Spider Vein Removal
The best and gold standard treatment for spider veins is laser. Laser vein removal is an easy, fast, and effective way to treat superficial veins Laser therapy has been used in the medicine for more than 30 years. Advances in technology have helped developed many different lasers. The laser uses a focused beam of light. In the treatment of veins, the wavelength of light is targeted to the pigment in the blood. The laser heats up the small vein and destroys it. The laser beam is focused and does not damage the nearby skin tissue. Over a period of four to six weeks, the vein is reabsorbed by the body and disappears.
The laser pierces the skin and penetrates the superficial blood vessel. The heat generated from the laser coagulates the blood inside the vessel causing it to collapse and seal. Over the next few weeks, the vessel will disappear and all the blood will be removed by the body's scavenging cells. The newer laser treatments allow the delivery of a precise dosage of energy to each blood vessel without injuring any nearby structures.
In most cases, only the very small superficial veins are treated with a laser. The majority of individuals do not require any type of anesthesia, but for those who are squeamish or anticipate pain, the physician may apply a topical anesthetic 20 minutes prior to the procedure. Most current day lasers also have a cooling system which prevents the tip of the laser from getting hot.
Many people, especially fair-skinned people in sunny climates, will develop areas of the face as they age where superficial veins and capillaries in the skin become enlarged and highly visible. Because of their typically irregular and spidery appearance, these superficial cutaneous vessels are commonly referred to as 'spider veins'.
The medical term for this phenomenon is 'telangiectasia', which is essentially Greek for 'the stretching out of the very end of a blood vessel'. And that's essentially what 'spider veins' are. They occur most frequently in the central face, particularly on the anterior cheeks and at the base of the nose. Some people develop very prominent spider veins on the dorsum and tip of the nose, where they are difficult to conceal.
Rosacea is a condition of the facial skin where the central face (nose, cheeks, chin, central forehead) gradually turns red and develops numerous fine telangiectasias. These areas easily become flushed, particularly after physical exertion, eating spicy food, or having a glass of wine. Rosacea has traditionally been treated with topical agents and oral antibiotics, however most patients experience improvement only when the medications are in use, with return of rosacea once the treatment is stopped. For many patients, rosacea is fairly resistant to topical and oral medications.
The cause of spider veins and rosacea is not completely understood, and appears to be multi-factorial. Contributing factors may be a genetic predisposition, the chronic use of topical steroid agents, and solar damage to the facial skin that gradually builds up over many years. Rosacea occurs most commonly in warm climates where people get a great deal of year-round sun exposure.
These conditions can perhaps be prevented (in part) by the avoidance of excessive exposure to ultraviolet radiation (the sun, that tanning bed), the avoidance of chronic topical steroid use, and by the daily use of a high-SPF facial sunblock. In some cases, telangiectasias are associated with a systemic autoimmune disorder, such as scleroderma. Once a person develops facial telangiectasias and/or rosacea, these conditions in general do not spontaneously disappear.
So how do I get rid of rosacea, or my facial spider veins, or both?
The ideal treatment for 'spider veins' and rosacea should be easily administered, safe for the patient, reliably effective, should not require an excessive number of treatments, should be non-invasive, and should not have a prolonged recovery period.
Here's the good news: such a vein treatment does exist. A pulsed-dye laser developed specifically for the treatment of cutaneous vascular disorders, can completely eliminate most facial 'spider veins', usually in two to three treatments (large areas of long-standing spider veins may require more treatments), and can reverse the cutaneous manifestations of rosacea as well. In addition, the laser energy pulse delivered by the laser has been modified to limit the development of post-treatment bruising (purpura), a problem associated with older pulsed-dye lasers.
The laser uses light energy of a wavelength that is specifically absorbed by structures which are reddish or purple in color, i.e. capillaries and small arteries and veins. The laser beam incorporates a Dynamic Cooling Device which sprays the skin with a cooling agent immediately before every laser pulse. This advanced technology both protects the skin from thermal energy and reduces the discomfort previously associated with pulsed-dye laser treatment. The laser pulses are generally described by patients as feeling like 'a rubber band snapping against the skin'. No anesthesia (topical or otherwise) is required.
While pulsed-dye laser technology has been available for decades, pulsed-dye laser treatment of rosacea and facial telangiectasia was not frequently performed as the laser energy tended to explode superficial blood vessels, producing facial bruising that may persist for several weeks. The new laser modulates both the peak energy and the duration of the laser pulse in order to coagulate rather than explode dermal blood vessels, which allows treatments to be performed that produce little or no bruising. This advanced technology makes it possible to achieve significant clearance and even complete elimination of facial redness and spider veins with no 'downtime'.
Is Laser therapy a 'cure' for rosacea?
That really depends upon how one defines 'cure'. If by this one means "can you eliminate the facial redness, flushing and spider veins that I walk into your office with?", then the answer is YES - we are able to completely eliminate these findings for many of our patients with a series of laser treatments. However, any individual who has experienced resolution or significant improvement in rosacea following laser treatment is at risk for recurrence of facial redness and flushing if they do not take steps to avoid the primary risk factor: ultraviolet light (sunlight) exposure.
We strongly recommend that our patients 'protect their investment' by using a high-quality, chemical-free sunblock on a daily basis, rain or shine, summer or winter. Hats are also highly recommended in the summer months. Appropriate protection from damaging UV rays can prevent the recurrence of the facial redness and flushing associated with rosacea for most patients.