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Monthly Archives: December 2016

2 Varicose Veins Treatments Equally Effective

Although laser treatment and surgery are both effective in treating varicose veins, it appears that recurrence of one form of the problem is more common with the laser treatment, German researchers report.

Varicose veins are twisted and enlarged veins that usually occur in the legs. As many as 35 percent of adults suffer complications from varicose veins, usually when the leg’s so-called great saphenous vein becomes blocked, affecting blood flow. Standard treatments include removing the vein either with surgery or a laser procedure, which can prevent complications and improve quality of life, researchers say.

“Our opinion is that both procedures can be equally offered to the patients with great saphenous vein insufficiency,” said lead researcher Dr. Knuth Rass, from Saarland University Hospital in Homburg.

However, patients should be informed that there might be a risk for a higher rate of clinical recurrences beyond two years after the laser treatment, he said.

Bulging varicose veins — often purple and dark blue — are usually seen in the legs or feet because standing puts more pressure on them. In some people, the problem may simply be cosmetic, but in others it can cause aching and pain, muscle cramping, itching and other symptoms. When accompanied by skin ulcers near the ankle, varicose veins can even signal a serious vascular disease.

The report was published in the Sept. 19 online edition of the Archives of Dermatology.

For the study, Rass and colleagues randomly assigned 346 patients to undergo either a surgical procedure called high ligation and stripping, or a laser treatment called endovenous laser treatment.

The surgical procedure involves tying off the vein, which runs between the hip and the foot, through a small incision at the hip. In the laser procedure, a catheter is inserted into the vein and the laser’s burst of light causes the vein to disappear.

During two years of follow-up after the procedure, the researchers looked for recurrence of the condition, severity of the condition, blood flow in the vein and other side effects. They also evaluated how satisfied patients were with each procedure.

Overall, recurrence was 16.2 percent for those who had the laser treatment and 23.1 percent of those who had surgery. But ultrasound revealed that many more patients who had the laser treatment developed one form of the condition called duplex-detected saphenofemoral reflux, where blood flows backward through the vein (17.8 percent of laser treatment patients versus 1.3 percent of surgical patients).

Both treatments equally improved the severity of the disease and the patient’s quality of life, and patients were satisfied with both treatments, the researchers noted. “Ninety-eight percent of the study population would undergo each treatment once again, when asked two years after treatment,” Rass said.

Although there were more minor side effects with the laser treatment, including pain, it did produce better blood flow in the legs and was associated with faster recovery and a better cosmetic outcome, compared with surgery, the investigators found.

Commenting on the study, Dr. Enrique Ginzburg, a professor of surgery at the University of Miami Miller School of Medicine, said that “it makes sense that the two procedures have similar results.”

Ginzburg noted there are other treatments, including radiofrequency-powered segmental thermal ablation and another laser treatment called radial laser fiber, which uses less power, thus reducing pain. There is also a technique that involves a spinning catheter that destroys the inside of the vein causing it to clot off, he said.

For people who have mild cases of varicose veins, experts note, doctors may instead recommend self-care (exercising, losing weight and avoiding tight clothes) or wearing compression stockings to help the blood flow more efficiently.

But there are often medical reasons, not only cosmetic reasons, for having procedures to treat varicose veins, Ginzburg noted. “In reality, it’s a combination of both. Varicose veins are painful as they get bigger. At the same time they are unsightly, so it’s not just a cosmetic procedure, it’s a therapeutic procedure,” he said.

Patients are charged about the same for each of these procedures, Ginzburg said. The average cost is about $2,000 whichever procedure a patient opts for, he noted.

As with all surgeries, vein stripping poses some risks, including that of blood clots, infection and nerve damage. Laser procedures for varicose veins also carry a small risk of infection, nerve inflammation and/or damage and blood clots.

Some patients, including pregnant women, should not undergo vein stripping. And as with any surgery, it is also crucial to check the background of the varicose vein specialist beforehand. Experts recommend using a board-certified vascular surgeon.

Liposuction May Lower Certain Blood Fats

A new study suggests that liposuction — which plastic surgeons often use to sculpt the bodies of people who aren’t extremely overweight — can lower levels of a type of blood fat called triglycerides.

“High triglyceride levels are known to be associated with an increased risk of cardiovascular disease,” study author Dr. Eric Swanson, a plastic surgeon, said in a news release from the American Society of Plastic Surgeons. “The decrease in these levels after liposuction was surprisingly dramatic, and revealed that the permanent removal of excess fat cells by liposuction has a major impact on circulating levels of triglycerides.”

The research doesn’t definitively prove that liposuction caused levels to drop, however, and an outside researcher questioned the value of the study.

The study looked at 270 women and 52 men who underwent either liposuction, a tummy tuck (known as an abdominoplasty), or both. On average, the patients were slightly overweight, although they ranged from nearly underweight to morbidly obese.

The patients underwent fasting blood tests before surgery, one month afterward, and again three months afterward. At three months after surgery, triglyceride levels dropped from an average of 151.8 milligrams per deciliter (mg/dL) to 112.8 mg/dL in patients who underwent liposuction alone, representing a decrease of 25.7 percent; they fell by 43 percent in those with levels considered to be “at risk” — that is, 150 mg/dL or more.

