Reticular veins are damaged veins where the valves don’t open and close properly, which allows blood to pool. The blue and green dilated veins are common on the face and legs. Reticular veins can cause many uncomfortable symptoms, and they can seriously affect your appearance and self-esteem. In size, these veins fall between small spider veins and larger varicose veins. Treatment options include laser therapy, pulsed light treatments, thermocoagulation, sclerotherapy and microphlebectomy. Sometimes, these techniques are used in combination to maximise therapeutic results.
Treatments for telangiectasias and reticular veins include sclerotherapy, laser therapy, intense pulsed light treatment, microphlebectomy and thermocoagulation. These techniques can be used in combination to maximise the effects and avoid any harms of the individual techniques.
Reticular Veins Present Big Cosmetic Concerns for Men and Women
The biggest concern for most people who have reticular veins is cosmetic, but there are health and wellness problems that affect some patients. The veins appear as short, jagged lines under the skin that can appear blue, green or red. When blood valves don’t close properly, the blood can pool or flow backward, which causes the vein to enlarge and/or change colour.
Although reticular veins are usually a cosmetic concern, they can cause burning, itching and general discomfort. When the veins appear on the legs, they can indicate dangerous blood backup that can result in blood clots, poor circulation and skin ulcers. Both spider and reticular veins are referred to as telangiectasias, but spider veins seldom raise as many health concerns as reticular veins pose. 
Symptoms of Reticular Veins
The symptoms of reticular veins range from unnoticeable to major health risks. About 80 percent of adults eventually develop reticular veins, they most commonly appear on the ankles, thighs, calves and behind the knees. The veins appear more often prominent in people with fair skin. Reticular veins are also common precursors to spider veins. When large concentrations of the veins appear, they can be as debilitating as varicose veins. Symptoms include:
- Unappealing skin skin clusters, marbling and darkened areas of the skin
- Feelings of heaviness and fatigue
- Skin discomfort
- Inflammation of the affected area
- Burning and itching of the skin
- Excessive tenderness of the skin
- Poor blood circulation – especially in the legs
- Possible blood clots and skin ulcers
Most people are more concerned about the cosmetic appearance of prominent, dilated and discoloured veins, but the condition can raise more serious vascular health issues. Venous insufficiency is a common problem associated with reticular veins, so it’s important to see a doctor to evaluate your vein issues to determine the cause.
Risk Assessment of Developing Reticular Veins
The common risks of developing reticular veins or other chronic venous disorders rises with age and other risk factors.  Some of the most common risk factors of developing reticular veins include:
- Hereditary predisposition
- Prolonged sitting or standing
- Excessive sun exposure
- Hormonal changes caused by age or health disorders
- Environmental or behavioural factors
- Previous history of thrombophlebitis
- Dietary habits
Medical management of reticular veins is based on clinical examinations conducted by general practitioners or dermatologist specialists. Early diagnosis and intervention are the keys to successful prevention and management of the condition.
Intervention Options and Their Efficacy
If you have any kind of issue with varicose, reticular and spider veins, the good news is that these conditions are very treatable with minimally invasive techniques. The old method of stripping veins through surgical incisions has largely been replaced. 
Vein treatment centres are offering less invasive options that produce better results at lower costs. The particular approach for your case depends on many factors that include the size, type and location of the veins. Some of the top treatment options for reticular veins include the following approaches:
Sclerotherapy seems to be the benchmark of treatment options in current medical practice. Also called injection therapy, this treatment approach is commonly the first choice of physicians and their patients. In this treatment, a small amount of chemical irritant is injected into the vein. The chemical causes the vein to swell, stick together and seal off from the circulatory system.
Your circulation isn’t impaired from this technique because other blood vessels compensate rapidly to deliver blood to the affected area. Sodium tetradecyl sulfate is most commonly used, but a new compound called polidocanol works just as well. There is always the possibility that someone will be allergic – especially those with a history of asthma or allergies. You should inform your doctor if you have allergies or asthma as a precaution. 
The treatment does cause some pain and temporary bruising and swelling. There is some risk of hematoma, scarring and ecchymosis. That’s why some doctors and specialists prefer laser therapies to treat facial reticular veins.
Sclerotherapy can be performed by licensed dermatologists, and the treatment usually takes one to three sessions. The procedure doesn’t require any anaesthesia, and each session lasts between 15 minutes and an hour. After treatment, you need to protect the area by wearing bandages or compression stockings until the veins scab over and eventually disappear.
Laser and Radiofrequency Treatments
Laser and radiofrequency treatments are preferred by most aesthetic practitioners for dealing with facial reticular veins. That’s because both radiofrequency and laser pulses deliver effective long-term results – usually without damaging facial skin.
Clinical studies show that laser therapy satisfies between 75 percent and 100 percent of reticular vein patients. Recurrence of the veins is limited to 10 percent or less of patients who elect laser therapy. There are some problems treating veins that extend into the hairline because the laser pulses can destroy hair follicles.
