Question:

I recently saw an ad in the local newspaper on "photoderm VL light treatment" of varicose/spider veins. What does the treatment involve? Does anyone know how effective it is?

Answer:

It seems as one gets older all the skin vessels all over the body become more prominent. Some are just enlarged deeper veins others are very small arteries or veins very close to the skin surface. Their treatment depends on which category they fall into & where on the body the lie. These vessels lower on the body respond better to injection sclerotherapy whereby concentrated solutions of sugar &/or salt water are injected to clot off the vessel. Again maintenance treatments may be required & sometimes there is some fine tuning of the injected solution. You want a solution that is strong enough to clot off the vessel but not so strong that it kills the skin. The lasers designed for blood vessel obliteration are absorbed by the color red such as arteries & their contents. Veins are darker in color. To adjust for this absorption difference laser manufacturers are marketing their tattoo, hair & mole removal lasers which are absorbed by darker colors as vein removal devices. The efficacy of this is marginal at best. My opinion is that surgical removal is better for larger veins & sclerotherapy for smaller vessels. The larger veins can be removed through a tiny incision. However, in the upper part of the face sclerotherapy cannot be used because of the proximity of the eyes & tendency for the sclerosant agent to migrate. Additionally, in most people compression stockings should be worn on the legs after treatment to prevent recurrence of visible leg veins.

Large varicose veins in the legs require treatment because the vein walls can be become so weakened that the vein bursts & bleeds throught the skin. For large straight veins radio frequency ablation applied via a small catheter threaded into the vein can be also be effective. This procedure first became available in 1999. As far as I know there are no creams that can be applied to rid the skin of the problems described above.

Since blood is a fluid which flows along the path of least resistance the removal or destruction of some blood vessels can cause the blood to flow into other vessels to a greater degree. Thus, new spider vessels and/or varicose veins can appear at a future date. Recurrence can be minimized by wearing support hose. Most smaller redder vessels that appear around sclerosed vessels (2nd generation vessels) go away within 1 year and it is counterproductive to keep sclerosing these vessels. Lumps may be felt under the skin surface especially if larger vessels are treated. This is coagulated blood that has collected and will resorb on its own or can be drained with a small needle one or two weeks after the procedure. Blood clots are known to travel from the legs up to the lungs. However, this is extremely unlikely when working with small superficial veins.

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