Articles on endovenous laser treatment

Varicose Veins: Treatment Options

Dr. Dhruv Kumar Rai, Radiologist
Treatment optionsThe patient with varicose veins obviously wants to know about the treatment and management options that are available at Varicose Veins Clinic. The management depends upon the stage of the varicose veins and therefor all patients do not require EVLT. The various management options are briefly outlined here. We perform EVLT & Foam sclerotherapy at our clinic.We do not perform surgical procedures for the treatment of varicose veins.In some cases, the veins are not treated at all and are best left alone. Other choices are the use of support stockings, injection treatment and laser treatment.No TreatmentIf you have only very mild varicose veins that give little, if any, trouble, your doctor will usually advise you to leave well alone. Varicose veins do not suddenly become much worse, and minor degrees of swollen veins are not subject to the various complications. Lifestyle modifications, exercise and follow up with your doctor, is all that is required.Elastic StockingsThe veins in your legs can be supported and compressed by elastic stockings, but these will not by themselves cure varicose veins.The stockings are, however, extremely useful in a number of categories.They are very helpful to elderly patients whose general health is not good enough for even the safe and fairly minor treatments used to cure varicose veins.The stockings are also useful in giving temporary relief to very overweight patients while they slim themselves down in preparation for more specific treatment.Support stockings are very valuable for the management of varicose veins during pregnancy.Compression stockings are available at our clinic.Micro foam sclerotherapyAn injection of an irritant solution will be given into penetrating, or communicating veins, called the perforators, which will set up an intense but controlled inflammation.The idea is that the body's defence and healing mechanism will immediately start to close off the blow-out by the creation of scar tissue, thus stopping the high-pressure back-flow of blood through the varicose vein and so reduce the swelling.To encourage the flow of blood from the leg and to prevent the slight risk of any extensive clotting of stagnant blood within the veins of the leg, you will be instructed to walk briskly at least 3 miles (5 kilometres) every day, starting with the day of treatment.Laser TreatmentEndovenous laser therapy (EVLT) has become treatment of choice of varicose veins. The laser pulse, from the latest 1470 nm laser fiber, is of a very short duration and destroys the veins from the inside. The vein is then removed by the body's immune system. There may be some reaction to the laser for the first 24 hours, with redness at the site, but this resolves quite quickly. This treatment is given on an out-patient basis and does not require any general anaesthesia. Mild sedation may be given in the case of patient anxiety. The patient is made to walk immediately after EVLT and is then discharged.The use of the 1470 nm laser fiber has ensured minimal patient discomfort and superior results.Advantages of EVLT & foam sclerotherapy:                                                High success rateNo hospital stay, day care procedurePerformed under local anesthesia, no general anesthesia requiredHighly affective, safe & simple to performEarly return to normal activitiesPossible complications of EVLT & SclerotherapyAs with any proceedure that is performed, EVLT and foam sclerotherapy also have their inherent risks and benefits. The possible complications of the procedure may be due to various factors. In general, the potential complications, are:Pigmentation of the skinMild pain / discomfort InfectionRecanalisation of the veinDeep vein thrombosis, etc.Most of the complications are transient and daily exercise / walking, weight loss etc., as prescribed, will help resolve most of them. In severe cases, treatment of the specific complication may be required. These complications can occur in inexperienced hands with poor ultrasound scanning technique. A typed Treatment & Discharge Card detailing the treatment given and the follow up instructions, along with the investigation reports and bills, are provided immediately after EVLT, to all patients and the provisions therein are explained to the patient. Post procedure follow up, as advised, is very important in ensuring a happy outcomeWe have not had any significant complications in our clinic.EVLT is a safe gold standard procedure with a high success rate.     

