Frequently Asked Questions For Veins

Frequently Asked Questions for PhotoFacial®

Frequently Asked Questions About Laser Hair Removal

Frequently Asked Questions About Compression Therapy

Frequently Asked Questions For Veins

What causes varicose veins and spider veins?

Although heredity and gender are the most important predisposing factors, the underlying cause is related to weakened valves in the saphenous vein which is a large superficial vein that runs the length of the leg. Valves in this vein become weak which allow blood to flow back toward the foot and result in pooling. Subsequently, these veins branch out and become enlarged and appear twisted. These large veins are called varicose veins. Symptoms include aching, swelling, heaviness, cramping, burning and itching. Pregnant women can also develop varicose veins. Circulatory changes that occur during pregnancy often produce enlarged veins in the lower extremities.

Spider veins result when the pressure from the deeper veins is transmitted to the smaller, more superficial veins causing them to also enlarge.

Is it true that crossing your legs and walking on concrete floors and other hard surfaces causes varicose and spider veins?

No, it is believed that these have nothing to do with the formation of varicose and spider veins.

How are these abnormal veins treated?

Treatment options for spider veins include laser therapy, intensed pulse light treatments, and sclerotherapy or injection of veins with a sterile solution.

Treatment options for varicose veins include endovenous laser treatments, phlebectomy, sclerotherapy and outpatient surgery. The Happel Laser & Vein Centre can also provide a combined approach should your condition require it.

Why should I have my varicose veins treated? What would happen if I left them alone and did nothing at all?

Treatment helps to relieve symptoms. If left untreated, these veins can lead to a number of complications including:

• Phlebitis - a recurring, painful condition involving the vein and surrounding skin which is caused by a blood clot within the vein. The area becomes red, warm, tender, swollen and hard from the blood clot.



• Ulceration of the skin -occurring usually around the ankles, that is often very painful, requiring months to heal.



• Stasis dermatitis - a permanent brown discoloration of the skin, also usually occurring around the ankles, is a frequent result of untreated varicose veins.



• Bleeding - although rare, it results in significant blood loss requiring an emergency room visit to suture the bleeding vein.

Will elimination of my varicose veins and spider veins adversely affect my circulation? Don't I need these veins?

When varicose veins or spider veins are treated, the nearby healthy veins take over and carry the blood. Your circulation is not adversely affected by treatment of these veins. In fact, 90% of the blood that passes through the veins in the legs is carried by the deep veins, which are not superficially visible.

After treatment, will my varicose veins reappear?

While true recurrence is unlikey for the veins that have been treated, new varicose veins and spider veins may recur in different locations. This is more likely to occur in people who have a family history of varicose veins and spider veins.

What can I do to prevent varicose veins or spider veins?

At one time it was believed that support stockings, weight loss and exercise provided some benefit in preventing varicose veins. However, now it is believed that there is no way to prevent these abnormal veins from occurring. Heredity and hormonal changes associated with pregnancy are more important predisposing factors in the development of varicose veins.

Frequently Asked Questions for PhotoFacial®

What is a PhotoFacial®?

A PhotoFacial® is a series of gentle, pulsed light treatments that can eliminate many minor skin imperfections. Treatments are especially effective for telangiectasis (spider capillaries) particularly on the nose and cheeks, as well as sun damaged skin and age spots. Treatments can also reduce large skin pores, improve skin texture and reduce fine lines by stimulating the skin to produce elastin and collagen, essential for youthful looking skin. A PhotoFacial® is particularly effective for treating the facial redness and flushing associated with Rosacea.

What is rosacea and can PhotoFacial® help this condition?

Rosacea is a common disorder, which typically involves the skin of the nose, cheeks, forehead, chin, and neck resulting in facial redness, flushing, dilated capillaries, and occasionally intermittent breakouts of acne. Although there are oral medications, antibiotics, steroids and creams which may help to partially control the acne-like breakouts, until recently, there has not been an effective treatment for the embarrassing facial redness and flushing that rosacea sufferers experience. With this laser-like medical breakthrough, Dr. Happel is able to individualize and adjust your PhotoFacial® treatments to address your specific problem (whether it is redness and dilated capillaries, sun damaged skin, fine lines, large pores or a combination of these conditions).

