PLASTIC, RECONSTRUCTIVE & COSMETIC SURGEON

Vascular lesions & thread veins

Vascular lesions can be congenital (present at birth) or acquired (occur later in life). They are a variety of skin conditions that have a collection of abnormal blood vessels. Due to their appearance, they may be a source of embarrassment in adults or bullying in children. Common vascular conditions include :

  • Spider naevi (spider veins)
  • Telangiectasia (thread veins)
  • Campbell de morgan spots (red coloured skin spots)
  • Capillary malformation (port wine stain)

Various types of lasers can be used to treat vascular lesions. These include Nd-Yag, KTP and PDL lasers. The best laser to use depends on several factors such as type of lesion, depth and extent of lesion. Usually several treatment sessions are required to fully treat a lesion and occasionally a combination of lasers may need to be used. In vascular lesions, the target is the abnormal vessels. The laser delivers energy to the vessel, heating it up and causing thrombosis. This usually presents as darkening of the lesion or bruising which then settles over a period of time. Once settled, the lesion should have resolved

What should I expect ?

Your requirements will be discussed during your consultation and suitability of treatment will be assessed. A test patch then needs to be performed initially to determine the optimum settings. The test patch area then needs to be assessed at 4 weeks. Occasionally the test patch may need to be repeated and in some instances, there may be no response of the lesion at all.

Once the optimum settings have been determined, treatment of the lesion may begin. Lesions such as telangiectasia and spider naevi are usually treatable with one or two sessions, however most other lesions require multiple sessions. The treatments can be done without any anaesthetic however larger treatment areas can be supplemented with topical local anaesthesia to reduce discomfort. The laser itself feels like an elastic band snapping against the skin. It is combined with cold air to reduce pain and heating of the superficial skin which helps to avoid a burn. Following treatment, the treated area will be mildly swollen and red. This usually lasts for 24 hours. Some superficial crusting may then develop which gradually improves over a period of 2 weeks. In lower legs, this may take up to 6 weeks. Blistering of the treated areas may also develop. If this happens, keep the area clean but avoid damaging the healing skin. Simple moisturisers can be applied to crusted areas and allowed to separate by themselves. Following treatment, ensure that treated areas are covered with high factor sun creams for at least 6 months. It is important to note that complete clearance of all lesions cannot be guaranteed and therefore you should have reasonable expectations of what is achievable, however significant improvement can be expected

What is the follow up ?

You will be seen at 2 weeks to assess the results of the treatment

What are the risks and complications ?

Bruising : Bruising may occur following treatment. This usually settles after a few days

Burn : A burn can occur if the settings are too aggressive on the laser. It is therefore important to perform a test patch prior to treatment. In addition, it is important to limit sun exposure and tanning prior to treatment as this can increase the risk of burning and scarring

Scarring : There is a small risk of scarring with any laser treatment

Pigmentation changes : Following treatment, there may be a risk of pigmentation changes which may appear as dark or pale patches. In the legs, these may appear as brown pigmentation spots which can take up to a year to settle of may even be permanent. You can minimise this risk by ensuring you limit sun exposure prior to and after treatment, and use sun creams

Recurrence : Vascular lesions can recur despite successful treatment. If they do, they can be retreated

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