10 Myths About Laser Treatments You Should Stop Believing!

Dr. Atul Taneja, Dermatologist
1. Myth: Lasers expose you to radiation.Truth: Lasers are safe since they use light and not harmful ionising radiation. In fact, normal sunlight contains more radiation that triggers cancer than most modern medical lasers. 2. Myth: Lasers are harmful to health.Truth: Laser light penetrates only 1-4 mm into the skin. That is why during laser hair removal procedures only superficial hair roots are destroyed since light cannot reach even till the deeper hair roots. And therefore, certainly, cannot reach or affect any deeper organ in the body.3. Myth: Lasers can cause burns.Truth: All modern lasers use the theory of selective photo-thermolysis formulated at the famous Harvard medical school. This basically means that laser light acts likes magic bullets and specifically searches and destroys only the intended target. Thus, for example, lasers using green light will be absorbed only by the red colour in blood vessels. Abnormal blood vessels in birth marks, in broken veins or even within the eyes in diabetics can thus be removed very safely. Just like with any other technology, side effects can happen but chances of burns are minimal with good machines in expert hands. 4. Myth: Laser hair reduction hurts.Truth: With proper use of scientific methods, during treatments, there is only a feeling of a bit of warmth or of a pin prick sensations. A very occasional patient, especially for sensitive areas like bikini or underarm areas, requires the use of topical anaesthetic cream before treatment.5. Myth: Lasers cause thinning of the skin.Truth: Lasers actually causes thickening of skin after treatments. Skin is living tissue and the controlled gentle heating in the dermis due to laser treatment induces new collagen and elastin formation, replacing the older damaged tissue. That is why lasers have a rejuvenating effect, reducing wrinkles and causing the skin to become plumper. Of course, your laser physician should have a thorough knowledge of laser physics to achieve the desired results. 6. Myth: Lasers are expensive.Truth: In the long run, it costs more to use razors, waxing, foams, etc. To keep your skin smoothing traditional hair removal methods. Moreover, these methods need to continue lifelong and are tedious and painful. In contrast, with just a few painless sessions over a few months, permanent hair reduction can be achieved with lasers.7. Myth: Lasers are unnecessaryTruth: There are many medical problems for which lasers are indispensable. There are no medications or creams which can permanently remove unwanted hair, remove scars, birthmarks, tattoos, varicose veins, port-wine stains. Laser technology is similarly indispensable for many other internal medical conditions.8. Myth: Lasers cause cancers.Truth: Lasers are actually used to remove skin and other cancers. Laser light does not contain wavelengths which trigger cancers.9. Myth: Stopping laser treatment can cause skin to deteriorate.Truth: Lasers actually cause skin rejuvenation. By aligning and tightening tissue they make the skin appear younger. Of course, the ageing process will continue each year. That is why even after a few sessions, some persons opt for long-term regular maintenance treatment to keep the skin youthful.10. Myth: All laser treatments are the same.Truth: No two lasers machines are exactly the same. Also, no two lasers experts are exactly the same. For optimal results, the laser machines have to be reliable. More importantly, your dermatologist should not only have in-depth knowledge of human skin but also needs to have special expertise and sound knowledge of lasers physics.

Have You Been Ignoring That Swelling on Your Feet?

Dr. Saurabh Joshi, Vascular Surgeon
The blood in veins of our legs normally moves from bottom to top, or from the foot to the thigh and then up towards the heart. Leg veins have one-way valves that enable them to push the blood up the leg against gravity.When varicose veins appear, it's often because these one-way vein valves are not functioning normally. The valves are not able to resist the constant push of gravity downward, and backflow occurs. As the backflow persists, venous blood settles in the lower leg. Hence, the leg swells up as the result of this elevated pressure in the veins, and the swelling tends to be most prominent after you've been standing for a long period of time. Endovenous laser therapy is an alternative and more cosmetic way of dealing with varicose veins. A fine laser fibre is passed up the vein under ultrasound guidance. The ultrasound guidance ensures that only the correct vein is treated. The vein wall is gently heated permanently shrinking and destroying the vein.The Key Benefits of Endovenous Laser TherapyScar-free procedure that can be performed entirely under local anaesthetic the majority of cases.It is applicable to nearly all patients including those with pre-existing medical conditions. Patients who have previously had unsuccessful varicose vein stripping can also have endovenous laser therapy.Cosmetic outcomes from laser are far superior to stripping. Patients report minimal to no bruising, swelling or pain following the procedure. Many return to normal within a few days. 

Is Laser Hair Removal The Right Thing To Choose?

