Why do they appear?
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.
How to remove minor veins and capillaries?
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.

How to remove larger veins?
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.
How many treatments are needed?
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.
How does the laser remove veins and capillaries?
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.
When do we recommend the performance of the treatment?
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.
Laser advantages in regard to classical sclerotherapy
- 1 laser treatment achieves results like 10 or more sclerotherapy treatments
- there is no allergic reaction
- the only method which solves capillaries in the ankle area
- best results
- safest treatment
- the elastic panties are worn for 7 days, and 21 days with sclerotherapy
Comparison of a laser treatment and sclerotherapy with foam
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.
What should be done before and after the treatment?
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.
Is the method painful?
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.
What are the possible complications?
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.
How to prevent the development of veins and capillaries?
- Avoid high heels especially does that are up to 5cm high;
- Do not expose your legs to sun and solarium, because the heat
effects the condition by expanding veins and capillaries, hot baths
should be avoided as well;
- When sitting and lying stand up and walk a bit every 30 minutes;
- Avoid standing up for longer periods of time and avoid wearing elastic stockings;
- Take vitamin C for strengthening of veins and capillaries;
- Move as much as possible or drive a bicycle.
Which laser is used?
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.