View Full Version : Dermatologists Debunk Myths, Offer Advice For Conditions That Hit Below The Belt

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12-04-2008, 07:38 PM
While spider veins, varicose veins, cellulite and pedicures gone awry may sound like the makings of a modern-day horror flick, the scary part is these dermatologic conditions and associated problems can strike anyone at anytime. In fact, much of what is perceived as common knowledge or factual information about these problems is little more than fiction.

Speaking today at the American Academy of Dermatology's SKIN (Academy) academy, dermatologist Robert A. Weiss, MD, FAAD, associate professor of dermatology at Johns Hopkins University School of Medicine in Baltimore, addressed common myths about spider veins, varicose veins and cellulite, the latest treatment options, and how to ensure a safe pedicure.

Spider and Varicose Veins

Spider veins, also referred to as roadmap veins, are very tiny superficial blood vessels that increase in size over time and commonly occur on the legs. Dr. Weiss noted that some people are more susceptible to spider veins, including women and those who have a blood relative with the condition. Spider veins also are common in workers who stand regularly in their jobs such as nurses, cashiers or hair stylists as standing increases the venous pressure in the legs and can cause the veins to stretch.

Although some spider vein suffers may mistakenly believe tanning their legs can help mask their condition, Dr. Weiss warned that excess sun exposure actually can cause spider veins. Harmful ultraviolet light breaks down collagen which composes the walls of spider veins and can cause thinning and spreading of the veins.

"There are many common myths about spider veins, so it is important for patients to consult their dermatologist for the best advice on how to minimize their risk of developing the condition and how to treat it," said Dr. Weiss.

Dr. Weiss set the record straight on the following myths about spider veins:

Myth: Crossing your legs causes spider veins. Dr. Weiss: "Everyone at some point crosses their legs, and not everyone develops spider veins. This common myth has no truth to it."

Myth: Gaining a lot of weight causes spider veins. Dr. Weiss: "When people lose weight, they actually may be more prone to spider veins, as weight loss causes the skin to deflate and reveal what is underneath. Fat under the skin actually helps mask spider veins."

Myth: Vitamin supplements that contain horse chestnut extract prevent spider veins. Dr. Weiss: "There is no truth that any vitamin supplements can prevent spider veins. The fact is that heredity accounts for 80 percent of people who develop spider veins."

"Even with the advent of lasers, sclerotherapy is still considered the gold standard in treating spider veins," said Dr. Weiss. He explained that sclerotherapy is the most efficient treatment because large areas of the veins can be treated with hair-thin needles. "One sclerotherapy injection can cover a very large area of veins, whereas with a laser you have to cover this same area dot by dot," said Dr. Weiss. Newer sclerosing solutions that have recently been introduced make the procedure more comfortable for patients and virtually eliminate any stinging or pain during the procedure.

Varicose veins are larger, dilated blood vessels that can be raised above the skin's surface and have a rope-like appearance. While Dr. Weiss noted that many of the same myths for spider veins apply to varicose veins, the main myth relating to varicose veins is that you only need to treat the veins that are visible on the surface of the leg.

"Most varicose veins stem from a hidden vein trunk beneath the skin's surface, that must be treated for any procedure to be successful," said Dr. Weiss. Two of the latest treatments for varicose veins include lasers and radiofrequency. With the laser procedure, tiny laser fibers are delivered to the vein through a needle puncture that is thread up to the main vein trunk responsible for these veins. The laser's heat shrinks the vein from the inside, and an ultrasound-guided anesthetic is placed around the vein to reduce discomfort and increase safety during the procedure.

With the new radiofrequency procedure, radiofrequency energy converted to heat is used to collapse the vein, which is then reabsorbed by the body. The radiofrequency energy is delivered by a simple needle puncture, and Dr. Weiss noted that 95 percent of treatments are successful.


Cellulite, a hormonally based condition unique to women, is caused by a herniation or rupture of fat through the fibrous tissue and the subsequent pulling back of this tissue that creates dimpled areas typically on the thighs. A common myth is that liposuction can improve the appearance of cellulite. Dr. Weiss explained that although liposuction removes excess fat, it can make the appearance of cellulite worse by creating more depressions in the skin.

Some new remedies being explored to treat cellulite work by softening the fibrous bands and contracting them at the same time, which effectively tightens up the fibrous bands. One procedure Dr. Weiss is currently studying in clinical trials involves using a large panel of red and infrared Light Emitting Diodes (LEDs) to emit certain wavelengths known to soften and disrupt fat tissue, which causes them to shrink. This procedure is combined with rollers and suctions to soften the fibrous bands that are pulling the skin back in and causing cellulite. In this controlled study, Dr. Weiss is treating 20 patients with the device on one thigh and the other thigh is left untreated. Patients receive two to three treatments a week for a period of three to four weeks.

Dr. Weiss also is studying the effectiveness of another new laser to melt fat and disrupt the fibrous bands of cellulite. The laser fiber is inserted under the skin and then stroked back and forth to break up cellulite.

"While we are still tabulating our results from this study, the initial results I have seen of the treated thighs are very encouraging," said Dr. Weiss. "We're also exploring another technology to improve cellulite using mono-polar radiofrequency, in which the tip on the device that delivers the energy is four times larger than the standard tip used for other skin rejuvenation procedures. All of these new technologies have the potential to improve cellulite more quickly, more effectively and with longer-lasting results."

Safe Pedicures

Despite their popularity, pedicures can pose serious health risks for nail salon patrons if proper sanitation is overlooked.

"Every instrument used for a pedicure needs to be sterilized properly to prevent the spread of fungal infections and even potentially serious antibiotic-resistant staph infections, such as Methicillin-resistant Staphylococcus aureus, or MRSA," said Dr. Weiss.

In order to ensure a safe pedicure, Dr. Weiss advised consumers to ask nail technicians how their instruments are cleaned and to avoid any salons that don't appear to be clean. Another option he recommended for people who regularly get pedicures is to consider buying their own instruments to use at the salon to minimize their risk of contracting an infection. Foot baths that are not properly cleaned after each use also can harbor bacteria and fungus, which can cause infections, so consumers should ask if they have been thoroughly disinfected before they use them.

Another potential hazard of pedicures is smoothing the surface of the nail too aggressively with nail files and buffers at the base of the nail, which can damage the cuticle.

"It's a common myth that pushing your cuticles back helps keep nails healthy and helps them grow," said Dr. Weiss. "Actually, the cuticle is the nail's protective barrier, and pushing back on the cuticle can damage it increasing your risk of infection."

Utilizing current technology, dermatologists can assist people with many of their skin and nail concerns below the belt. Dr. Weiss added that the best way to avoid being misled by myths concerning skin, hair or nails is to discuss your questions with a dermatologist.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails.

American Academy of Dermatology (AAD)
930 E Woodfield Rd.
IL 60173-4927
United States
http://www.aad.org (http://www.aad.org/)

08-17-2011, 03:08 PM
Many if not most dermatology programs also look at the quality of research.

Case reports are quick and easy but as such, are "worth less".

Just the mindset of the faculty at my program although I suspect this is probably not unique to my program.

02-22-2012, 03:01 AM
Hmm best posting.