Austin Vein Treatment doctors

John W. Hovorka, MD John W. Hovorka, MD
Austin General Surgeon
909 N. Jackson Road, McAllen
5 answers
Steven E. Rasmussen, MD Steven E. Rasmussen, MD
Austin Dermatologist
1717 West 6th Street Suite 120R, Austin
4 answers
Adam J. Mamelak, MD Adam J. Mamelak, MD
Austin Dermatologic Surgeon
12319 North MoPac Expressway Suite 100, Austin
1 answer
William H. Gorman, MD William H. Gorman, MD
Austin Plastic Surgeon
3003 Bee Caves Rd Ste 203, Austin
Thomas T. Jeneby, MD Thomas T. Jeneby, MD
San Antonio Plastic Surgeon
7272 Wurzbach Unit 801 801, San Antonio

Recent Answers

24 Yr Old White Female with Red Telangiectases Veins on Chest- Options? (photo)

I am a 24 yr old female with red Telangiectases superficial spider veins on my chest (a few on bridge of nose). I tanned regularly in university, burning a few times. I was on 100mg spironolactone for 2 mths, then went on accutane (20mg/day 120 lb) 5 mths (this worked for my acne), but the veins seem to be getting worse daily. I am very concerned given I am only 24. I am considering laser in a few months but want to understand the cause. I feel ugly, any suggestions or advice would be great.

A: Treatment for Broken Blood Vessels and Poikiloderma

While there are multiple causes of broken blood vessels in the skin, sun damage and excessive UV exposure is one of the major culprits. Poikiloderma is a specific type of sun damage where the skin in chronically sun exposed areas (particularly the sides of the neck and upper chest of women) changes color and the blood vessels under the skin become dilated.

Covering the area with a high SPF sunscreen on a daily basis can help prevent this condition from worsening and can help reverse the skin changes in some individuals. Lasers that specifically target the discoloration and red color of the blood vessels, such as Pulse Dye and Intense Pulse Light, can resolve this completely. More than one treatment is often required with both of these devices.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon
Are Blisters and Scabs Normal After Laser Treatment for Spider Veins?

I had laser therapy friday for spider veins on my nose, and now i have small blisters and purple scabs! Am I at risk to develop scars after this experience? Or will they go away and if yes when? Thank you!

A: Blisters and scabs after laser vein treatment...

Blusters and scabbing after transdermal vein treatment may occur. Skin cooling at time of procedure helps to decease this unfortunate maleffect. After occurrence, avoid any sun exposure. Use Vasoline based family of products such as Aquaphor or Biafine. Biafine with emollients is the most expensive and may work better.

John W. Hovorka, MD
Austin General Surgeon
Lasers Not Working for Broken Nostril and Chin Capillaries - What Next?

I have broken capillaries around my nostrils and under my chin. I have had several different types of laser treatments, including the JAG, but nothing really works. Typically, the vessels disappear for a week or two and then come back. Recently, I have tried again with laser treatments for this condition (same doc as before), but I think they may actually be getting worse. I am frustrated to see laser treatments for facial telangiectasias universally touted as a fail-safe treatment. What do you suggest for someone who has tried this without success?

A: Treatment including laser for facial telangiectasias and face and nose veins and the feeder vein

It is important to be appropriately classified so both the patient and the physician know what to expect.  I would suggest that you go back to your physician or vascular surgeon and review what is causing these small veins to appear.  The most common problem is the presence of "the feeder vein."  Small nose and face veins are what doctors call telangiectasias (the doctor word for small veins).  They are often "fed" by other veins that might not be under the surface.  Surgeons must always go for the feeder vein first.  There are three signs of a feeder vein.  The decompression test (rapid refill when one presses on it).  Another is visualization (seeing it).  This is aided (helped) with transillumination (a bright light and now the VeinViewer).  The last test to suggest a feeder vein is treatment failure which you are now experiencing. 

Cryo Laser and Cryo Sclerotherpy (CLaCS) is a specific method and technique designed and taught by Clinica Miyake to deal not only with leg veins but also veins elsewhere on th body including the face.  There is a specific classification scale (9 to 1) used to help clinicians and patients not only manage expectations but to guide treatment for lower extremity veins (veins on the legs).  For the face no such scale exists although the principle three tests mentioned above still apply. 

There are many accepted methods of dealing with facial telangiectasias and they range from using intense pulsed light (IPL) laser, radiofrequency and chemical ablation (sclerotherapy). 

It is important to realize that telangiectasias are classified as Clinical Class 1 of chronic venous disease.  Chronic Venous Disease is just that, a chronic condition.  If you do have some "feeder veins" that are causing the problem to recur even with CLaCS a series of staged treatments generally about two weeks apart are recommended.  In order to get rid of the veins in "one shot" more aggressive treatments are necessary which also increases the risk of adverse (bad) effects to the patient. 

John W. Hovorka, MD
Austin General Surgeon
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