Varicose veins and other vein disease in the legs

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varicose veins

Varicose veins and other vein disease in the legs

by Dr. Claudine Rae L. Javier

What is vein disease?

Vein disease is a condition affecting the veins in the legs causing leg pain, varicose veins, swollen legs, or open sores. Varicose veins are swollen and twisted veins.

When the veins in the legs do not work the right way, vein disease happens. Normally, the veins in the legs carry blood from the legs back to the heart. The veins have tiny valves inside them to help keep blood moving in only one direction (toward the heart). The valves open to let blood flow to the heart, and close to keep it from flowing back down the leg. When the valves are damaged, blood collects in the legs. Blood is especially likely to collect in the legs when a person sits or stands for a long time without walking.

What conditions can cause vein disease?

Vein disease can be caused by:

  • A blood clot in a leg vein
  • Leg injury
  • Being pregnant more than once – This causes a change in hormone levels that can weaken vein walls.
  • Weight gain

Vein disease is also hereditary.

What are the symptoms of vein disease?

  • Leg pain, or the leg feeling tired or heavy
  • Swollen veins – “Spider veins” are small leg veins that are swollen. “Varicose veins” are larger leg veins that are swollen and twisted.
  • Swelling in the lower legs or ankles – People can have swelling at the end of the day or all the time.
  • Skin color changes – The skin can turn red or red-brown. Skin color changes often happen first around the ankle.
  • Open sores, also called “venous ulcers” – These are usually at the ankle and can be painful and ooze.

Is there a test for vein disease?

Yes. Your doctor or nurse will do an exam to look at your legs. He or she might also do a test called an ultrasound. An ultrasound can check how well the valves in the legs work. It can also see if any of the veins in the legs are blocked.

What can I do to reduce my symptoms?

To reduce swelling, you can:

  • Walk around, and try not to sit or stand in one place for a long time
  • Raise your legs up 3 or 4 times a day, for 30 minutes each time
  • Do exercises to point your toes and feet down and up a few times each day

To treat dry or itchy skin, you can:

  • Use an unscented moisturizing cream. Ask your doctor or nurse before using any other type of cream or ointment, because some creams and ointments can cause a rash.

 

How is vein disease treated?

Doctors can use different treatments to treat symptoms and reduce swelling. These can include:

Special socks, bandages, or devices:

  • “Compression stockings” – special socks that fit tightly over the ankle and leg. If your doctor or nurse recommends that you wear them, he or she will tell you which type to wear and how to put them on.
  • “Compression bandages” – layers of bandages that wrap around a person’s leg.
  • “Compression pump” – a device that fits around the leg and squeezes the leg every few minutes.

Special coverings that are put on an open sore to help it heal

Medicines – Doctors can use different types of medicines to treat different symptoms. For example, people who cannot use compression stockings or bandages might be able to try medicines that help the veins work better. People with a skin infection might need antibiotics. People with itchy skin might need a prescription cream or ointment.

Procedures – Doctors can do procedures if other treatments do not work. A doctor can remove or destroy damaged veins so they can no longer fill with blood by liquid or foam sclerotherapy, laser, ambulatory phlebectomy, and the like.

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Laser Hair Removal

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Laser Hair Removal

by Joanne B. Gonzalez, MD

What is Laser hair removal?

Laser hair removal is a procedure where laser beams are used to deliver intense heat to the hair follicles to miniaturize or reduce hair growth. The laser light is absorbed by the dark pigment  (melanin) in the hair roots, the heat produced causes miniaturization or destruction of the hair.

Since melanin is the target pigment, laser hair removal is most effective in dark hairs that are in the active hair growth cycle (Anagen phase). The most common areas treated are the upper lips, beard, underarms, bikini, chest, back, arms, legs. It may not be effective in naturally blond, red, gray, white, and very thin hairs.

How is the procedure done?

There are several kinds of lasers for hair removal, most entail some degree of discomfort like a sensation of a rubber band snap on the skin. This discomfort is usually tolerable but for some sensitive areas and patients, topical anesthetic cream may be applied 30-60 minutes before the procedure.

The area to be treated is cleaned using mild cleansers and water, dried and shaved. The handpiece is applied to the skin to deliver the laser light pulses, passing through the areas where the hair grows. The length of time for the procedure depends on the area being treated. On average, the upper lip may be done in 1-2 mins, underarm area about 5-10 mins, legs may take 30 minutes to more than an hour.

What do I expect after the procedure?

Patients usually don’t feel anything unusual after the procedure. For a few, there may be a slight flushed color of the area treated and small red bumps which subsides in a few minutes.