Am I a candidate for PhotoFacial®?

Individuals who desire a more youthful appearance and do not want to undergo a more invasive procedure like laser skin resurfacing with its persistent redness and "downtime" are good candidates for this new procedure.

Are there any contraindications for PhotoFacial®?

Yes, people who are currently sun tanned or who plan to suntan up to one month after a procedure should not undergo treatment. You should refrain from using artificial tanners during this same time period. People taking Accutane should wait for at least 3 months after their last dose before starting treatments. Pregnancy, connective tissue disorders, such as systemic lupus erythematosis, and those with autoimmune disorders should not undergo treatments. People who use Retin A/Renova or tetracycline should discontinue them 3 days before the procedure. Aspirin should be discontinued at least one week before each treatment.

What are the advantages of PhotoFacial® over other procedures?

Chemical peels and laser skin resurfacing are ineffective in reducing redness, dilated capillaries, and blushing. Before PhotoFacial® there was no effective treatment for this difficult problem. It is also helpful in areas of generalized skin redness, where the tiniest of vessels are packed so tightly together making it impossible to see them individually.

To aid in the stimulation of collagen and elastin, microdermabrasion may be used in conjunction with PhotoFacial® to enhance the results. After a series of PhotoFacials®, many patients are delighted with their freshened "new look".

A significant advantage of this procedure is the lack of down time and pain associated with more invasive procedures. A PhotoFacial® treatment only takes about 30 minutes and you can usually return to work the same day. The resulting skin "glow" usually resolves within in 2-24 hours depending upon the specific treatment.

I have darkened areas from sun damage and some shallow acne scarring and large pores. Can I be helped?

Yes, the settings on the machine are precisely adjusted each time that you come in to individualize your treatments. These settings are changed with every visit to concentrate on either pigmentation problems, reddened faces with dilated blood vessels, or mild scarring and fine wrinkles, (depending on your specific problem). However, the deeper acne scars cannot be helped with this technique. It is the ability to modify the parameters of intensity, duration and depth of the penetration of the pulsed light therapy that makes this treatment so unique and effective for each individual problem.

I have dark lines under my eyes. Can PhotoFacial® help me?

Yes, this condition requires that the initial settings be adjusted to concentrate on the layer of the skin where melanin is produced which causes the darkened pigmentation. As the treatments progress, the settings are gradually readjusted to reach and cover the entire layer of pigment producing cells. Similarly, PhotoFacials® are effective in eliminating the V-neck appearance of photo damage and hyperpigmentation on the upper chest and neck that results from a lifetime of excessive sun exposure to this area.

Will the PhotoFacials® treat "frown lines", sagging skin, puffy eyes, raised skin lesions (lumps and bumps) or sebborheic keratoses.

No, these conditions are treated with other modalities including Botox, face-lifts, plastic surgery or blepharoplasty. PhotoFacials® can remove minor actinic keratoses, a precancerous condition, and can remove acquired freckling. Genetic freckles usually return after treatment.

Are PhotoFacial® treatments safe?

Yes, this procedure is FDA approved and now this innovative technology has finally arrived in Pittsburgh and is now available at the Happel Laser and Vein Centre.

Is there any special before or after skin care regimen that I need to follow?

We recommend a gentle skin cleansing and hydrating regimen for 2 to 3 days before and after the treatments to enhance their effectiveness and to decrease any irritation that might occur otherwise. Deliberate sun exposure should be avoided. Sun protection including hats, sunglasses and sunscreen are important before and after the treatments to prevent hyperpigmentation. This recommendation should be followed throughout the series of treatment sessions.

Following the series of PhotoFacial® treatments, patients report a high degree of personal satisfaction, especially in being able to "wear less or no make-up" to cover their problem. Although the skin care is very simple around the time of the treatments, complete written pre and post treatment instructions will be given to you.

Frequently Asked Questions About Laser Hair Removal

How does laser hair removal work?

Laser hair removal uses a highly concentrated beam of light energy, which is absorbed by the pigment in the hair follicle. The laser flashes for just a fraction of a second, but with each laser pulse, hundreds of hair follicles are disabled without damaging the surrounding skin.

