Capillaries (called “telangiectasias” in medical parlance) of the lower limbs and face have long been a blemish that is very much felt particularly by women, but increasingly by men as well.
They do not cause major damage, but the appearance is very important, and if they then become very numerous, they can be a cause of sometimes major venous insufficiency. Women are more affected by this condition than men likely due to hormonal causes, predisposition, but especially pregnancies.
Until a few years ago there was only sclerotherapy for the lower limbs and sometimes diathermocoagulation for rosacea. For the past few years it has also been possible to correct this blemish with special types of lasers with special wavelengths.
I personally use the diode laser for lower limbs and for more dilated capillaries in the face, while for facial capillaries, especially very thin ones, I still use the diode laser with a much thinner fiber that is really a revolution, with very good results.
What are the advantages?
The result sometimes overlaps with sclerotherapy treatment, but there is no needle, the pain and burning is really very limited and the end result good.
In addition, many capillaries that were difficult to access with sclerotherapy, such as those on the foot and ankles, or difficult ones along the course of the saphenous veins, on the inner face of the thigh, can be treated.
Finally, for “Matting,” those very thin capillaries that develop after surgery or after major sclerotherapy, the laser is truly irreplaceable.
In conclusion, I think the combination of the two techniques gives the best results.
What is laser?
A laser, an acronym for Light Amplification by Stimulated Emission of Radiation, is basically a device that emits light.
Obviously a very special kind of light and above all very variable: because we can have numerous wavelengths that determine many characteristics of the laser, particularly the color target on which it acts, (the so-called chromophore) and the depth to which the radiation reaches the skin. The diode laser reads blue and dark red very well.
It has optimal skin penetration and thus reaches deeper dermal layers. It can therefore also be useful for the
How does therapy take place?
Lower extremity capillaries are just the tip of an iceberg and appear on the surface because the underlying venous circulation, reticular veins or saphenous veins are dilated. Therefore, if this is the cause, first you have to think about treating the larger veins, which create the insufficiency, and only at the end the telangiectasias.
For this reason, in my opinion, the best therapy is an integrated therapy that sees at the beginning the treatment of the major venous insufficiency and at the end of the minor one. Very often, therefore, we talk about an integrated therapy with both sclerotherapy and laser to finish the result.
It is very important to be able to make a complete diagnosis, possibly with a venous ecodoppler of the lower extremities. This will allow an accurate diagnosis of venous insufficiency to be made, accurately mapping the points of venous insufficiency.
Therapy always begins with treatment of major dilated veins and varicose veins, such as with sclerosing foam. But if it is the saphenous vein that is insufficient, then the surgery of choice may also be radical saphenectomy.
The Nd-Yag laser is among the lasers with the best effect on capillaries and also on venules of a certain caliber. The capillary is closed by the laser energy reading the specific color: the skin remains absolutely undamaged! In addition, the laser I use also includes a special type of cooling at the tip, in contact with the skin, called Terma Cool, which further reduces inflammation and burning.
Elastic stockings must still be worn at the end of the sessions, and all normally prescribed preventive therapy must still be followed.
How many sessions are needed?
If the capillaries are many, it may take several sessions, but on average with 4-5 sessions you can treat a fairly major defect. Obviously the therapy does not have a definitive result, but over the years the capillaries that are to appear will certainly appear.
This is not because you have closed on one side and then a new capillary opens on another, but it is because individual predisposition causes additional capillaries that would have appeared over time anyway.
What diseases can be treated?
Fine capillaries of the legs, rosacea capillaries of the face represent the best target.
Ruby angiomas, single or multiple star angiomas, and flat angiomas are also good targets, sometimes disappearing after a single treatment.