Get Rid of Spider Veins on Your Legs:
and get your kids to pay for it

Posted by: Dr Elaine

May
2012
13
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get rid of spider veins on the leg

 

Get rid of spider veins on your legs
and get your kids to pay for it

Uh oh.  A Mother’s Day post on another thing to put on your “blame my mother” list.  That’s awkward. So let’s shift our focus to how you can get rid of spider veins on your legs, and how you can get your kids to pay for it.

Unfortunately, we have these ugly spider veins and summer is fast approaching. Whether your legs look like a map of rural Montana or Houston, Texas, there are options to help treat and get rid of spider veins. All of the treatments involve altering the lining of these abnormal veins so that they shut down, seal shut and re-route the blood to other nearby normal veins. When no blood is flowing through the abnormal spider veins, you can’t see them and from your standpoint they are gone.

The options for treatment include sclerotherapy treatment of spider veins, ambulatory phlebectomy, Intense Pulsed Light (IPL) and laser vein removal.

Sclerotherapy is the injection of a solution into the vein with a tiny needle.  The solution alters the vein wall. The body absorbs the vein and it disappears.  Blood flow is shifted from the abnormal vessel to other healthy veins.

  • Number of Treatments— when we do sclerotherapy in our office, for the usual patient we will treat all of the veins at each 45 min-hour session.  Because each vein often requires several injections to disappear, an average patient needs 3-4 treatment sessions at 10 week intervals for 60-90% improvement.  Some other offices treat a lesser number of veins in a shorter treatment session, and therefore would require more sessions.
  • Discomfort— there may be stinging or discomfort at the injection sites at the time of treatment, and some aching afterwards.
  • Time to See Results— in ten weeks, the effects of one injection to an individual vein is noticeable.
  • Duration of Results— most treated smaller veins do not reoccur but over time new veins may develop in the same area. New veins may be more resistant to treatment.
  • Recovery Time/Side Effects— most patients have bruising/darkening along the vein fading over several weeks. Very fine red blood vessels may develop at the site of treatment usually disappearing spontaneously. Occasionally as the vein disappears brown pigmentation occurs but usually resolves spontaneously. Because the solution is strong enough to destroy the lining of the vein, if it leaks out of the vein it can damage the skin over the vein. Uncommonly a small sore may develop which may take several weeks to months to heal and may leave a small scar. Very rarely a patient may have an allergic reaction to the medication injected. Sometimes an individual vein develops a superficial clot that may be tender but is not significant medical problem. Deeper phlebitis is a very rare complication.

Laser spider vein removal involves the use of one of several lasers that target hemoglobin in blood, heating it up thereby damaging the lining of the vein wall, and as in sclerotherapy, causing it to close down.  One of the common misapprehensions regarding treatment of spider veins is that laser leg vein treatments give better results without pain for spider veins on the leg. It is not unusual for me to see a patient who has had laser treatment for spider veins elsewhere and is quite surprised that it didn’t work, gave them pigmentation or even scarring and that it hurt! Because it is more high tech than injection sclerotherapy, the assumption is that it must be better. It is not.  Although laser treatment at times can be helpful for treatment of spider veins, it is both more painful and less effective than injection sclerotherapy.

  • Recovery Time/Side Effects— as with sclerotherapy, most patients have bruising/darkening along the vein fading over several weeks or longer. Very fine red blood vessels may develop at the site of treatment usually disappearing spontaneously. It is not uncommon for the vein to develop brown pigmentation after treatment, which may take months or years to resolve.  Burns to the skin, healing with a scar may also occur.

Ambulatory phlebectomy involves making very small incisions into the skin over sections of a reticular or small varicose vein and pulling a section of the vein out through the skin, cutting it and removing the section of the vein. When the section of the vein is gone, the blood flow through the vein is interrupted and blood flow is shunted to other, nearby veins.  It is appropriate for sections of veins in certain patients under certain circumstances. It is usually combined with injection  sclerotherapy.

IPL (Intense Pulsed Light) —works very well for dilated blood vessels, redness, flushing and blushing on the face, neck, chest, arms and the back of the hands. It can be helpful for the very tiny blood vessels that sometimes occur after sclerotherapy, but is less effective than sclerotherapy for removing spider vein on the legs. It is very easy to burn the skin of the legs resulting in permanent brown pigmentation or scarring when attempting to treat spider veins on the legs with IPL. Since it doesn’t work well and the risk of complications is moderately high, it is not one of the best choices for primary treatment of leg veins.

So what is the most effective spider vein treatment? Physicians who are experienced in the treatment of spider veins of the leg most often use injection sclerotherapy, as it usually the most effective with the least number of treatments, and with the least amount of discomfort. I almost always treat spider veins on the leg with sclerotherapy, although we have a spider vein laser sitting in the back room. Sclerotherapy is much more technically demanding to perform well compared to laser vein treatment. I do all the sclerotherapy in our office. It is tedious, but worth it.

On another note—I am intermittently asked about some cream that is being promoted online, on TV or in a magazine ad that supposedly can be applied to the skin to get rid of small broken capillaries. While there are many topical therapies to lessen skin redness, there is no topical therapy to decrease small broken capillaries, called telangiectasia. If it sounds too good to be true, it often is. So don’t waste your money. Use your money for sclerotherapy if you want effective spider vein removal.

How are you going to get your kids to pay for your spider vein removal? Well, it is at least in part their fault, so one would think they would want to help. If not, the old reliable guilt trip may work. And if all else fails, it is Mother’s Day.

