Spider Vein, Varicose Vein Therapy

American Academy of Dermatology

 

Spider Vein, Varicose Vein Therapy

Spider veins are dilated small blood vessels that have a red or bluish color. They appear mostly on the legs, occasionally on the face or elsewhere, and may often be unwanted. Larger dilated blood vessels called varicose veins may be raised above the skin surface. They may occur along with spider veins.

What Causes These Blood Vessels to Become Visible?
The cause of spider veins is not known. In many cases they seem to run in families. Identical twins can be affected in the same area of the body and to the same extent. The condition can very occasionally occur as part of an internal disease.

Spider veins can appear on both men and women the hormones of estrogen and progesterone may play a role in their development. Puberty, birth control pills, pregnancy or hormone replacement therapy often seem to bring them out. They may also appear after an injury or as a result of wearing tight girdles or hosiery held up with tight rubber bands. Spider veins may also occur with large varicose veins.

Spider veins on the nose or cheeks of fair skinned persons may be related to sun exposure.

Can Spider Veins Be Prevented?
Spider veins can't always be prevented. Wearing support hose may prevent some unwanted blood vessels from developing. Keeping one's weight at a normal level and exercising regularly may also be helpful. Sun protection is important to limit the number of unwanted vessels on the face.


How Are Unwanted Blood Vessels on the Legs Treated?
A procedure called sclerotherapy is used to treat unwanted blood vessels. One of several kinds of solutions called sclerosing solution is injected with a very fine needle directly into the blood vessel. This procedure has been used since 1930 and before that for longer veins. The solution irritated the lining of the vessel, causing it to swell and stick together and the blood to clot.  

Over a period of weeks, the vessel turns into scar tissue that fades, eventually becoming barely noticeable or invisible.

A single blood vessel may have to be injected more than once, some weeks apart, depending on its size. In any one treatment session a number of vessels can be injected.

How Successful is Sclerotherapy?
After several treatments, most patients can expect a 50 to 90 percent improvement. Scelerotherapy can be used on all skin types. Side effects of sclerotherapy is stinging or pain at the sites of injection, swelling of the ankles or feet or muscle cramps which almost always occur when the injection takes place in the ankle areas. These usually go away within 10 to 15 minutes after injection. Red, raised areas at the sites of injection which should disappear within a day or so. Bruises at the site where the needles went into the skin which disappears in a few weeks and are probably related to the thinness of blood vessel walls. Other treatment methods new lasers may hold promise for treating blood vessels, but currently vessels in the legs do not respond uniformly to laser treatment.

How are Spider Veins on the Face Treated?
There are several ways to treat spider veins on the face. Lasers have been used successfully, alone or in the combination with electric needle therapy.

What Do I Do After Treatments?
Physicians may differ in their after treatment instructions to patients. Depending on certain factors, such as size of the blood vessels injected, patients may be instructed to put their legs up for an hour or then and then walk. Others are asked to walk immediately. All patients are instructed to walk a good deal in the days following to procedure so that blood will be pushed through other vessels.

Some Physicians bandage the injected areas and instruct patients to "compress" the treated vessels by wearing support hose. This may help seal the treated vessels, keep the blood from collecting under the skin and reduce the number of treatments necessary, and the possibility of recurrence. Other put tape dressings on the areas and do not use compression unless the veins are large or have other characteristics.

Between treatments, many physicians recommend the use of compression of support hose. this may particularly recommend  for people who spend a lot of time on their feet.







 

Q&A Uncovering The Cause Of Armpit Irritation

Cosmetic Dermatology
Dermatology Times January 2014

Zoe Diana Draelos, M.D., is a Dermatology times editorial adviser and consulting professor of dermatology, Duke University School of Medicine, Durham, N.C.

Q: Why do antiperspirant/deodorant cause skin irritation?

A: Antiperspirants and not deodorants are the culprit in skin irritation. The antiperspirant decreases sweating while the deodorant simply provides a pleasant scent to the armpit.
   The active ingredient in all widely marketed antiperspirants is an aluminum salt possibly mixed with a zirconium salt. The aluminum salt is very irritating to the skin, especially in high concentration. As a matter of fact, the aluminum salt functions to decrease the release of perspiration from the armpit by coagulating protein in the eccrine and apocrine sweat ducts, and it may also coagulate the stratum corneum protein lining the armpit as well. More modern antiperspirant formulations minimize this irritation by incorporating dimethicone, listed on the skin protectant monograph.
   For patients that experience irritation from antiperspirant/deodorant and wish continue using these products, it is possible to offer some advice. The antiperspirant/deodorant should be applied at night since the armpit is at rest with less sweat and will work better. In the morning, a thin dimethicone-based moisturizer could be applied to the armpit. This provides a compromise between sweat reduction and skin irritation.

