Temple Veins

Seems his usual anger is gone, less veins are popping on his ...temple.

Temple veins - as spider veins - are basically just a treatable cosmetic nuisance that not too many practitioners are eager to tackle.

From a practical point of view these veins are too “big” to burn them with lasers yet too “small” to be removed by ambulatory phlebectomy. Therefore, the only remaining practical modality is good old-fashioned injection sclerotherapy using the correct sclerosing agent in a proper volume and concentration. If there is a case where “less is more” it is in this delicate area.

Like in case of spider veins, in average 2-4 sessions may apply. One has to be very careful, as a small, bulging, tortuous branch of the temporal artery may be present in the same area together with the veins. Injecting it by mistake could cause severe skin slough with residual scarring as well as blindness on the same side!

If needed I will use Doppler ultra-sonography to sometimes convince an insisting patient that indeed "the bulging and undesired structure" is a pulsating artery and a “no-no” to inject.

 Before and After Treatment 



What do I do for a skin injury received after Sclerotherapy?


            I have seen skin injuries after sclerotherapy but usually, very small ones 2-3 mm in diameter but larger than that should not happen! I do not know what size vein(s) have been injected and where the ”skin burn” is localized, hope not in the ankle area where the healing will be much slower. You must have been possibly injected with a too high concentration and the high volume of the sclerosing agent and also possibly not injected properly into the vein but rater in the skin and tissues along the vein! Occasionally, there are open communications between veins and arteries and the possibility does exist that the sclerosing agent while properly injected in the vein crossed into a small artery and caused severe tissue damage (necrosis) responsible for the damage and thus skin ulceration.

Unfortunately, there is not much one can do as eventually all will heal but it will take a few months. Most probably a scar for life will remind you of the “experience”.

            The injured area should be kept clean and covered with dry gauze to prevent any possibility of infection. If the area is by now clean namely not infected one should discuss with the practitioner the possibility of applying a colloid dressing called Duoderm. Compression stocking the knee is mandatory to prevent swelling which is the biggest enemy of any wound healing. Whenever just possible one should elevate the leg about the level of the heart; this should also reduce swelling by gravitational drainage. Any creams you may want to apply should never cover the ulcerated skin, just beyond its margins. In conclusion, be patient, it will go away but very slowly. How it is in Spanish: “Con paciencia se gana il cielo” or “Heaven is won with patience."