Dr. Dhwani Shah (Vakta), Dermatologist
Frequently Asked Questions(FAQ)Excessive hair growth can be caused by the hormonal shifts of puberty, pregnancy or menopause. You may also have unwanted hair growth patterns caused by heredity, medication, hormone replacement therapy, diseases or other reasons. In any case, hair growing where you don’t want it to is a problem, no matter what the cause!No matter what way you may use to remove unwanted hair, be it waxing, threading, bleaching, plucking or shaving, laser treatment for hair removal is permanent, safe and easy!Not just women, even men are walking in for laser Hair removal for Beard Shaping, Unwanted hair on ears, chest etc.1. What is LASER hair removal?It is non invasive treatment of removing unwanted hair by using laser machines. which are specifically designed for it.2. How does it work?The laser gets absorbed in the melanin of hair follicle (the growth centre of hair) and it increases the temperature to destroy follicular cell permanently.3. How does the DIODE LASER  works?The High Speed DIODE  is a laser that produces a larger beam of highly concentrated light. The light emitted is well absorbed by the pigment located in the hair follicles. During the procedure, the laser pulses for a fraction of a second, allowing the hair to absorb the light and heat up, without damaging surrounding skin.As it heats up, the hair shaft and bulb are damaged which significantly impedes its ability to re-grow.4. Is LASER painful?You may feel a tingling or snapping sensation like a rubber band. It is definitely less than waxing and Electrolysis.5. Why multiple treatments are required?Laser hair removal requires multiple treatments. This is because the laser works best when hairs are in an early growth stage (referred to as anagen), and all the hair are not in this phase at the same time.6. How much time is there between sessions?Subsequent sessions are scheduled when the hair begins to regrow. The timing for this can range from four to eight weeks, depending on hair type and the part of the body being treated. On average, appointments are scheduled 4-6 weeks apart.7. What are the advantages over electrolysis?It is invasive technique and has side effects, as well as very time consuming because single hair is removed at a time. 8. Is is beneficial to alternative treatment?The primary benefits of laser hair removal include:Larger areas may be treated with less discomfort than with electrolysis, waxing or tweezing.It offers you a long term reduction in both the amount of hair, and also in many cases a reduction in thickness.It is safest and fastest amongst all methods of permanent reduction.9. Is treatment Economical?Considering the life long 4-6 weeks visits to parlours, investment of time, energy, money for nearly 18-20 years. Laser treatment is most economical.How?Saving time and energy:As you probably have to visit 3-12 sessions depending on response. Some will get 80-90% results in three, some in 5, average is 6-7.Patients with hormonal imbalance, post electrolysis, resistant follicles etc. needs more are almost saving 17 years of your 3-4 weekly visits to parlours .Saving of money: Spending small amount of money every 3-4 weeks for 18-20 yrs would mount to huge total, spending little more just for few sessions will definitely be less than any treatment available today10. Are there any possible side effects?The appearance of the treated area immediately following treatment will vary from patient to patient depending on the extent of the procedure and skin type.Side effects, if any, are usually minor.There may be some redness and swelling around the treated hair follicles; this is a desired clinical result indicating that the follicle has responded to treatment.This reaction typically disappears within hours. Most people return to normal activity right away.   Limiting sun exposure before and after each treatment will minimize the risk of complications.11. What areas of the body can be treated?All parts of body can be treat with hair removing Laser.Laser Hair treatments work best in lighter skinned, darker haired patients. Because the primary target in hair follicles is melanin pigment (the “color” in skin and hair), less laser energy is absorbed by the skin and more by the hair follicle. The darker and thicker the hair, higher the chances of removing it. Lighter hair will be reduced but may not go away completely.Treatment areas in women: Face, Upper lip, Side lock, Chin, Forehead, Nose, Arms, Forearms, Legs, Thighs, Full body, Back, Chest, Abdomen.Treatment areas in men: Beard shaping, Shoulder, Back, Ear lobes, Brow separation .12. Are there restrictions of activity?You can go directly to work after treatment. Only avoid direct sunlight.

