“I was asked a number of questions about a service that we certainly provide here and is often hard to find a lot of information about and that is the treatment of unwanted veins and typically these veins, particularly in woman, occur on the lower extremities the calf and ankle area and even behind the knee up onto the thigh in some cases and they’re often called varicosities or varicose veins.

What these veins represent are dilation or enlargement of the veins that are very close to the skin surface and since they’re carrying primarily a low oxygenated blood they appear as blue veins. Some of them can actually get quite obtrusive and be protruding and tortuous or snake like in their appearance and then really be quite embarrassing for people, and even prevent them from wearing skirts or short pants which is tragic because they’re very easy to address and fix.

The reason that these veins occur is that there’s a vein as I’ll show you at the junction of the groin that has a valve. That valve is responsible for preventing a back flow or back pressure if you will, on the system downstream toward the feet and if that valve becomes incompetent which is a very common during pregnancy, the valve doesn’t stop the back flow of the blood to the vein and it results in higher venous pressure. Higher venous pressure means that those veins can dilate a little bit and be visible, they can also present as small networks of matted vessels or capillaries near the skin surface or what we call spider telangiectasias which have a central feeder vein and radiating little feet and that’s the term spider coming out from them.

These are actually commonly seen on the face, neck and back as well as the chest and not just on the legs. The treatment for these are very simple there’s a couple of options, lasers are used and they have to be special lasers, a little different than the IPL laser that we might use on the face for flushing or general red spots but a specifically tuned lasers that has a wave length that is long enough in its nature to get to the vein which is a little far than below the skin surface and actually is the one that tuned in to the color of the vessel and thus when the laser is fired, it penetrates the skin without hitting or damaging the skin itself that energy is absorb by the pigment in the vessel which if hemoglobin, it heats the vessel very rapidly and causes that vein to either contract or sclerosis or it can actually in the smaller vessels burst them which gives you a little bruise. In the larger vessels it will very commonly contract at a couple of points and that dilated vein is now plugged off from the system and we can ultimately get rid of it which as what we’re trying to do with all varicosities.

The other way of treating them is with a process called sclerotherapy where we’ll take a very fine needle and syringe and we’ll cannulate or put the needle into the vessels themselves, and these can go anywhere from very small 1 millimeter lesions all the way up to 5 or so millimeter which is quite large as it relates to veins. We inject an irritant into the vessel, there’s a newer one that we use typically or historically we use very salty water hypertonic saline solution or a soapy based detergent type of solution. We are more commonly using one now called asclera which eliminate some of the older disadvantages where people can get some ulceration or have a lot of pain if the vessel wasn’t hit or targeted perfectly. So asclera seems to minimize some of the side effects and be quite effective in shrinking or sclerosing the vessels.

At the end of the day, these vessels again are caused largely by back pressure. There are certain characteristics we’ll look for in legs as we’re doing your evaluation and like veins and treatment of the veins that are unwanted generally in the body are something that we can do with consistency and with really, great patient satisfaction.

So if you have any questions about unwanted veins on the legs, the varicosities or varicose veins, the matted or small groups of very tiny vessels or that spider telangiectasias, a little central feeder and feet radiating out from it, please feel free to write me at DrMaas.com or send a video or picture of your vessels and let us take a look at them and certainly so we can discuss them openly and discuss those treatment options because it’s always great to allows us to share that information so other people can learn.

As always it’s my pleasure and be happy to answer any questions, please contact me as I said at DrMaas.com or visit our website at MaasClinic.com and of course like us on Facebook Facebook.com/Maasclinic. This is Corey S. Maas MDTM on Looking Your Best.”

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