Treatment Of Non-aesthetic Facial Veins: A Case Study Of The Combined Method Of Laser With Polidocanol Foam

Abstract

Background: The veins in the frontal region of the face, Right Supratrochlear Vein, and Left Supratrochlear Vein can become exaggeratedly dilated in situations of emotion (crying or smiling), stress, physical exertion, lowering the head and other situations that can cause great embarrassment. Nd:Yag 1064nm is the most versatile LASER for the treatment of facial vessels, and can be used in telangiectasias and reticular veins. It’s different spot size and pulse duration settings allow the most suitable parameterization for different types of veins. Due to its ease, practicality of use and for delivering good results, sclerotherapy is still the gold standard technique for sclerosis of varicose veins and telangiectasias. The 1064 nm Nd:YAG LASER is also efficient. Its limit is more restricted in veins of larger caliber (>3mm) and faster flow and, for physical reasons, the distance from the varicose vein to the skin should not exceed 3.5mm to 4mm. The pain at high fluences, the higher cost and the occurrence of relapses when used alone, make us opt for combined therapies in some situations. Case: Patient P.B.C, female, 43 years old, dancer, without previous comorbidities. She looked for an outpatient doctor with vascular care in February/2022 with a complaint of discomfort due to the forehead, with significant vessel dilation after physical exercise. Physical examination showed a dilated right and left supratrochlear veins. The treatment of sclerotherapy with polidocanol foam associated with the QS Nd:YAG 1064nm laser was indicated. Conclusion: Sclerotherapy associated with selective and immediate photo thermolysis, using the long-pulse Nd:YAG 1064 LASER increases the efficiency of the treatment of varicose veins, reducing possible complications when any of the techniques are used in isolation.