Erasing Unwanted Lines
Lasers and injections effectively eliminate unsightly spider veins
About the time a person enters his 40s or 50s, he is likely to notice little squiggly lines, purplish or red in color, around his nose, nostril rims, or junctions of the nostril and cheek or nostril and lip.
Some people are genetically predisposed to such spider veins, technically known as telangiectasia. In other cases, they may occur as the result of exposure to the sun or prolonged excessive drinking.
Spider veins present cosmetic issues, not health issues. They are unsightly, not serious, and the good news, said Dr. Alfredo Paredes with the Tallahassee Plastic Surgery Clinic, is that they are easily “zapped” with a laser.
“These lines are maybe a centimeter in length,” Paredes explained. “You often see a series of them like a starburst pattern, particularly around the nose, but often around the cheeks.”
Paredes has found that facial spider veins are “super responsive” to a Yag laser, which is selective for red and purple color.
The laser light is set at precisely the right wavelength for purplish/red pigment, which absorbs the light and then disappears.
“It’s a low risk procedure, and it’s easily tolerated,” Paredes said. “You are in and out in minutes, and there is no recovery time. You can go right back to work. I have even done it on children, who can develop capillary lesions of the face.”
Only one or two appointments are required to eliminate facial spider veins.
Spider veins also occur in the legs, where two procedures are used to remove them.
The “gold standard,” Paredes said, is the use of hypertonic saline solution injections. The solution, which is concentrated salt water, is injected into the bothersome veins via tiny needles.
“The solution runs down the tributaries, and makes them shrink or sclerose,” Paredes said. The effect is immediate.
Lasers are also used to treat spider veins in the legs, especially in cases where patients are recalcitrant about injection treatments. However, laser treatments focused on the legs may require six to eight treatments.
Spider veins on the legs occur for a variety of reasons. Again, some people are genetically predisposed to them.
“Or it may be trauma to the legs, including simple things like the soccer ball that hit you in the thigh in high school,” Paredes said. “They may develop in women at a spot where a skirt crosses the leg when driving. Genetics, trauma wear-and-tear and lots of sun exposure can all be factors.”
Spider veins on the legs are not usually associated with swelling, and should not be confused with much larger varicose veins.
“Bigger veins called varicose veins are green or grayish-blue, and raise the skin almost to the point where you could grab them,” Paredes said. “It looks as if you have a small mole moving beneath your skin.”
They can be tender and painful, and may result in poor circulation in the legs leading to swelling of feet and ankles. Some people may need procedures to restore blood flow in their legs.
Removal of varicose veins, Paredes said, requires attention by a vascular surgeon, who has a couple of options at his disposal.
He may cut out the problematic veins or employ a minimally invasive procedure whereby a catheter is inserted in veins and emits a laser or a radiofrequency that damages the veins’ walls.
Winter and spring are optimal times to remove spider veins.
“While it can be done in the summer, we will recommend that you avoid the sun for two weeks before and two weeks after the procedure,” Paredes said. “We don’t want you to come in burned or tanned because that can create a chance for complications or cause pigmentary changes.”