Levels of white blood cells also dipped after liposuction and in patients who had both procedures. (High white blood cell counts are linked with an increased level of inflammation within the body and have been associated with coronary heart disease, high blood pressure and diabetes.) Levels of cholesterol and blood sugar didn’t change significantly.

Commenting on the study, University of Colorado researcher Rachael Van Pelt, who has studied the after-effects of liposuction, said the findings are “virtually meaningless” because triglyceride levels vary from day to day, and the researchers didn’t include a control group.

In addition, “changes in lifestyle (diet and exercise) over time would have profound effects on serum triglycerides, so without knowing how this changed over time in these surgery patients, one can’t attribute any improvements to the surgery per se,” said Van Pelt, an associate professor of medicine at the University of Colorado Anschutz Medical Campus.

The study is slated for presentation Sunday at the annual meeting of the American Society of Plastic Surgeons in Denver. The findings should be considered preliminary until published in a peer-reviewed journal.

Tips to Hide a Cold Sore

Cold sores have a habit of breaking out when you have a cold, but they can be also caused by stress. That’s why you might discover a cold sore on your lip or around your mouth when you least want to deal with it.

Whether you’re going to a wedding or a big job interview, it’s hard to feel your best with a cold sore on your face. Using makeup such as concealer may help, but the timing can be tricky. “I wouldn’t recommend trying to cover a cold sore if it is not partially healed or scabbed over,” says Denise Gevaras, a professional makeup artist in Toms River, N.J. “Most cold sores will ooze in the beginning, and trying to put makeup on them will not only draw attention to them but can probably prevent them from healing properly.”

“It’s hard to conceal a cold sore when it has blistered and is still weeping,” agrees Danielle M. Miller, MD, a dermatologist at the Lahey Clinic in Burlington, Mass. “But you might be able to use a concealer safely when cold sores are in the healing stage. You also might be able to use an antiviral medication to prevent a cold sore from breaking out or to make it heal more quickly.”

Concealer to Hide a Cold Sore

Once your cold sore has begun healing, you can use makeup to lessen its appearance. “To cover a healing cold sore, I would recommend using a highly concentrated heavy concealer,” says Gevaras. “I have done this often in the past with clients having a breakout right before their wedding.”

Gevaras recommends these steps to best conceal a cold sore:

  • Use a concealer with a creamy texture, not a liquid. These concealers are usually sold in small jars, tubes, or compacts, and are very concentrated.
  • Only a small amount of a heavy concealer is needed — a little goes a very long way.
  • If you have a lot of redness, you may benefit from using concealer in two different shades: a yellow-based concealer to neutralize redness and a concealer that matches your skin tone.
  • Dab on the yellow concealer using a disposable makeup sponge. Start with a very small amount and build it up, if necessary, to avoid cakiness.
  • After the yellow concealer is applied, top it with a very light dusting of finishing powder. Pat it on lightly to avoid disturbing the concealer.
  • Next, gently dab on the concealer color that matches your skin tone and use a stipple motion to blend.
  • Apply another light dusting of finishing powder to set.

“Because cold sores are contagious, to avoid contaminating makeup products, use only disposable sponges and brushes, even if the cold sore is scabbed over,” warns Gevaras. “Never ‘double dip’ in the concealer or powder with the same makeup sponge or brush.”

Getting Rid of Cold Sores Sooner

While there is nothing you can do about an active, oozing cold sore, you might be able to shorten the life of the cold sore or even keep it from showing up.

“In many cases, symptoms of numbness and burning around your mouth or lip are early warning signs of a cold sore,” explains Dr. Miller. “Taking medication at this stage may suppress the blistering phase and shorten the duration of cold sores.”

If you commonly get cold sores or you have the early warning symptoms of a cold sore, ask your doctor if a prescription antiviral medication can help you.

Summer’s Heat May Enflame Hives

Nearly one in four people developshives at some time or another, and they can be triggered by hot summer weather.

Hives are itchy, red or white bumps, welts or patches on the skin. The condition can be acute or chronic, according to the American Academy of Allergy, Asthma & Immunology.

Acute hives, which can last less than a day or up to six weeks, are likely a reaction caused by contact with an allergen such as food, animal dander, insect bite, pollen or latex.

Other possible triggers included medications, heat, stress, exercise, chemicals or viral infection.

The academy says you should consult with your doctor to identify the cause of acute hives.

Most people with chronic hives have symptoms that last longer than a year. Allergies cause only a small percentage of chronic hives. In most cases of chronic hives, the exact cause can’t be identified. This means that routine testing such as general blood counts or screens are not cost-effective and don’t help in planning treatments to relieve symptoms, according to an academy news release.

Hives are not contagious, and most cases get better on their own. Doctors may advise patients to avoid hot baths and showers, wear loose-fitting clothing, or take antihistamines to reduce itching and swelling.

Corticosteroids are prescribed for people with severe flare-ups of hives. In rare cases, hives can be a symptom of a life-threatening allergic reaction called anaphylaxis. Call 911 if you or someone else experiences hives along with any of these symptoms: fainting, shortness of breath, tightness in the throat, tongue/face swelling, or wheezing, the academy said.