Wit cellulite, capillaries and veins in legs are a woman's worst enemy. Almost every woman has problems with veins and capillaries. With some women they are minimally expressed, while with other moderately to severely. Usually they present an aesthetic problem but with time they become a health problem as well because they inevitably grow. Initially there is heaviness in ones legs, then cramps, then swelling... Therefor it is necessary to remove them as they start to develop. It is never to late but one should not wait.
Genetics plays a main role in their development, because the connective tissue is of a poorer quality and more prone to expand the vein and capillary walls while standing up. Veins have valves which prevent reverse blood flow in legs. People with weaker connective tissue have weaker valves. With weaker or damaged valves blood returns to legs instead of going towards the heart and this is why vessels expand. With genetics, estrogen is the main culprit. Veins and capillaries are created during pregnancy and contraception intake, i.e. supplemental therapy when the level of estrogen is enhanced. Estrogen weakens the connective tissue which builds the wall of the vessel which then induces expansion. By blood accumulation in veins and capillaries while standing pressure rises and expands the weakened vein or capillary. Standing, weight, physical inactivity, heat sources, for example sun and hot baths and high heels are just some of the factors which provoke their development.
Sclerotherapy and surgery were up until recently main methods for vein and capillary removal. Only veins can be removed with surgery, without any effect on capillaries and smaller veins. With sclerotherapy a substance which causes inflammation and damages veins and capillaries and causes them to disappear is injected. The method itself is flawed: it is unpleasant, many injections are needed, results are poor, a great number of treatments is needed, allergic reactions may appear, chemicals are injected into one's body, long lasting bruises and pigmentation... Many people are afraid of needles, therefor they could not be helped. Sclerotherapy where the chemical is shaken to produce foam gave somewhat better results. Burning with electricity gives bad results and oftentimes scars with pigmentation. IPL and AFT treatment, which remove changes with optical energy, do not penetrate deep enough and cannot remove veins, but do remove capillaries but with modest results. For now the treatment of choice is laser. For veins that are 4-5mm thick and capillaries regardless of their color lasers are a method of choice. Neodymium Yag laser 1064 gives best results, although other types of laser can be used: 585 nm Pulsed Dye laser, 755 Alexsandrite laser and a diode 910-980 nm laser. Since we started using lasers for vein and capillary removal, many women were given hope.
For veins that are more than 5mm thick, radio frequency or a laser which uses a probe to enter and destroy the vein can be used along with surgery. There is still an option of classical sclerotherapy which is not advises because of poorer results than sclerotherapy with foam which gives excellent results.
1. Laser removal of leg veins and capillaries
Veins and capillaries cannot be removed 100% and forever, because they have a lifelong tendency of coming back. It is realistic to expect that they can most of the times be removed almost completely. Destroyed veins and capillaries never return, but new ones form. That is why a maintenance treatment is advised every few years. Along with capillaries and veins, with laser we treat clusters of capillaries which look like bruises. With the initial treatment we advise that you treat the leg in whole from ankles to thighs, and later only the remaining vessels. If appropriate, only problematic areas can be treated. First treatment in average lasts 5 to 15 minutes, and the following treatments are shorter each time. After the treatment you compress the area with ice for 15 to 30 minutes and you are ready to go home.
Most people react excellently to the treatment, but there is a really small group that reacts somewhat poorly. The number of treatments is individual and cannot be predicted. 1 to 3 treatments are needed but sometimes a few more are necessary if there is a large number of veins and capillaries. Usually most of the veins and capillaries are removed with one treatment and the next one just removes the residuals. The interval between the treatments is 3 to 12 months.
Protein hemoglobin, located in the red blood cell, absorbs the laser ray while liberating energy which then destroys the blood vessel. By destroying the blood vessel an inflammation occurs through which the organism disposes of veins and capillaries. In that period blood vessels are usually visible 2 to 4 weeks more, afterwards their visibility diminishes until they disappear.