Q: Do lipsticks protect against lip sun damage?

A: Lipsticks provide excellent photo protection if they are completely opaque. As a matter of fact, opaque lipsticks provide better photo protection than SPF- containing lip balms because they have an unlimited SPF and excellent substantivity. Substantivity is the ability of the lipstick to remain in the place on the lip. Products that stay on better provide superior longer-lasting photo protection. The best lip sunscreen for female patients with actinic cheilitis is an opaque lipstick.

Q: Do lipsticks contain lead?

A: The presence of lead in lipsticks has created a stir on consumer websites. Indeed, there are some dyes, especially red dyes, which are used in lipsticks that may contain trace amounts of lead. Remember that the government regulates the pigments used around the mouth, where ingestion may occur. This regulation is necessary to prevent safety issues. The trace amounts of lead that may be found in lipsticks are not felt to be health issue and indeed the amounts are very small compared to the lead contamination possibilities from old lead based paints.

Q: Which sunscreens are more likely to cause acne?

A: Many patients claim that they do not wear sunscreens because they cause acne. I do not believe that it is the organic and inorganic filters that cause acne, but rather the vehicle in which the sunscreens are suspended. It is even unclear that the vehicles contain ingredients that cause acne.
  Most patients that complain of acne within 48 hours of applying sunscreen probably are not experiencing true acne with follicular contact dermatitis or possibly miliaria rubra and miliaria pustulosa. The irritant contact dermatitis could be due to the emulsifier in the formulation and the miliaria rubra or miliaria pustulosa could be due to occlusion of the ecrrine sweat units with the sunscreen film.
  It is hard to generalize as to which sunscreen formulations are more likely to cause acne-like skin problems, but thicker creamier products are probably the culprits. It may be worthwhile to suggest to patients who claim that sunscreens cause acne-like eruptions to consider a spray formulation.

Don't Worry, Get Botox

The New York Times
March 2013

Don't Worry, Get Botox

FEELING down? Smile. Cheer up. Put on a happy face. No doubt you've dismissed these bromides from friends and loved ones because everyone knows that you can't feel better just by aping a happy look.
      Or perhaps you can. New research suggests that it is possible to treat depression by paralyzing key facial muscles with Botox, which prevents patients from frowning and having unhappy-looking faces.
      In a study forthcoming in the Journal of Psychiatric Research, Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, randomly assigned a group of 74 patients with major depression to receive either Botox or saline injections in the forehead muscles whose contraction makes it possible to frown. Six weeks after the injection, 52 percent of the subjects who got Botox showed relief of depression, compared with only 15 percent of those who received the saline placebo.
     (You might think that patients would easily be able to tell whether they got the placebo or Botox. Actually, it wasn't so obvious: Only about half of the subjects getting Botox guessed correctly. More important, knowing which treatment was received had no significant effect on treatment response.)
     Other studies over the past several years have found similar effects of Botox on mood. Micheal Lewis at Cardiff University reported that non depressed patients at a cosmetic dermatologist clinic receiving Botox injection about the eyes frowned less and felt better than those who did not receive this injection. And M. Axel Wollmer at the University of Basel Found that Botox injection was superior to a placebo in a group of depressed patients.
     Is paralyzing the muscles involved in frowning truly enough to make depressed patients feel better? The notion that your expression can exert a powerful influence on your mood turns our sense of psychological causality on its head. After all, we smile because we feel happy, and cry because we feel sad, not the other way around, right?
    Not necessarily. The idea that facial expressions may feed information back to our brain and influence our feelings goes back to a theory of emotion first proposed by Charles Darwin. In "The expression of the Emotions in Man and Animals, " Darwin posted that the control of facial expression causes a liked effect on subjective emotions. William James took the idea further and proposed that emotions were the result, not the cause, of various bodily sensations, suggesting that "we feel sorry because we cry, angry because we strike, afraid because we tremble, and not that we cry, strike, or tremble, because we are sorry, angry, or fearful, as the case may be."
   We are used to thinking of the brain, not the body, as the prime mover of our emotional states. Consider the field of so called psychosomatic medicine, which emphasizes a mischievous flow of information from brain to body: hence, the psychosomatic stomachache, headache and the like. You can literally worry yourself sick.
   The Botox studies, by contrast, suggest a circuit between the brain and the muscles of facial expression in which the brain monitors the emotional valence of the face and responds by generating the appropriate feeling. (Obviously, information flows in both directions, as you can think yourself into practically any emotional state and then have the face to match it.)
   There are other treatments for depression that appear top use facial feedback in a similar way. Light therapy stimulates the retina and excites the optic nerve, which sends signals directly to the brain and effectively treats seasonal depression. And the direct electrical stimulation of the brain's vagal nerve has antidepressant effects.
   Botox for depression is part of a long tradition of "outside-in" somatic therapies- many of dubious efficacy- that manipulate the body with the aim of altering the brain and mind, for instance by using cold wet sheet packs to treat severe agitation or acupuncture for anxiety.
  In a broad sense, these Botox studies underscore one of the biggest challenges in treating people with depression. They might think that the reason they are depressed is that they have little interest in the world or their friends- a mistaken notion that is the result, not the cause, of their depression. They insist that only once they feel better will it make sense for them to rejoin the world, socialize and start smiling. Their therapists would be well advised to challenge their invested sense of causality and insist that they will start feeling better after they re-engage with the world.
  Whether Botox will prove to be an effective and useful antidepressant is as yet unclear. If it does prove effective, however, it will raise the intriguing epidemiological question of whether in administering Botox to vast numbers of people for cosmetic reasons, we might have serendipitously treated or prevented depression in a large number of them.