Laser Hair Removal - Frequently Asked Questions

Dr. Nithya Raghunath, Dermatologist
In the past, the usual remedies for unwanted hair were plucking, shaving, waxing, or chemical depilatories. Some are painful, some are messy, and all are only temporary. Laser hair removal is an FDA-approved process of permanently reducing or eliminating unwanted hair on almost any part of the body except near the eyes. The process takes anywhere from several minutes to several hours, depending on the area of the body involved.What is laser hair removal?Laser hair removal uses a low-energy laser, which passes through the patient's skin, being absorbed by the pigment in the hair follicle. Each pulse of the laser targets and inactivates a large number of hair follicles. Approximately 3-6 treatments are necessary, although some people do require more treatments.Inadequately trained technicians can cause permanent scarring, hyperpigmentation and disfigurement. Always make sure the person who is performing any laser treatment has the required training and experience as well as the correct laser for your skin type and color. Popular areas of treatment include the brows, lip, chin, chest, shoulders, neck, back, legs, thighs, arms, underarms and ears.Is the hair removal permanent?During each treatment session, a certain percentage of the hair follicles are damaged such that hair will not grow from them again. With each treatment session, additional hair follicles are damaged until hair is completely absent in most cases.Is the treatment painful?There is some discomfort during laser hair removal, but the pain is generally less than waxing or electrolysis. Depending on how aggressive the treatment session is, the skin may be slightly to significantly pink following treatment. A certified dermatologist offers a potent numbing medication, which significantly dulls the pain. In most cases, no anesthesia is necessary.For maximal results, it is best to avoid bright sunlight for approximately 10 days prior to treatment. The area to be treated should be shaved immediately prior to the treatment. The aftercare is minimal. Sun exposure should be avoided for a few days after treatment.What are the risks and side effects of laser hair removal?The possibility exists that some side effects or complications can occur given various variables, including:NormalItching, during treatmentRedness for up to 3 daysSwelling (around the mouth) up to 3 daysPain, tingling, or feeling of numbnessRareCrusting/scab formation (on ingrown hairs)BruisingPurpura (purple coloring of the skin) on tanned areasInfectionTemporary pigment change (hypo-pigmentation or hyper-pigmentation)Side effects occur infrequently and, as a rule, generally are temporary. If any of the above last for more than 3 days, make sure to contact your doctor. The doctor needs to know in order to adjust settings on your following treatment.What are the stages of hair growth and how does it affect me?There are three phases of the hair growth cycle:Anagen (active) is the growing phase or when the hair fiber is produced. During anagen, the hair contains a great quantity of melanin, the pigment which gives your hair its color. This is the phase during which laser hair removal treatment is most effective.Catagen (club hair) is the period of controlled regression of the hair follicle. This phase is when the lower part of the hair stops growing, but does not shed, and the follicle is reabsorbed. It will be difficult for permanence to be achieved when the hair is in the catagen growth cycle.Telogen (tired) is the last of the hair growth cycle. In this resting phase, the old hair falls out in preparation for the development of a new anagen hair. Permanence cannot be achieved when the hair are in the telogen growth cycle.

Laser in Dentistry

Dr. Rajat Sachdeva, Dentist
Laser treatment is becoming widely recognised and can be applied to prevent caries from developing and to reduce the progression of caries. The mechanism of laser should be understood before a dentist could apply in his daily practice.The Enamel surface of tooth is made of crystals called ‘Hydroxyapetite’ and it is permeable in nature therefore, allowing diffusion of ions. During laser treatment, moderate heat(CO2 laser produces temp > 1000 degree celcius) is produced which changes the composition of Enamel from ‘hydroxyapetite’ to ‘carbonated apetite’ in which there is loss of water in the crystals, as a result the pores of Enamel shrink down to form ‘Microspace system’. The Microspace system provides a means for trapping Calcium, phosphate and fluoride ions which release during demineralization and acts as site for re-precipitation. The trapped minerals phases inside the Enamel and impedes lesion formation and progression causing enhanced resistance against demineralization. As the microspaces are smaller in size, it decreases the permeability of the Enamel thereby reducing the diffusion of ions in and out thereby reducing the demineralization process. Thus a seal is achieved and so is resistance to caries.The Dentin also gets acid resistance as there is increased mineral content due to burning of organic matter from tissue so there is increased Calcium and Phosphate found in recrystallized Dentin.LASERS IN ENDODONTICSEndodontic procedure carried out by conventional methods may not be successful in spite of utmost care. Despite the mechanical removal, irrigation and disinfection of canals, the bacteria can still persist which cannot be reached by conventional techniques. As the technology has advanced, now lasers are used in endodontic procedures to improve the prognosis of the treatment of tooth. Laser light penetrates upto >1000 micrometre into the dentin and provides a distinct advantage since the bacteria can immigrate upto 1000 micrometre into tubules. When in contact with laser, cell membrane gets destroyed due to the impact of direct heat and this damage is enough to stop the growth of the bacteria depending on the wavelength and frequency of laser irradiation used by the dentist. It is a very effective tool for disinfecting the root canal after mechanical root canal treatment as it has sufficient penetration depth.It is effective in curved canals also and the energy is transported by thin flexible fibres which have diameter of only 200 micrometer. Laser eradicates the microbial flora of root canal and also has same effect on surrounding dentin without affecting the surrounding tissue and has good disinfection mechanism without causing pain and improving the prognosis of the endodontic treatment.LASERS IN ORAL AND MAXILLOFACIAL SURGERYLasers have played an integral part in the evolution of practice of oral and maxillo-facial surgery as the procedures can be executed efficiently with less complication. There are many advantages such as :-Maintenance of sterile condition.Precise and accurateDecreased post-operative swellingImproved tissue scarring and healingMore accessibleLess instruments neededLess painLess cost, staff and timeLaser in Implant (Peri-implantitis)Laser makes it possible to remove diseased tissue around a dental implant without causing any significant harm to the healthy tissue. It is gentle, reducing inflammation and discomfort while encouraging new bone growth to reinforce and save your implant. Cosmetic facial Laser surgeryLaser is used to treat facial lesions and skin wrinkles by removing the surface layer of skin allowing the underlying skin to re-epithilialize in a uniform manner. E.g. tissue tags, epidermal nevi, lentigines, superficial pigmentation, skin wrinkles, scar revision, melisma etc.‘Laser’ in routine dentistryPericoronitisFrenectomy and AnkyloglossiaLaser assisted Biopsy

