Welcome to the Cosmetic Vein & Laser Center where Dr. Kimberly Moskowitz specializes in state-of-the-art, non-surgical treatment of varicose and spider veins on the legs, face, hands, and body. Treatments are performed in-office and include the latest techniques in sclerotherapy, foam sclerotherapy, Endovenous Laser Treatment (EVLT), duplex-guided sclerotherapy, ambulatory phlebectomy, and Intense Pulsed Light.

Are you tired of hiding your legs?

You are not alone. Unattractive leg veins plague more than 80 million Americans both female and male. Fortunately, exciting new options are available for treating spider veins and varicose veins non-surgically, comfortably, and with no down-time. Today’s treatments are highly effective, and have very few risks or side effects. With today’s technology, we can improve cosmetic appearance, restore healthy circulation, and relieve symptoms such as pain, aching, burning, swelling, and nighttime cramps. The longer you live with abnormal varicose veins, the greater the likelihood of developing serious medical complications such as phlebitis, dermatitis, permanent skin discoloration, ulceration, and blood clots in the legs.

What are varicose veins?

Veins are the vessels that return blood to the heart. Varicose is derived from the Latin term meaning dilated.

Varicose veins are abnormally dilated rope-like veins that bulge from the skin. They most often occur on the legs but can also be found on the hands, arms, breast, and genital regions. They occur when vein valves weaken resulting in pooling of blood in veins near the surface of the skin.

What are spider veins?

Spider veins, medically known as telangiectasias, are dilated capillaries (the tiniest of all veins) that are visible just below the skin’s surface. They are blue, red, or purple and often resemble a tangled spider’s web; hence, the name. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it. Spider veins are primarily a cosmetic concern but can be associated with symptoms such as burning, aching, itching, or restless legs syndrome.

What causes varicose veins and spider veins?

Varicose veins develop in the legs when vein valves become weak or malfunction, allowing blood to flow in the wrong direction (reflux). When this happens, pressure in the veins increases (venous hypertension), and blood begins to pool in the abnormal veins causing them to dilate and protrude from the skin. These abnormal veins are not properly returning blood from the lower legs to the heart.

The primary factor contributing to the development of varicose veins is hereditary predisposition to weakness of the vein walls and valves. Other factors contributing to the development of varicose and spider veins include hormonal changes (pregnancy, birth control pills, hormone replacement therapy), occupations requiring prolonged sitting or standing, obesity, aging, lack of exercise, and physical trauma to the leg. Women are at least twice as likely to develop abnormal veins as men.

Pregnancy causes increases in hormone levels and blood volume which in turn cause veins to enlarge. In addition, the enlarged uterus causes increased pressure on the veins. Varicose veins due to pregnancy often improve within 3-4 months after deliver. However, with successive pregnancies, abnormal veins are more likely to remain.

What are the symptoms of varicose and spider veins?

In addition to being unattractive and often embarrassing, varicose veins are a chronic progressive disease that left untreated, causes chronic venous insufficiency. This compromises the nutrition of the skin and leads to serious and difficult to treat complications such as:

  • Leg achiness, Pain, heaviness, fatigue
  • Throbbing, burning, itching, cramping
  • Restless legs Syndrome
  • Swelling
  • Bleeding
  • Rashes or dermatitis
  • Inflammation of the leg (phlebitis).
  • Abnormal discoloration and chronic leg ulcers
  • Deep Vein thrombosis (blood clots)

What are the treatment options for varicose and spider veins?

Conservative treatments?

The most conservative way to manage varicose vein disease is wearing prescription-strength compression stockings. Compression stockings will temporarily support the venous circulation of the legs and improve symptoms such as pain and swelling. They may slow the development of new veins but they will not cure or eliminate existing problems. There is no evidence to show that compression stockings prevent the formation of varicose veins. Because the diseased veins that are causing the symptoms are not being eliminated, the stockings must be worn indefinitely.

Corrective medical treatments?

Corrective treatments restore proper venous blood flow by eliminating varicose and spider veins from the abnormal circulation. The Cosmetic Vein & Laser Center is proud to offer state-of-the-art treatment options for medical and cosmetic improvement of abnormal veins. These include:

The choice of medical treatment depends upon determining the size, severity, and location of the abnormal veins. A non-invasive, diagnostic duplex ultrasound is initially performed in our office to determine if there is abnormal blood flow (reflux) in the underlying saphenous veins. This diagnostic workup is essential for determining the best program for treating your abnormal leg veins.

What is Endovenous Laser Treatment (EVLT)?

Until recently, the only successful treatment option for large, painful, varicose veins in the leg was surgical vein stripping. This required general anesthesia, a long painful recovery period, and the risk of unsightly scars on the legs.