Laser light is monochromatic light of one wavelength. The photons, light particles, are lined up in a steady stream and carry tremendous energy. The energy is used to target and heat up small veins, which shrink, close and disappear as the body heals. Doctors and dermatologists can target veins precisely with different types of lasers and settings, so the therapy can be used to target red, blue or green veins at different skin depths.
Different levels of power can also be used, so doctors can target the area to be treated very precisely with minimal damage to surrounding tissue. That makes lasers particularly effective for facial treatments where aesthetics is especially important. Access to laser treatments with flexible treatment options allows doctors to individualise treatment. The therapy does require an experienced operator, which is why some aesthetic companies use pre-programme settings.
Electrolysis and Radiofrequency Ablation
Electrolysis and radiofrequency machines generate electrical or radiofrequency pulses using the tip of a fine-bore needle to heat up the treatment area. This method of treatment is the most affordable way to eliminate small clusters of facial reticular veins.
The heat generated by the electrode or electrodes destroys veins and tissue, but the technique requires an experienced operator for the best results.
Intense Pulsed Light
Pulsed light beams are perfect for facial treatments of reticular veins. IPL machines generate concentrated bursts of white light, which can heat the veins and cause them to shrink and dry up and shut down. The white light contains some ultraviolet and infrared wavelengths. Different filters are used to block unwanted wavelengths before they hit the treatment area. The area treated can be quite large, which makes IPL treatment effective for treating large areas of the skin for problems like rosacea or extensive spider or reticular veins. 
Microphlebectomy is the process of making small incisions with surgical blades hypodermic needles and other devices to remove blood vessels that generate health risks or unappealing aesthetics. Clamps are used to limit bleeding during the process. 
Phlebectomies of facial reticular veins and spider veins aren’t highly recommended. The approach works better with larger varicose veins, and it takes an expert technician to work on facial veins without damaging surrounding tissue and leaving scars. The technique works fairly well for bulging veins in the centre of the forehead and the periorbital and temporal regions, which are located around the eyes and the temple area respectively.
The incisions used in microphlebectomy are usually less than ¼ of an inch, which is just large enough to remove the vein. The incisions don’t require stitches to close, and small strips of tape are used. The procedure is done on an outpatient basis, but like any surgical procedure, there is pain afterward and a longer recovery period. The cosmetic results are usually positive, and the swelling, bruising and pain disappear within a short time.
Thermocoagulation is similar to sclerotherapy and laser therapies. The technique uses High Frequency Current to discharge heat energy in a small, focused area. The energy discharge produces a thermal lesion that causes the vein – or other skin imperfection – to disappear. The process generally produces no damage to surrounding skin and results in a small, red mark that disappears within just a few hours. The procedure is considered very safe, can be done in an hour or less and poses no risks of scarring or blistering.
Combination Therapies for Treating Facial Reticular Veins
The most important aspect of treating reticular veins is discovering whether the condition was caused by an underlying venous insufficiency. If not, it’s safe to use the cosmetic treatments for spider and reticular veins caused by genetics, pregnancy, hormonal changes, and behavioural or environmental factors.
Combination treatments might include treating the veins with a laser and following up the treatment with the injections of a sclerosing agent into a feeder vein. The secondary treatment usually takes about 20 minutes a session, and most patients schedule two to four sessions. There are many modalities for treating reticular veins, and you and your doctor can work together to craft a treatment plan that offers the best prospect for long-term success.
Vein Treatment: Safe, Affordable and Effective
In general, the smaller the veins, the easier they are to treat when they don’t function properly and/or create an unappealing facial appearance. Reticular veins can darken, become prominent and create an unwanted facial focal point. Treating venous problems in the face is a common aesthetic procedure. Different treatment options work well in general, so most people can find a procedure that suits their needs.
Only those veins that pose a significant health threat qualify for insurance cover, but spider, varicose and reticular veins all indicate some degree of venous insufficiency. You can improve your circulatory health, remove unsightly blemishes and strengthen your holistic wellness by getting treatment for facial reticular veins. Ahajournals.org: Circulation
www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.113.008331  Phlebolymphology.org: Testing the potential risk of developing chronic venous disease: Phleboscore
www.phlebolymphology.org/testing-potential-risk-developing-chronic-venous-disease-phleboscore/  Health.harvard.edu: Minimally invasive treatments for bothersome leg veins
www.health.harvard.edu/staying-healthy/minimally-invasive-treatments-for-bothersome-leg-veins  Thepmfajournal.com: Facial veins – diagnosis and treatment options
www.thepmfajournal.com/features/post/facial-veins-diagnosis-and-treatment-options  Ncbi.nlm.nih: Ambulatory Phlebectomy
www.ncbi.nlm.nih.gov/pmc/articles/PMC3036274/  Ncbi.nlm.gov: Treatment for telangiectasias and reticular veins
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