 

Spider Veins On the Legs:
Blame your children and your mother

Posted by: Dr Elaine

April
2012
20
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spider veins on the legs

 Spider Veins On the Legs:

Why your children and mother are to blame

Its that time of year again, drag out the shorts, short skirts and sandals. Get your pedicure. And then look at your legs. OMG those ugly spider veins. Very common in women, and often very fixable. Though women frequently tell me they have varicose (or veryclose!) veins, often what they really have are spider veins. Varicose veins are usually larger than a pencil in diameter, ropy, bulging, skin colored, bluish veins that are a symptom of vein disease in the larger veins deep in the legs and pelvis. Spider veins are smaller, hair diameter to spaghetti diameter sized blue, reddish, or purple ugly lines all over your beautiful legs, ankles and feet. Reticular veins are in between sized, bluish or greenish veins that connect smaller veins to the larger ones.

Since varicose veins a symptom of deeper vein disease, they require a more in depth work up and have a whole different set of treatment options. Some women with spider veins also have varicose veins, only an exam by your physician can determine if you do. I am not going to talk about varicose veins today, only about the much more common, and much more easily treatable spider veins.

Spider veins on the legs are small dilated blood vessels, most commonly caused by pregnancy, birth control pills, hormone replacement, occupations requiring prolonged standing, pressure on surface veins from abnormal larger deeper blood vessels, weight gain, and family history.  They are very common in adult women, much less common in men due to the special and wonderful differences between men and women. Sometimes they cause aching or throbbing, especially behind the knee. They are ugly, and women hate them. Luckily, effective treatment often gives good and long lasting improvement.

What causes spider veins on the leg? In other words, why me Lord? Because you are a special and wonderful estrogen filled baby making, hard working, biological machine, that’s why.

Causes of Spider Veins On the Leg

  • Pregnancy—during pregnancy hormonal influences causes your blood vessels to go into overdrive. You are making blood vessels like crazy to feed that wonderful little angel. Unfortunately you don’t just make blood vessels in your uterus; the hormonal effects cause you to make them everywhere. Your blood volume, the total amount of blood in your body, increases so that you have enough for two, or more. So you have blood vessels growing, and more volume of blood in your veins which puts pressure on the veins. And you also have that bowling ball, or watermelon sleeping right on top of where your larger, deeper veins in the legs go through your pelvis trying to reach your heart and lungs. So you can keep going. And although I often have women tell me that they didn’t have any or many spider veins with the first child or two, but only with the last one, each pregnancy stretches those veins in your legs. Just like your belly, which bounces back pretty well after the first child, less after the second and even less after the third and so on. And if you have a multiple birth, it just multiplies the fun. So don’t blame your last child, the blame should be shared equally and each should contribute equally to the cost of your treatment.
  • Birth Control Pills—are really just fooling your body hormonally into thinking you are already pregnant so it doesn’t get any cute ideas.  Without the bowling ball in your pelvis.
  • Hormone Replacement Therapy—ditto, but less ditto.
  • Occupations— that require prolonged standing, such as teaching or hairdressing. My very “best’ spider vein removal customers are teachers and hairstylists. That’s because they stand in one place all day. The muscles in your calf are referred to as “your second heart.” When you walk, the calf muscles pump the blood in your leg veins back up to your heart, as long as the little valves in the veins are working properly. So women who are on their feet all day, but walking around, usually do better.
  • Abnormal Larger Deeper Blood Vessels—the smaller veins drain into the larger, deeper blood vessels in your legs and then back to your heart. There are one way valves inside the veins that are designed to open when blood is pushed through them by the pressure of the contraction of your calf muscles, and then close to prevent the blood from falling back down from gravity. At least that is how they are supposed to work. When they don’t, varicose veins develop. Abnormal valves in the larger leg veins often run in families. Some women with spider veins also have abnormal valves in the larger veins, some don’t. Your physician will tell you if you do or not.
  • Weight Gain—causes more pressure on the veins, and fat makes estrogen. Double whammy.
  • Family History—yep, like a lot of things, the tendency runs in family. Another thing to put on your “blame my mother” list.

So now you know why you have spider veins. Next—how to get rid of spider veins, and how you can get your kids to pay for it.  Your mom probably thinks you should pay her.

 

 

Cosmetic Dermatology Up Close

Posted by: Dr Elaine

September
2010
5
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Elaine Cook MD

Elaine Cook MD

Welcome to the SkinTreatment.com blog, opinions and observations of board certified cosmetic dermatologist and creator of  Dr Elaine’s Advanced Skin Treatment skin care line, Elaine Cook M.D.  I’ve been specializing in Dermatology for 27 years, the last 15 of which have been devoted to the practice of cosmetic dermatology, the development of my own skin care  line, and running SkinTreatment.com. This blog represents the summation of the knowledge and experience I have gathered over the years seeing countless patients and developing multiple prototypes for our skin care products. Some of the medical stories happen over and over again, some are more unusual. Some are purely cosmetic. Some are symptoms of underlying medical disease. All are important. All affect peoples lives.

I plan on discussing a variety of topics. Among them: the so-called “cosmetic” skin problems–acne, melasma, rosacea, aging skin, wrinkles, spider veins, cellulite, stretch marks, hair loss, age spots, sun spots, discoloration and more. I will also discuss the cosmetic procedures used to remedy these problems: Botox, Juvederm, Restylane, Sculptra, Laser, Fraxel  Laser, Intense Pulse Light Photorejuvenation (IPL), Thermage, Therma-Frax (also called Fraxage), Sclerotherapy, Chemical
Peels and the various other light-based treatments such as LED and blue light. Finally, I will be using my understanding of the skin in health and disease and my experience developing my own skin care line as a basis to discuss anything and everything about skin care products.

Basically, I will be discussing whatever I want on any given day.