It is usually advised not to use any chemical products on the skin for the next 24-48 hours like deodorants, anti-perspirants, whitening products, peeling agents etc. It is also best to avoid sun-exposure, scrubbing and scratching of the area treated.

How many sessions do I need?

Laser hair removal targets the actively-growing hairs, therefore, follow-up sessions are needed to treat the new, growing hairs. Succeeding sessions are usually done at intervals of 4-6 weeks. Most patients would require about 3-6 sessions.

What are the risks?

Any kind of laser can be dangerous especially if performed by untrained personnel. The Philippine Dermatological Society recommends that Skin Laser procedures should be done by well-trained, experienced, and certified PDS dermatologists.

Some of the complications and risks are:

  • blisters, darkening, scars from burns
  • bacterial infections
  • breakout of cold sores
  • whitening or depigmentation

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MELASMA

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melasma

MELASMA

by Beatriz G. Carpo, MD

Melasma is a very common skin condition wherein tan, brown to grayish patches appear on the cheeks, cheekbones, forehead, forehead, bridge of the nose, and upper lip, or chin. In a few patients it can even involve the sides of the neck, shoulders and upper arms. It is more common in women, especially in the ages of 20-50’s. It is also seen more frequently in darker skin types and certain races such as Asian, Hispanic, Latin, African-American, Mediterranean, and Indian descent.

CAUSE:

Although the exact cause is unclear, the following are the major triggering and aggravating factors in melasma.

  • Ultraviolet Light Exposure (UV). This and hormonal changes play the biggest roles in Melasma. Ultraviolet rays stimulate the skin’s color-producing cells (melanocytes) to produce the dark patches. Patients with melasma should always use sunscreen and practice sun avoidance.
  • Hormonal Changes. Melasma is common In pregnancy when it is called “Mask of Pregnancy” or “Chloasma”. The use of birth control pills and hormone replacement pills also serve as triggers.
  • Genetics. There is also a genetic predisposition and having a close relative with melasma increases your risk of getting melasma.
  • Cosmetics and skin products that cause skin irritation may aggravate melasma. Certain ingredients in skin products may make you more sensitive to the ultraviolet rays of the sun and these may worsen melasma.

TREATMENT

Sun protection and the daily use of sunscreen is of utmost importance. Even visible light indoors may aggravate melasma. When outdoors, it would be good to also wear a wide-brimmed hat and proper clothing for extra sun protection.

Medications that may help improve or lighten melasma include:

  • LIghtening creams. These include Hydroquinone and Non-hydroquinone products like arbutin, azelaic acid, kojic acid, etc.
  • Tretinoin- this may be prescribed in combination with lightening creams.
  • Mild steroidal creams- this may also be used in certain cases. It is used to decrease the irritation from other applied medications like tretinoin for instance.
  • Dermatological procedures- this may include chemical peels, microdermabrasion, and laser. Results from laser procedures may be varied. These must be tailored and individualized based on the severity, and skin types and characteristics.

WHAT TO EXPECT:

Melasma can be quite stubborn and may stay for months to years. But with a guided treatment advice by a dermatologist, you may be able to lighten and improve it.

You may need some form of maintainance therapy to keep it under control.

SOME HELPFUL TIPS:

  • Wear a good sunscreen daily. Both outdoor and indoor light may worsen melasma. There is significant UV outdoors even on cloudy days.
  • Wear a protective hat when outdoors as sunscreen use may not be enough.
  • Use gentle skin products. Products that irritate skin can worsen melasma.
  • Avoid heat. Heat can irritate skin and can trigger the cells that produce the color of your skin (melanocytes) to become more active.

If you have melasma, consult a Dermatologist to discuss medications or clinic procedures that may help improve it.

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WARTS

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flat-warts

Warts

Overview

  • Non-cancerous growths by human papilloma virus (HPV) that infect skin and mucuous membranes.
  • There are over 150 distinct HPV subtypes that exists.
  • Occurs most commonly in children and young adults.
  • Increased risk for infection in patients with atopic dermatitis and immunosuppresion
  • Transmission via skin to skin contact

Kinds of Warts

  • Common Warts (Verruca Vulgaris)
  • Plantar Warts (Verruca Plantaris)
  • Flat Warts (Verruca Plana)

Course:

  • Most warts eventually spontaneously resolve and therefore treatment is not always necessary/mandatory.
  • Reasons for treatment:
  • Associated with pain and discomfort
  • Cosmetic acceptability
  • Immunosuppresion

Treatment

  • Topical Solutions
  • Electrocautery
  • Liquid nitrogen (cryotherapy)
  • Laser therapy and Surgery

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