure target this problem?
Ultherapy was tested for about one year before FDA approval. When all patients (many over age 65) were included in the studies, 80% responded to treatment and half of the non-responders had a response with a second treatment. Though we can not guarantee results, we will treat patients a second time at no cost. There have been a few changes to the protocols used to treat patients since the studies were done, and some centers are seeing a 100% response rate. We certainly can not say that it is 100% effective yet, but those are very encouraging statistics. Though you are not in our prime age range of 40-60 years old, it is really the patient’s ability to create new collagen that causes the lift, and not the failure of the device to cause denaturization of the collagen, as the science behind the method of injury is quite reliable and will work in 100% of patients. The only reason a patient would not have a response is if their tissue can not create enough new collagen (mainly due to age and sun damage). If your skin looks younger than your age, then you might still be an excellent candidate for Ultherapy. The results thus far have lasted 18 months and counting. By the mechanism of injury and healing, the result should really be “permanent” in that the patient will get the improvement and then age forward.
Ultherapy will not treat facial vessels, but we do have two lasers that are extremely effective at ridding patient’s of unsightly vascularity of the face, body, and legs. We would be happy to discuss this further at your consultation.