Dermatologic Treatments

Cooper University Hospital

Chemical Peels

Thousands of chemical peels are performed each year. Dermatologic surgeons have agents for the last 100 years and are experts in performing multiple types of chemical peels public's increasing interest in rejuvenating skin and slowing effects of the aging process which has emerged as an exciting supplement to a total skin care program. Dr. Lawrence will evaluate before embarking upon a chemical peel.

Indications
Melasma, Acne, Skin aging, sun damage, wrinkles (depends on peel solution)

Melasma is a brown discoloration of the face most often seen in women. This change can get worse in the summer when exposed to the sun's harmful rays and often fades. Pregnancy is the most common cause of melasma.

The Center for Dermatologic Surgery treats melasma with prescription bleaching topical in addition to a series of chemical peels. Since sunlight is a major factor in the melasma, it is imperative top continue to avoid the sun, wear protective clothing and apply sunscreen.

Benefits

• Superficial: Freshens skin, makeup goes on nicer, may decrease some fine lines.
• Medium Depth: Chemical peeling is often used to treat fine lines under the eye and mouth. Wrinkles caused by damage, aging, and hereditary factors can often be eliminated with this procedure. However, sags, bulges and more severe wrinkle peeling and may require other kinds of cosmetic surgical procedures. Dr. Lawrence determines the most appropriate treatment for your needs.

Mild scarring and certain types of acne can be treated with chemical peels. In addition, in the form of sun spots, age spots, liver spots, freckles, blotchiness, due to taking birth control that is dull in texture and color may be improved with chemical peeling . Areas of sun damage precancerous keratosis and scaling patches may improve after chemical peeling. Follow lesions or patches are less likely to appear.

Age spots, also known as sun spots, are flat, brown discoloration of the skin which usually is around the neck, hands, and other areas of the skin exposed to the sun over many years.

A German Study Underscores the Benfits Of Full-Body Screenings

Skin Cancer World News Round-Up
Skin Cancer Foundation Journal 2013


Since its inception in 1979, The Skin Cancer Foundation has recommended that everyone have an annual full-body skin exam performed by a physician. In 2012, A German skin cancer screening study- The largest ever conducted-found that regularly having total-body skin exams can cut melanoma deaths by more than 50 percent.
    Over the course of this year-long program in the German state of Schleswig-Holstein, doctors have found more melanomas than had been detected prior to the start of the program. This was not expected, since screenings typically lead to identification of greater numbers of skin cancers. What was more striking was how much earlier the melanomas were bring found. According to the researchers, this early identification slashed the melanoma death rate in half--very likely because tumors were thinner. As a general rule, the thinner the lesion, the easier to treat. Melanoma killed 43 men and 45 women in Schleswig-Holstein in the three years before the study, but just 23 men and 21 women in the post-study follow-up from 2006 to 2008.
    The results were so impressive that in 2008, Germany began a national skin cancer screening program, offering people ages 35 or older a total-body skin exam every two years. The authors suggested that such large-scale screening programs are feasible and advisable around the world, and have "the potential to reduce skin cancer burden, including mortality."

