Baltimore Dermatologists

How Effective is Sclerotherapy?

I have had Sclerotherapy injections for several years in an attempt to combat the spider veins which are in greatest concentration around my shin and ankle areas.

My physician has told me that there is a limit as to what can be done to eradicate these veins, as they are so tiny and numerous. Is there any hope for me to ever have lower legs and ankles that don't look red and blotchy?

When done by an experienced physician with training in vein treatment and an understanding of leg veins, sclerotherapy is extremely successful with an excellent safety record.  The most important thing is to find the right doctor.  Dermatologic surgeons who perform sclerotherapy are typically your best choice; knowing how leg veins connect with each other, what solution to use and in what concentration, and when to perform ultrasound testing is very important.

McGraw-Hill is publishing the second edition of our textbook on vein treatment in January 2012.  We have over 25 years of experience with more than 30,000 patients.  

For the ankle, experience and skill of the physician are key.  Sometimes, a vascular laser may be used.  It is very rare to not be able to get success.  You may need to have maintenance treatments, perhaps as often as once or twice a year.  But that's better than having lower legs and ankles that would otherwise worsen to becoming purple. 

Margaret Weiss, MD

Baltimore Dermatologist

How is Sclerotherapy Done to Treat Veins on Breasts?

Is it true that hypertolic saline can treat spider veins on the breasts?

We have more than twenty years of experience in the safe and effective treatment of enlarged, typically blue, veins on the breasts.  These veins are more common in women who have had breast implants.  We usually treat these veins with sclerotherapy, the injection of either polidocanol (Asclera) or sodium sotradecol sulfate (Sotradecol). Very careful technique by an experienced physician is important for success.

Sometimes, a 1064 nm Nd-YAG laser is used, but sclerotherapy is less painful, less costly and faster.  

Margaret Weiss, MD

Baltimore Dermatologist

What Areas of my Face Can I Get Botox Injected?

I have wrinkles pretty much across my entire face! So where would Botox be best suited/safe/effective?

Some people get a lot of wrinkles because they are very expressive:  raising their eyebrows or frowning when they concentrate or listen to others, furrowing their brow in deep thought or concern, crinkling their eyelids when they smile or laugh, pursing their lips in a habitual pout.  Skillful use of Botox, Dysport or Xeomin can help soften those lines by relaxing the appropriate muscles.  An experienced physician can do this without leaving someone looking unnatural or expressionless.  The forehead, frown lines between the brows, crowsfeet, lines around the mouth, neck wrinkles--all these areas can be safely treated by a skilled physician.

Other lines can come from sleep positions or sundamage or heredity, and these do not respond to Botox but they can be treated by other noninvasive means, such as laser, fillers, or nonsurgical tightening devices.

The key is to find an experienced physician. 

Margaret Weiss, MD

Baltimore Dermatologist