The vanity of veins

Have you ever noticed those blue or red road maps on a client’s legs? Those are called varicose veins and there is a good chance their children will get them too. More medical spas are cashing in on this and expanding their service menus to include non-surgical treatments for varicose veins. With more treatment options available, these unsightly veins are becoming a thing of the past.

Varicose veins are veins that become enlarged and twisted, often appearing as noticeable blue, red or skin-coloured bulges. This is caused when the valves inside of our veins weaken; these valves allow deoxygenated blood to flow upward toward the heart. When the valve becomes faulty, blood flows backwards and pools inside of the veins. The build-up of blood causes them to stretch and swell in size, which is why they become more visible under the skin.

Heredity is the main factor causing varicose veins, but they can also result from pregnancy, being overweight, standing for long periods of time and hormone changes such as puberty, menopause or birth control use. These factors increase blood volume and put pressure on the veins, which weakens the valve and causes complications.

According to The Toronto Vein Institute, women are more likely to suffer from abnormal leg veins; nearly 70 per cent of all women and 30 per cent of men will develop a venous disorder due to insufficient blood circulation.

It is most common to see varicose veins on the legs and ankles. Although many people consider varicose a cosmetic concern, some sufferers experience aching pain, throbbing or cramping when they sit or stand for long periods of time.

Non-surgical approaches are used in spas to eliminate varicose veins or diminish their appearance under the skin. Most spas will only treat spider veins and mild varicose veins. If the severity of the varicose veins is extreme, patients should be referred to a vascular surgeon as more invasive methods such as surgery may be required.

Pari Moghaddam, owner of Medical Spa Pari in Montreal, offers sclerotherapy, a minimally invasive procedure, and a non-invasive IPL (intense pulse light) treatment for varicose veins.

Sclerotherapy is a method best used for spider veins and mild varicose veins. During this procedure, a salt or sugar solution is injected into the abnormal veins using a small needle. The solution irritates the lining of the blood vessel, causing it to swell and close. Over time, the vessel turns into scar tissue that fades from view. Each session takes approximately 20 minutes and most patients require two to six treatments in monthly intervals. The results vary and depend on the size of the veins; spider veins respond to sclerotherapy in three to six weeks and larger veins respond in three to four months.

On average, most spas in Canada charge $350 per session for sclerotherapy, but this can increase depending on the severity of the varicose veins. Laser and light-based therapies such as IPL are also commonly used methods. IPL delivers a highly concentrated beam of light to heat, damage and constrict the vein. The heat destroys the vein and stops blood flow, and eventually the vein is absorbed by the body and disappears. Most patients require four to six treatments with at least one month in between.

Recently, Moghaddam purchased a new IPL machine for $60,000. But when Medical Spa Pari first introduced laser vein treatments seven years ago, Moghaddam chose to rent the IPL machine once a week for $600 per day. At the time, clients were paying roughly $300 for one IPL vein removal session. Because the IPL machine was used for both hair and vein removal, Moghaddam was able to book enough clients in one day to make a significant profit.

Sacha Bourdage, medical aesthetic director at Victoria Park Medispa in Montreal, uses the Vbeam perfecta pulse dyed laser to treat spider veins. Each treatment takes 30 minutes and most patients require three to six treatments with one month in between each session. The price to treat both legs with spider veins is $200 a session at Victoria Park Medical Spa.

“Not a day goes by where we are not using the Vbeam at least four times,” says Bourdage. Winter is the busiest time of the year for laser vein removal. Bourdage says this is because clients are preparing for the summer. There are few regulations in place to monitor spas that perform cosmetic procedures. Ensuring your staff is qualified to perform sclerotherapy or use laser and light based therapies to treat veins is crucial.

Moghaddam only allows medical doctors to perform sclerotherapy on her patients. She says nurses are also allowed to perform the procedure under supervision of a doctor, but this is not a risk she is willing to take. Because sclerotherapy is invasive, she wants to ensure her spa has full lawsuit protection. Moghaddam also hires a registered nurse to use the IPL machine and ensures that all of her staff is qualified to use the equipment.

Bourdage says she refers patients with advanced varicose veins to a surgeon or dermatologist for more specialized treatment. The doctors often refer the patients back to the spa for laser therapy to treat post-op bruising and smaller varicose veins leftover from surgery. Bourdage calls this the “perfect marriage.”

If vein removal treatments are not performed by qualified personnel, risks such as nerve damage, burns and blood clotting are more likely to occur during laser, IPL or sclerotherapy sessions. Moghaddam says training and certifying staff members to use laser and IPL machines can cost between $1000-2000 for a workshop that spans over a few days.

Moghaddam says that spa owners are catering to a tough market today. She stresses how difficult it has been to survive in the medical spa industry over the last few years. She says many spas in Montreal have closed their businesses since the introduction and popularity of online vouchers.

“Services that were once valued in the thousands are being reduced to the hundreds,” she says. In order to compete, she felt forced to hop onto the bandwagon and offer a deal for IPL vein removal. The original price per session for IPL vein removal at Medical Spa Pari is $450. The current deal offers two sessions for only $120. “I am already at rock bottom. I offer a 90 percent discount. At this point, it’s not your choice, you just have to. You either close the door or manage with what you have.”

If a spa already offers IPL hair removal, Moghaddam recommends they invest in training staff to perform vein removal treatments as well. “If you already have the equipment, it makes sense to add the service. Instead of being used to collect dust, make some extra money off of the machine.”

For spas owners who are considering to purchase or rent equipment to introduce laser vein removal to their menu, Moghaddam advises against it. “Unless you can guarantee you will have a high volume of loyal clients paying full price, the risk is too large in the unstable spa market.”

Bourdage’s experience is different from Moghaddam; she says business at Victoria Park Medispa is booming. And this is likely because of Victoria Park Medispa’s unique umbrella structure, which includes the medispa as well as a traditional spa, salon and health club, with dermatologists and plastic surgeons all under the same roof.

Victoria Park Medispa greatly benefits from their partnerships; Bourdage says many of her clients are referrals from the plastic surgeons and dermatologists. “We work well together and try to cross reference our services with patients.” She says Victoria Park is a “one stop shop” and this is what attracts and retains clients.