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Varicose veins vs. 'spider veins'

E-mail Dr. Brenda Scott at This email address is being protected from spambots. You need JavaScript enabled to view it. . Scott is a board certified family physician and practices with her team at her Inspir Medispa in the Portland/Troutdale area.

Dear Dr. Scott,

I went to see my medical doctor to have my varicose veins 'stripped.' I was told that I didn't have varicose veins, I had 'spider veins' and that mine could not be 'stripped.' I was also told that my medical insurance would not pay to have them removed because it was considered an elective procedure. I know it is not medically necessary to have them removed, but they are ugly and prevent me from wearing shorts. What is the best way to have these removed?

Signed, Jill

Dear Jill,

Let me first explain the difference between varicose veins and 'spider veins.' Varicose veins and spider veins both typically occur on the legs, but varicose veins are larger. They are the thick, ropey, bulging veins that protrude above the skin's surface.

Spider veins, also called telangectasias, are smaller in diameter. They tend to have a branching pattern, and can cover a small area or extend up to several centimeters. They are usually red to purple in color.

Spider veins can be treated using sclerotherapy (inserting a needle into the vein and injecting a substance that damages that blood vessel) or by laser vein treatment (placing a laser hand piece against the skin that delivers a wavelength of light energy that heats and damages the blood vessel).

Laser vein treatments are preferred for removing the smaller spider veins because it is difficult to get a needle into the smaller diameter vessels to inject them.

Varicose veins are treated using either sclerotherapy, vein ligation/stripping (cutting and removing the damaged vein), or by radiofrequency endovenous ablation (inserting a catheter probe inside the blood vessel and using radiofrequency to heat and destroy the vein).

Dear Dr. Scott,

I have facial hair that I want to have permanently removed, but I was told that because it was gray, it would be difficult to treat. Is there any way to get rid of my gray facial hair?

Signed, Mary

Dear Mary,

Permanent methods of removing unwanted facial hair include electrolysis and laser hair reduction.

Up until recently, the only effective way to permanently remove gray, blond or red hair was by using electrolysis. Electrolysis is still effective at removing lighter colored hairs, but it is time consuming and painful. It is practical only when used to treat small areas needing hair removal.

Until recently, laser hair reduction has been ineffective at removing lighter colored hair (it works best on dark brown to black hair). But, with the introduction of a recently FDA approved product called Meladine™, clients with lighter colored hair can now have effective laser hair reduction results.

Meladine™ is a liquid that is sprayed onto the skin and is absorbed directly into the hair follicle. The hair below the skin surface absorbs the melanin and becomes darker, but no change is seen above the skin surface.

The hair follicle now contains the necessary melanin that is required for the laser treatment to be effective. The laser releases a wavelength of light that targets the melanin within the hair follicle, heating it and destroying it to prevent hair re-growth.

The material in this column is in no way intended to replace professional medical care or attention by a qualified physician and is intended for educational purposes only. Dr. Scott is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances. You should never delay seeking medical advice because of what you have read in this column. If you have, or suspect you have, a health problem, you should consult your physician.

Visit Dr. Scott's Web site at www.InspirMedispa.com.