Varicose Veins: What Causes Them?

Dr. Raksha Nandagudi, Dietitian/Nutritionist
The ugly looking bluish purple veins on the legs may not be merely a cosmetic problem. Varicose veins can cause pain, swelling, discomfort and in rare cases bleeding ulcers and ruptured veins. Measures taken to combat enlarged veins in early stages can relieve the symptoms and prevent complications.Dysfunctional valves in your veins are the cause:Veins carry blood towards the heart and they have valves which prevent regurgitation. Varicose veins occur when these valves in the veins become weak and fail to prevent blood from flowing backwards. Blood begins to collect in the veins instead of flowing towards the heart. Varicose can occur anywhere in the body but its most common occurrence is in the legs as they are the farthest from the heart and even the gravity makes it harder for the blood to flow upwards.These may be the reasons for  your varicose Veins:HeredityOccupations that involve a lot of standing, such as nurses, hairstylists, teachers, and factory workersObesityHormonal influences of pregnancy, puberty, and menopauseThe use of birth control pillsPostmenopausal hormonal replacementA history of blood clotsConditions that cause increased pressure in the abdomen, such as tumors, constipation, and externally worn garments like girdles.Trauma or injury to the skin, previous vein surgery, and exposure to ultraviolet rays.They are painful:Though for some, the appearance of varicose veins seems to be only a cosmetic issue, but many people with varicose complain of pain, described as an aching or cramping in the legs. Other common symptoms include tiredness, restlessness, burning,throbbing, tingling, or heaviness in the legs. Left untreated, it can lead to swelling, ulcers and darkening of the skin, especially in the ankle region. Further it can cause rupture of veins and bleeding.How do I know, it is a varicose vein? When you meet your doctor, they can diagnose it by physical examination and your history of pain, swelling or other symptoms. Meanwhile, they may also suggest an ultrasound test to see the functioning of your veins and rule out certain other conditions like DVT. How do I treat them?The symptoms of pain and swelling are usually relieved by elevating the legs. But unresponsive cases always need non-invasive or less invasive treatments to tackle the pain and related symptoms and to prevent complications.Stockings: The most conservative approach is to simply wear properly-fitting support stockings. Support stockings help to reduce swelling and discomfort. They help the veins and leg muscles to effectively move the blood within. They are easily available and easy to wear.Dynamic sequential compression therapy:  This is a new generation non-invasive therapy which is very effective in treating venous insufficiency, lymphedema, lipedema and other swollen leg conditions. It involves a sequential pressure and release cycle and its directional compression which promotes the flow of blood upward towards the torso and assists its way towards the heart.Once again, this is a very comfortable and reliable therapy for people having varicose veins and for whom wearing support stocking for long duration seems uncomfortable and not wearable which forces  them to stop using it and worsen the condition.Life style changes: Exercise to boost circulation.  Elevate your legs at, or above, heart level. Do this a couple of times each day if possible. Avoid leg crossing. Avoid the heels and go for flats. Check your undergarments. Avoid tight panty-leg girdles. This type of undergarment tends to restrict blood flow to the legs. Avoid sitting or standing for long periods of time. Lose weight, or watch your weight.Other less invasive treatments for varicose veins include Sclerotherapy, Endovenous laser treatment, Radio frequency occlusion etc.Surgical techniques to treat varicose veins include ligation (tying off of a vein), stripping (removal of a long segment of vein) and ambulatory phlebectomy.