Diode made spider veins worse. I'm afraid of scarring. (Photo)

Question

I had a few red spider veins on my nose and cheeks and my dermatologist recommended I try the Diode laser to remove them. Below are my before and after pics. My cheek is now filled with spider veins post Diode. Will this heal in time? I'm keeping my face out of the sun and using sunscreen religiously. I stopped Retin A a few weeks ago as well. Anything else I should try?

Raffy Karamanoukian, MD, FACS · Answer

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian
Realself100 Surgeon

Michael M. Omidi, MD, FACS · Answer

Thank you for the question!  It is rather difficult to fully evaluate your situation without an in-person exam. It's likely that you're experiencing hyperpigmentation rather than spider veins. It can be treated with a topical ointment but you should see your physician first to determine the exact cause of discoloration. 
An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and obtain expert medical advice. Best of luck!

Hratch Karamanoukian, MD, FACS · Answer

The treatments as you have outlined have caused hyperpigmentation and this has to be addressed using topicals that are HQ based and non HQ based, See the link below for topicals that help reduce this effect. As well, it is important to avoid sun exposure.

Albert Malvehy, MD · Answer

Hi. It looks as though you may some discoloration (also called hyperpigmentation), as opposed to spider veins, in your 13 week pictures. To test it, push hard on the area with your thumb - if the coloring disappears for a second or two after it's released, they are veins; if the coloring stays exactly the same, it is likely a hyperpigmentation. You may have to do this a few times to tell. 
If you have not visited with the physician who treated with, I suggest following up with them as they may be able to treat hyperpigmentation, or discoloration, with an additional laser treatment. If you prefer not to do laser, you could ask for a bleaching cream such as hydroquinone.

Diode made spider veins worse. I'm afraid of scarring. (Photo)

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