Tanning Machines Are Twice as Dangerous As the Midday Mediterranean Sun

Skin Cancer Foundation 2013

In their recent research into the dangers of ultraviolet (UV) tanning, British investigators didn't just crunch numbers. They also compared the "controlled dose" of UV radiation emitted by tanning machines with the intense midday Mediterranean sun -and refuted tanning salons operators' claims about the so-called "safety" of indoor tanning. The researchers found that the average indoor tanning machine in England is 2.3 times more cancer-causing than the midday Mediterranean sun, and some tanning machines are up to six times as dangerous. A 2003 study suggests that US tanning beds are about as dangerous as their English counterparts. Researchers determined that nine out of 10 tanning beds in England emit more UV radiation than recommended by British and European safety standards, typically, almost double the recommended amount. These excessive levels are especially worrisome considering that any UV tanning causes DNA damage that ages the skin and can ultimately cause skin cancers.

The Best Sun Shield for Car, Home and Office

Window Film
Skin Cancer Foundation 2013

The Best Sun Shield for Car, Home and Office

Whether you're driving, at home gazing out at your garden, or sitting by a window at work, you actually may be suffering continual skin damage. While everyday windows block most of the sun/s ultraviolet B (UVB) rays, they allow much of its ultraviolet A (UVA) rays to pass right through. UVA penetrates deep into the skin, causing DNA damage that can accelerate skin aging and lead to skin cancer.
If you frequently sit by windows, the single best safeguard against UV damage is transparent window film, sometimes referred to as window tint, which has been treated to screen out both UVA and UVB rays. Installing protective film on your windows will keep you virtually UV-free on the road, at home, or at the office.

Curing Car Trouble
In cars, only the laminated windshield comes with both UVB and UVA protection. The side and back windows allow in more than 60 percent of UVA rays. Research has shown that UV damage is more extensive on the side of the body closer to the window; long-time drivers also have rougher, slacker, more wrinkled skin on their window side. Babies and young children — who have little protective skin pigment — often sit in back, where none of the glass (even darker glass found in SUVs and mini-vans) offers adequate UVA protection. Fortunately, UVA-filtering window film can go a long way to prevent skin damage. Combining UVA absorbers in varying strengths, the transparent films are available from clear to dark tints for vehicles’ side and back windows in all 50 states; it screens out more than 99 percent of UVA and UVB without reducing visibility.

• Drivers in the US have more skin cancers on the left side of their faces: drivers in Australia have more skin cancers on the right.

Alternative Measures For Sun Protection While Driving
'It's wise to practice the following sun safety strategies everyday:

• Cover up with clothing. Long-sleeve shirts help prevent UV damage to the drivers' window-side arm, and long pants protect your legs.
• Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher. Don't forget often-missed spots like the top of the head, neck, hands and ears.
• Take extra precautions in convertibles and cars with sunroofs. Wear a wide-brimmed hat and wraparound, UV-blocking sunglasses.

UV-absorbing auto window film reduces skin cell death 93 percent.

Sun Protection Indoors

Indoor workers stationed near windows have significantly more wrinkled, rough-textured, and sagging skin on the side of the face closer to the window.
Today, however, UV-screening residential and commercial film is available for home and office. UV absorbers are added to clear or tinted polyester or vinyl to create film, which comes in varied tints, allowing 30-80 percent of visible light to get through. The installers apply it on the interior glass surface of the windows from flat sheets.

Window film will help prevent sunburn and skin cancer, as well as the brief daily UV exposures that accelerate skin aging over time.


Chronic exposure to UVA rays through windows may accelerate skin aging by 5 to 7 years.

More than 90 percent of skin cancers and the visible signs of skin aging, are caused by the sun.

Advantages of Window Film

• In hot weather, it cuts down heat within the vehicle or home, reducing air conditioning expenses.
• In cold weather, some films reflect interior heat back into the house, reducing heating costs.
• It helps keep sunshine from fading car upholstery and home furnishing.

UV-protective window film is available worldwide. For professional installation, look online or in the yellow pages under "glass tinting" or "glass coatings."

Several companies now carry The Skin Cancer Foundation's Seal Of Recommendation, offering assurance of safety and effectiveness.