Laser treatment of varicosities

Varicose veins are damaged veins in which blood does not circulate well. They are bluish, dilated and twisted and can be more or less prominent.
Most often, varicose veins are formed on the legs. They can also appear in the region of the vulva (vulvar varices) or scrotum (varicoceles).
Varicosities are permanent dilations of the intradermal veins of the lower limbs (small dilated vessels).
They are present in both women and men, and are difficult to treat because of their variable diameter and depth.
It is estimated that 15% to 30% of the population has varicose veins. Women are 2 to 3 times more affected than men.
There are two types of varicosities:
• Blue varicosities with a diameter between 0.5 mm and 2 mm
• Red varicosities with a diameter of less than 0.5 mm.
Some varicosities are parallel to the skin surface, others dive deep, communicating with the hypodermic or even intramuscular network.
The advantage of laser treatment is that there is no needlestick or injected product either. No bandage is necessary and there is no bruising.

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Even if the laser is the solution of choice to treat this type of vascular lesions on the legs, it will be necessary to plan a preliminary phlebological assessment with a possible venous Doppler ultrasound in order to detect venous insufficiency. When this examination detects reflux of large venous trunks, the initial treatment should focus on this reflux.
The existence of one or more veins for feeding varicose veins should also be investigated and treated with micro-sclerosis.
Vascular lasers are particularly interesting in cases of very red superficial varicosities, arranged in layers or in dense and fine spots. It is recommended to treat these varicosities as soon as possible for maximum effectiveness.
Their diameter is less than 0.3 mm, making them inaccessible to the finest needles used in micro-sclerosis. Some areas such as the ankles are excellent indications for the laser (while the use of sclerotherapy entails risks of necrosis).
There are several types of vascular lasers for the treatment of varicosities.
The wavelength is targeted on the absorption of oxyhemoglobin from red blood cells. The desired effect is that of selective photocoagulation: the laser beam passes through the skin without damaging it to coagulate the red blood cells in the blood vessel. The pulse duration will be adapted to the size of the vessel and the desired therapeutic effect.

The doctor follows the course of the varicosities with a pen-shaped handpiece that conducts the laser light. A tingling and warm sensation is felt during the treatment.
On average, a session lasts 15 to 30 minutes, but several sessions should be scheduled at intervals of 4 to 6 weeks.
The wearing of protective glasses for both the patient and the doctor is mandatory for the duration of the treatment.
A healing cream is applied immediately after the treatment to the treated area.

There is always an erythema and a feeling of warmth. A slight oedema, as well as a temporary bleaching are visible around the treated area. The appearance of small crust from the second day is frequent. These small crusts result from the coagulation of the epidermal proteins and disappear within a few days without leaving a scar. Do not try to remove them.
Blisters may appear, they correspond to a skin burn. Their presence requires the practitioner to modify the laser treatment parameters.
Rarely is temporary hyperpigmentation of the skin observed. This side effect may persist for a few months and will be accentuated in case of sun exposure. On dark phototypes, temporary hypopigmentation may occur.
It is important that the treated area should not be exposed to the sun in the month following the treatment.

About Laser treatment of varicosities

Contraindications:
• A dermatological lesion located on the area of skin to be treated
• The identification of a proven venous insufficiency requiring prior treatment
V High phototypes (V, VI)
• Pregnancy and breastfeeding are contraindications in principle
Any additional questions? Ask your MEDICAIM doctor about it: careteam@medicaim.com