When are the results visible? The initial result can be seen only 30 days after the treatment and improves on a daily basis. Usually the treated capillaries and veins are more visible 2 to 4 weeks after the treatment and gradually fade. The final result is visible 6 to 9 months after the treatment. Minor veins and capillaries disappear faster then bigger ones. The speed of removal is individual and cannot be predicted, nor can the results be predicted.
The treatment can be done in the beginning of November until the middle of April. We do not recommend its performance afterwards only out of practical reasons because if you wear skirts capillaries and veins are more visible because of bruising.
It is not possible to compare the two because the laser can remove veins of radius up to 4mm and sclerotherapy with foam veins of a larger radius. Oftentimes these two treatments are combined in a way that bigger veins are removed with foam sclerotherapy and smaller veins with capillaries are then removed with laser.
Before the treatment it is necessary to get elastic panties of 100 or 140 dens. An elastic bandage can be used as well but it is more impractical. The panties are worn for only 7 days, and are taken off at night. After the treatment it is advised to keep the area cold for some time while at home. Physical activity or standing is not recommended, i.e. walking 7 days after the treatment. Sick leave is not needed and you can drive immediately after the treatment. In case of bruising you can use a heparin gel. In case of tingling, pain or uneasiness report immediately to your physician.
The method itself is not pleasant and is painful, but not unbearable. The uneasiness lasts only during the treatment! While being treated you feel a cold air flow and ice can be used, so it can be borne and if needed we can take breaks during the treatment. Local anesthetics are not used and only shrink the vessels which weakens the result.
Sometimes bruises and pigmentation are visible after the treatment but they disappear on their own. With some women tendency to bruise is more likely, regardless of the treatment, and they bruise easily. Generally, we can say that bruises are a sign that vessels are destroyed. Sometimes, unfortunately a capillary or a vessel cannot be removed without bruising. Heparin gel is recommended to women which have a tendency to bruise or if after the treatment bruises occur. The same stands for development of pigmentation after the treatment, immediately report to your doctor. If there are pigmentation residues they can be removed with cream or laser. Scars and wounds almost never appear. If the treated capillaries or veins are strongly accentuated and are near the skin surface, minor superficial skin damages are possible. Very rarely scabs or bubbles can appear on the skin.
The treatment does not affect your health or breastfeeding. No new capillaries or veins are caused by the treatment. Destroyed vessels do not effect the circulation because they do not have any function anyway.
Neodymium Yag laser has a wave length of 1064nm. The bigger the wave length the deeper the laser penetrates the skin. This laser is special because it penetrates deep into the skin and can destroy the deepest vessels. Skin color, unlike with other lasers, is not important. Other lasers are not as safe when treating darker skin. The problem with other lasers is that because of a shorter wave length they do not penetrate the skin deep enough and there is a significantly larger percentage of complications followed by a poorer result. Neodymium Yag laser is not only the best choice, but is also the safest choice, without almost any complications.
2. Sclerotherapy with foam
Sclerotherapy with foam efficiently destroys larger veins of 4-5mm. A special substance is used that is injected into the vein where it causes inflammation and vein destruction. Before the treatment it is necessary to mix the substance to make a foam because in that way the vein is destroyed better and a significantly smaller number of treatments is needed in regard to classic sclerotherapy... With classic sclerotherapy this is not done and that is the reason why it is significantly weaker in results in regard to foam sclerotherapy. At the same time this procedure has numerous advantages in regard to classic sclerotherapy as for example a significantly smaller number of injections needed. The treatment is not painful or unpleasant and after the treatment it is advised to wear elastic panties of 100-140dens. In average 1-3 treatments are needed, although just 1 treatment is enough to remove most veins while others are removed later (the smaller ones). Some smaller bruises and minor sensitivity is possible after the treatment. It is advised that the treatment is conducted by a vascular surgeon (for vessels) if needed with a Doppler device which shows the best area for injections into the vein. This method can by its results be compared with surgery.