What are spider veins (telangiectasias)?
Spider veins are dilated small blood vessels that are just below the surface of the skin. Visible spider veins are frequently found on the cheeks, nose, chin and legs. They appear as thin red lines or web-like patterns of blood vessels. Facial spider veins are common with age, due to broken vessels but some medical conditions such as Rosacea cause visible facial veins. They are usually harmless but are unattractive. When spider veins appear on the ankles it may be an indication of a more serious health problem.
What are Varicose veins?
Varicose veins are enlarged blood vessels that are causes by damaged veins with weak vein walls. Varicose veins may be an indication of or create a risk for a more serious condition, such as a blood clot in the veins or phlebitis. Veins have valves that are designed to prevent blood in the legs from flowing backward and pooling in the veins. Varicose veins develop when the valves in the veins are damaged, and the blood that was to circulate back to the heart instead pools in the leg veins (venous reflux).
Most varicose veins cause no symptom and do not require treatment. However, if you have symptoms such as discomfort, leg ulcers, swelling and discoloration, treatment will be recommended. When your main concern is cosmetic, treatment will remove the offending veins.
What causes visible veins?
There are multiple causes of visible veins:
- Sun damage
- Unbalance of hormones due to pregnancy, birth control pills and hormone replacement
Sclerotherapy is the gold standard treatment to eliminate spider veins and varicose veins. Using a very fine needle, sclerotherapy involves the injection of a prescription medication into the offending vein which causes the vein walls to collapse and seal off the abnormal vein. The treated vein disappears over the course of a few weeks. Some veins may require more than one treatment. Sclerotherapy is an office procedure performed under local anesthetic. Activities may be limited for several days after treatment.
Laser vein treatments use advanced laser technology (laser and intense pulsed light (IPL)) to destroy visible blood vessels. The heat from the laser or IPL targets the blood vessels, seals the abnormal vessels and does not damage the skin.
Laser treatment is a preferred treatment for facial veins because it requires no incisions and doesn’t injure healthy skin. The laser targets the red color and eliminates the vein without bruising. The body reabsorbs the unwanted blood vessels during healing. There is no downtime and normal activities can be resumed almost immediately.
RFA is a minimally invasive outpatient treatment. Under ultrasound guidance, radiofrequency energy is used to seal off the disease varicose vein with only minimal damage to the surrounding tissues. Treatment removes the veins and their symptoms. There is no need for sutures and there are no scars. It can be performed under local anesthetic. This procedure may be covered insurance.
The procedure involves the insertion of a small catheter into the diseased vein. The laser emits head which seals the vein shut. With time, the vein shrinks and disappears. After treatment some patients experience tenderness and bruising which can be treated with over the counter pain medications and should resolve within a week. RFA has been proven 99% effective for large varicose veins. For smaller dilated veins in the legs, sclerotherapy may be the best option.
These procedures have been replaced by laser or radiofrequency ablation.
This procedure removes the abnormal vein through small slits in the skin. It is reserved for large various veins close to the skin. It is performed using local anesthesia. After treatment, there will be temporary bruising and swelling which will respond to over the counter pain medications. The patient will wear compression stockings for a week.
Contact Dr. Dhaval Bhanusali and Hudson Dermatology & Laser Surgery for more information about vein treatments. Dr. Bhanusali is an expert board-certified dermatologist who provides medical and cosmetic dermatological services.