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Posted by 08.31.14

Audrey Rosinberg, MD, spends a lot of her time debunking myths about varicose and spider veins. For example, many people still believe you can get them from crossing your legs. While she does counsel about prevention, Rosinberg is also an expert at getting rid of them for once and for all. More than just a cosmetic issue, these veins can greatly impair an individual’s quality of life and also cause pain and problems with mobility.

The good news is that treatments are far less invasive than ever before, explains Rosinberg, a vascular surgeon  at Union Square Laser Dermatology in Manhattan. She is board certified in both general and vascular surgery. Rosinberg took some time to chat with Beauty in the Bag about this unique niche.

What causes varicose or spider veins?

There is a strong hereditary component to varicose veins. In addition to genetic predisposition, age, pregnancy, and obesity all contribute to the development of varicose veins. People in occupations that require standing or sitting for long periods of time such as a hairdresser or a surgeon may also be at increased risk from developing varicose veins and would likely benefit from wearing compression stockings on a regular basis. Contrary to popular belief, there is no scientific evidence that crossing one’s legs leads to varicose veins.

Do they occur in men or just women?

Both men and women are affected but there is a higher incidence in women. A large population based study reported the annual incidence of varicose veins to be 2.6% among women and 1.9% among men. Although not clearly defined, the incidence of spider veins is thought to be much higher.

Are vein disorders cosmetic, medical, or both?

Vein disorders can range from cosmetic to serious in nature. Spider veins are nearly always cosmetic in nature and do not pose any serious medical risks. For the vast majority of patients, varicose veins are cosmetic in nature as well. A small percentage of patients will have symptomatic varicose veins with symptoms ranging from pain, tenderness, itching, and bleeding to much more serious complications involving, darkening of the skin with stasis dermatitis and ulcers that are difficult to heal and infections. Phlebitis can also be seen in patients with varicose veins and these clots can then propagate to the deeper veins that can cause deep vein thrombosis and even fatal pulmonary emboli.

 How do vein disorders affect quality of life?

Even cosmetic spider veins and varicose veins can affect a patient’s quality of life. Lower limb varicose vein disease is estimated to be the 7th most common reason for physician referrals in the US. Many women are self-conscious of their legs due to the presence of spider veins and may be embarrassed to wear shorts or skirts in the summer. They may be reluctant to enjoy outdoor summer activities like a day at the beach or the pool. Quality of life scales are used to measure disability due to varicose veins. Chronic venous disease has been shown to impact quality of life due to pain, decreased mobility, and limited activities of daily living. The impact increases with increased disease severity. In these patients, quality of life scores improve dramatically with treatment of the underlying venous reflux and varicose veins.

When is the best season to treat vein disorders?

Fall, winter, and spring are the best times to treat your veins. Whether you have large bulging varicose veins or just a few spider veins, we recommend that compression stockings be worn for two weeks following treatment to maximize the cosmetic outcome. In addition, tanning and sunlight should be avoided for six weeks following the procedure to minimize the chances of skin discoloration. Most people don’t want to wear compression stockings during the hot days of summer. Some bruising and discoloration can result from the treatments and these often take several weeks to fade, which is not ideal during shorts and swimsuit season. The maximal effect of fading of the veins is seen 6-12 weeks after sclerotherapy, so if you want to see the results in time for summer, you really need to start in winter as most people will require several sessions of sclerotherapy to cover all of their veins.

What is the greatest advance in treating varicose veins?

The greatest advance in the treatment of varicose veins is the development of endovascular technology. Varicose veins result from increased pressure in superficial veins due to incompetent valves in the underlying saphenous veins resulting in reverse flow or reflux. To treat the varicose veins effectively, the underlying saphenous veins need to be evaluated with ultrasound and if they are found to be the source of the varicose veins, traditionally, the veins were stripped. This required general anesthesia and caused significant discomfort, bruising, and swelling. If the underlying refluxing saphenous veins are not treated, the increased venous pressure will find other escape paths and new varicose veins will form. With the approval of endovenous thermal ablation techniques in 1999 and 2002, the treatment of varicose veins was revolutionized. Local tumescent anesthesia is administered around the vein and a fiber is then placed inside the vein using a small needle. Energy is used to generate heat and the vein is closed by heating it from the inside. The energy source can either be a laser or radiofrequency. Both work equally well in closing the veins. The entire procedure takes about 20-30 minutes and the patient is ambulating and ready to go home 20 minutes after the procedure is finished. In experienced hands, the procedure is very safe with a low incidence of complications.



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Posted by 08.25.14

Nail fungus—called onychomycosis—causes your nails to turn colors, thicken, and become brittle. Nail fungus can show up on your hands as well as your feet, and it isn’t pretty.  Infections start at the tip of the nail and work their way under the nail bed, causing white, yellow, or brown streaks, and thickening the nail. The nail ends up being a shield that allows the fungus to grow.

Podiatrists and dermatologists often prescribe oral drugs like Lamisil and Sporanox, but they usually need to be taken for months to work, and there is a risk of side effects. Many people are reluctant to take these drugs because in very rare cases they may cause liver damage. Over-the-counter antifungal creams and ointments are not usually too effective, and repeat infections are commonplace. When all else fails, having the nail removed and the nail matrix medically destroyed to prevent the nail from growing back is a last resort.

The newest way to stay fungus-free is with lasers. Heat is able to target infectious agents, which makes laser therapy  extremely exciting. The universal appeal of lasers is that they can selectively destroy nasty fungi, while sparing healthy surrounding tissue and cure the condition.

Syneron Candela just earned FDA clearance for their proprietary new 5-millimeter spot size for the Gentle Pro Nd:YAG Laser Series  to treat nail fungus. In addition to Gentle Pro’s speedy hair removal and vascular and pigmented lesion procedures, nail fungus can now be reversed in just a few brief treatment sessions.

According to New York City podiatrist Krista Archer, “Lasers have greatly improved options for treating infected nails safely, effectively, and without a lengthy plan. With three pain-free CoolTouch CT3 treatments that take about two minutes per nail, we can restore healthy nails,  and patients can resume their normal activities the same day.” The best part is that you can continue to polish your toenails throughout the course of the treatment.

Practice safe mani/pedis, warns Archer, who sees a lot of toenail fungus caused from unsanitary conditions at nail salons. “Busy salons can be a breeding ground for fungus. Bring your own tools and polish to avoid the spread of fungus, and don’t get your cuticles cut. The cuticle forms a protective layer between your nail and the bed, and removing it makes it easier for fungus to get underneath and cause infections.”



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Posted by 08.20.14

Hanging out with mompreneur Rosie Pope, the star of Bravo’s Pregnant in Heels and maternity and baby clothing designer, is like talking to any other mom on the playground. You trade tricks, share complaints… and almost forget this particular mom is building quite the impressive empire which also includes her Mommy IQ book and MomPrep parenting classes.

Pope recently hosted a media event to unveil her Fall collection for expectant moms and their tots.

Her current line of baby clothes mirrors the best in her personality. The prints are warm and sweet, yet functional and pragmatic in their design. Rompers have removable feet to extend the life of outfits for fast-growing babies. The use of warm, muted greys as the new gender-neutral color is a welcome change from the tired yellows. Sweat material provides comfort and durability for active little ones. Overall, this line offers well-styled yet comfy options for babies and toddlers. The maternity line is also what you would expect from Pope — chic, shi shi and yet uber comfy.

The collection will be available in Rosie’s stores and on her website.

– Reporting by Pamela Zimmerman

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