Am I a Candidate for Laser Hair Removal?

Not everyone is a candidate for laser hair removal. Individuals with dark hair are best suited for laser hair removal. The pigment in the dark hair absorbs more light energy and is therefore easier to treat. Individuals with light blond, red or light colored hair may not be suitable candidates for laser hair removal. In addition, individuals with darker complexions or dark tans will have less of a benefit from the laser because the pigment in the skin will absorb some of the light energy of the laser.

What is the treatment like?

The procedure is simple. A clear gel is applied to the skin and then the laser pulses are delivered quickly and evenly. You may experience a tingling or a slight stinging sensation depending upon the area of the body being treated. A topical anesthetic is always available. Although results vary, improvement is generally noticeable shortly after treatment.

How many sessions will I need?

Multiple treatments are usually necessary to deliver the best results. A popular misconception is that only one treatment is required. In fact, the laser only affects those hair follicles in the active phase of their growth cycle. Additional sessions are necessary to disable hair follicles emerging from their resting or dormant phase. Age, ethnicity, diet, medications and metabolism are all factors in hair growth. Maintenance sessions may be required depending upon the outcome desired.

Are all lasers alike?

No! Some offices still offer a laser-like device called intense pulsed light (the trade name is Epilight) which is somewhat similar to a laser. For anything other than a small area like the lip, the Epilight is very slow and often painful when compared to our new state-of the-art Alexandrite laser. Not only is it inconvenient, but in our opinion, the technology is simply not optimal for hair removal. For these reasons, we do not use intense pulsed light for hair removal.

Is the laser safe for hair removal?

Properly trained medical professionals have excellent safety records performing laser hair removal. Common sense will tell you that non-medical personnel such as aestheticians, cosmetologists, or beauticians should not be performing these medical procedures. When inquiring about any type of medical procedure, it is always wise to carefully examine the qualifications, training and background of the person who will actually perform the procedure. Be careful because some unscrupulous laser companies, medical offices, as well as, insurance companies are compromising your safety for the sake of profits.

Will the results last?

Lasers provide the most effective long term solution for hair removal. Since the laser affects only those hair follicles in the active phase of their growth cycle, hair follicles lying dormant will not be affected by the laser treatment. Eventually as these dormant follicles become active, periodic touch ups may be desired.

Is there any special care that is needed before the treatments?

We recommend that you not pluck, wax, or use depilatories for about a month before the treatment. There must be short stubble apparent at the time of the laser treatment for optimal results. Men should shave their backs about three days before the treatment, if possible. You must not suntan for one month before and after each procedure.

What can I expect after treatment?

The treated area becomes slightly reddened similar to a mild sunburn. This usually subsides within 24 hours. You should avoid tanning and use a sunscreen on any treated areas exposed to the sun. Although results vary, you should notice significant improvement approximately two weeks after treatment.

Does insurance pay for laser hair removal?

Unfortunately, no. It is considered a cosmetic procedure by all insurance companies even if there is an underlying medical condition causing the abnormal hair growth.

Frequently Asked Questions About Compression Therapy

What is Compression therapy?

Compression therapy involves several modalities used in the treatment of varicose veins and venous insufficiency. Compression therapy is used to provide gradual compression to the lower extremities to improve circulation.

I currently suffer from varicose veins. Will I benefit from compression?

Yes, with rare exceptions, almost everyone with varicose veins would benefit from compression.

What kind of compression do I need?

Your doctor will discuss this with you. In general, patients with varicose veins or spider veins limited to a specific area will benefit from a compression wrap/bandage, similar to an ace bandage. Patients with more diffuse veins will do better with compression stockings or panty hose.

Will any type of support hose work?

No. Standard stockings or support hose usually do not exert the needed pressure. In addition, support stockings are usually not graduated which means that more pressure is applied at the ankle and lower leg and less to the upper calf, thigh and waist. This actually improves your comfort while it improves your circulation.

Where can I get these graduated stockings?

The best and strongest stockings are available only by prescription. The Happel Laser & Vein Centre offers Sigvaris compression stockings for your convenience. These stockings have several advantages:

• Superior look and fit and they do not look like therapeutic stockings.



• Multiple colors to choose from.



• Highest quality.