Since its FDA approval in 2002, EVLT has replaced the need for painful surgical stripping of large, varicose veins in the legs.

EVLT is a minimally invasive, outpatient procedure that is performed in 30- 45 minutes and has a 97-99% success rate.

Patients experience minimal to no discomfort during the procedure, no scarring, and no downtime. Most insurance companies will pay for the procedure because it is performed out of medical necessity.

How does EVLT work?

First a non-invasive ultrasound “mapping” of the main veins in the leg is performed. An ultrasound is then used to guide placement of a thin, sterile, laser fiber into the abnormal Saphenous vein in the leg. After applying tumescent anesthesia to the vein, laser energy is used to seal the vein shut at the precise origin of the problem. The body then reabsorbs the vein causing the blood flow to be re-directed to the healthier veins in the leg (the deep veins).

As we reduce the pressure coming from these abnormal large veins, it allows the unsightly branches close to the surface to shrink away. The result is beautiful legs and improved circulation. There is no post-operative scarring and patients usually notice improvement in symptoms within one to three weeks.

Advantages of EVLT (Endovenous Laser Treatment)

  • 45 minute, outpatient procedure
  • No general anesthesia
  • Minimal to no discomfort
  • 97-98% success rate
  • No scars
  • patients resume normal activities same day
  • Covered by most insurance plans

What about thru-skin lasers for leg vein treatments?

Here at the cosmetic vein & laser center, we use a wide array of laser treatments for facial veins and a variety of other skin conditions. Although there has been much publicity about laser treatment for spider veins, most vein specialists consider laser therapy to be less effective and more painful than sclerotherapy for leg veins. Hence, sclerotherapy remains the “Gold Standard” therapy for smaller varicose and spider veins on the leg.

There are special circumstances in which our physician may choose to treat your leg veins with thru-skin lasers. All of the available treatment options will be discussed during the initial consultation. Our aim is to find a treatment plan that best suits your specific vein problems as well as your overall needs.

What is Sclerotherapy?

If the ultrasound reveals normal circulation within the larger vessels i.e. the Greater Saphenous & Small Saphenous Veins, the treatment of choice for both varicose and spider veins is sclerotherapy. Sclerotherapy is a simple procedure in which a solution (called a sclerosing agent) is injected into the unwanted veins with a very tiny needle. The solution is designed to cause irritation of the vein wall which then collapses and is naturally reabsorbed by the body. Fading of the veins gradually occurs over a period of several weeks. The number of treatment sessions needed typically ranges from two to six and is determined by the severity of the problem and the desired cosmetic result. Patients generally see a 70-90% improvement in both the appearance of their veins as well as their symptoms.

What is Duplex-guided sclerotherapy?

Duplex-guided sclerotherapy is performed by using ultrasound imaging to guide sclerotherapy injections. This makes it possible to inject abnormal veins that are not visible on the skin’s surface. Duplex-guided sclerotherapy is ideal for larger veins such as the saphenous veins and their immediate branches. It is also used for treatment of abnormal (incompetent) perforating veins.

What is foam sclerotherapy? Why Does foam sclerotherapy work better than liquid-sclerotherapy for medium & large varicose veins?

Sclerotherapy relies on an effective concentration of the medication acting on the vein wall for a sufficient amount of time to cause endothelial damage. Without this injury to the inner vein wall, sclerotherapy will be ineffective and the body will not close the vein. With traditional liquid sclerotherapy, once the sclerosing liquid is injected in a vein, it immediately dilutes the blood, resulting in decreased concentration of sclerosing agent within the lumen of the target vein.

Because FDA-approved sclerosing agents have detergent properties, they can be converted into micro-foam. As this micro-foam is injected into the vein, it acts like a sponge and pushes the blood out of the way. As it displaces the blood, it allows nearly 100% contact between the sclerosant and the vein wall for a longer and more effective period of time than regular sclerotherapy. This makes foam sclerotherapy a much more effective treatment than liquid sclerotherapy. Foam sclerotherapy allows specialists to use lower concentrations and lower volumes of sclerosant, resulting in less post treatment local pain, discomfort, and pigmentation of the overlying skin.

Many European pioneers of foam-sclerotherapy prefer foam over surgery. Physicians who lack experience in liquid-sclerotherapy and are not trained in foam-sclerotherapy should not perform sclerotherapy.

Dr. Moskowitz is one of only 248 Board-certified* Vein specialists (Phlebologists) in the United States. She has treated thousands of patients using sclerotherapy, duplex-guided sclerotherapy, and foam sclerotherapy. We look forward to treating your veins. Please call for a consultation Today: (850)233-0264 or Toll free 888-435-8346.

 

*The specialty recognition identified herein has been received from a private organization not affiliated with or recognized by the Florida Board of Medicine