Why Thread Veins need Duplex before Treatment

This lady in her 50s, came to have her thread veins treated at The Whiteley Clinic this week.

Apparently "simple" Thread Veins of the Leg 

She had been to one General Practitioner who had told her that they were cosmetic veins only and did not need treatment. This general practitioner had then given her "cream" telling her the veins with disappear.

Of course they did not, has thread veins of the legs cannot be treated successfully with cream of any sort.

More importantly, no doctor can ever pass judgement on veins without a duplex ultrasound scan showing exactly what is going on in the veins, deeper in the leg.

Apparently "simple" thread veins of the leg on standing

Fortunately, she saw a second general practitioner who is aware that almost 90% of people with "simple" thread veins have underlying venous reflux - or "hidden varicose veins".

Therefore she was referred for a full assessment to The Whiteley Clinic.

Although no varicose veins are visible on standing, a full venous duplex ultrasound scan was performed which is shown below.

Duplex ultrasound scan - X shows venous reflux 

The venous duplex ultrasound scan shows that the great saphenous vein (GSV) has venous reflux from the upper thigh all the way to the ankle. The patch of thread veins is coming straight off one of the branches (or tributaries) from this.

Therefore blood refluxing or "falling" down the great saphenous vein (GSV) is impacting directly onto the thread veins.

If this patient had gone to a cosmetic practice or beauty clinic which did not have a minimum of hand held Doppler but preferably colour flow duplex ultrasound, it is likely that she would have been offered treatment for the thread veins.

Treating these thread veins without treating the underlying cause first is highly likely to cause a disaster, with the patch of thread veins becoming either larger and more difficult to treat (telangetic matting) or brown staining with a progression to more thread veins in the future.
The thread vein course run by The Whiteley Clinic at The Clinical Exchange teaches all delegates why it is essential to perform Doppler examination as a minimum, and how to perform it correctly.
For anyone who has read "Understanding Venous Reflux - the cause of varicose veins and venous leg ulcers" you will be able to see that this patient has phase 1 passive reflux. As such a hand held Doppler at the groin alone would not have been enough to diagnose her.
This patient needs endovenous laser ablation or radiofrequency ablation of her great saphenous vein before her thread veins can be successfully treated.
For more discussion about this and similar cases, please see www.collegeofphlebology.com.
For information about thread vein courses please see www.theclinicalexchange.com

Varicose veins of abdomen and leg ulcer

This patient presented to The Whiteley Clinic this week. He is in his 60s and has a leg ulcer of the right ankle.

Leg ulcer of right leg (covered by clear dressing)

As a child, he had been given injections penicillin into his thighs at age 3 weeks. As he grew up, his legs swelled regularly and he had "fragile veins".

Examining his abdomen when standing, he showed varicose veins of his right lower abdomen running from groin to flank.

Varicose veins of patients left lower abdomen groin up to the flank

This is a rare pattern of varicose veins seen when the veins deep in the pelvis have been blocked for a very long time.

For more pictures and discussion about this case, see: www.CollegeofPhlebology.com

Whiteley Clinic - 9th Fastest Growing UK Health Company

The Whiteley Clinic - 9th Fastest Growing UK Health Company

This month, the Plimsoll "UK Private Hospitals and Clinics Industry - Individual Company Analysis" was published.

The Plimsoll analysis compared the 261 UK Private Hospitals, Clinics and Health Companies.

We are delighted that The Whiteley Clinic came out as 9th fastest growing of these UK companies - and was listed as 22nd best trading partner.

  

Early venous eczema from Varicose Veins

Many people are put off from have their varicose veins treated by doctors, nurses or even just "friends" who erroneously tell them that "Varicose Veins" are just cosmetic".

Varicose veins which have been left for years starting to damage the skin
as evidenced by the onset of Venous Eczema

Unfortunately for the patients who listen, varicose veins are usually the sign that the major truncal veins in the legs have lost their valves, and that the blood is falling back down the veins rather than being pumped up to the heart.

This falling blood (called "venous reflux") impacts on the skin capillaries, and over years causes damage and inflammation.

This patient had left her varicose veins for years, and over the last 12 months, started to notice her ankle was swelling by the end of the day.

Over the last 3 months, an itchy red patch has appeared just below the varicose veins - that she finds she scratches when asleep preventing it from healing.

This is early venous eczema - and the only cure for it is to have the varicose veins scanned and treated effectively - stopping the venous reflux and making the blood pump the right way up the leg veins.

For more information see: http://www.venouseczema.co.uk/ and http://www.venouseczema.com/micro/conditions/venous-eczema/what-is-it/

Perfecting results of varicose vein surgery with RFiTT

George Badham - Whiteley Clinic Summer Research fellow in 2010
Results of RFiTT presented at The Venous Forum April 2012

The RFiTT procedure for treating varicose veins was introduced over 5 years ago as a new technique for "keyhole" varicose vein surgery.

The Whiteley Clinic initally would not use the device as the initial results were disappointing compared to the near perfect results that we expect by treating patients by The Whiteley Protocol(TM).

In Summer 2010, George Badham, a Whiteley Clinic summer research fellow and Cardiff Medical student, preformed a prize winning research study to show how the recommended treatment technique was sub-optimal and he showed how to modify this to optimise the procedure (The Whiteley Clinic Method).

George used a model to perform his research - but of course this doesn't necessarily mean that the optimised technique would work in patients.

Therefore George has analysed one year of patients treated with his optimsed technique - "The Whiteley Clinic Method" - and is presenting his research as a poster at The Venous Forum this week in the Royal Society of Medicine in London.

In this work, George Badham has shown that using his modification to the technique, we have managed to get 100% closure of the treated Great Saphenous Vein at one year - perfect results!

We would recommend that anyone using RFiTT in the treatment of Varicose Veins should use The Whiteley Clinic Method as described by George Badham, to ensure that they get optimal results for their patients.  

Reducing costs of endovenous surgery

Maria Boland - Whiteley Clinic summer research fellow 2009 

This week, Maria Boland will be presenting her research about endovenous surgery at The Royal Society of Medicine in London, at the Venous Forum meeting.

Maria, a medical student and summer research fellow at The Whiteley Clinic in 2009, has assisted in a project analysing how endovenous surgery under local anaesthetic has changed in The Whiteley Clinic since 2005.

Her research has monitored how since endovenous surgery started being performed under local anaesthetic, the amount of work that can be done in local anaesthetic session has increased. This has been due to a combination of new procedures and improved techniques.

As one of the world's leading vein clinics, The Whiteley Clinic experience has shown that they can keep the same excellent high standards of treatment, with excellent patient satisfaction scores and yet have:

• Reduced the number of endovenous devices used per patient
• Increased the amount of work that can be done per local anaesthetic session
• Decreased the number of sessions needed to treat patients

These changes have meant that The Whiteley Clinic is able to reduce the costs of endovenous surgery without any decrease at all on the quality of their work.

Maria's Poster will be on display at The Venous Forum this week at The Royal Society of Medicine and will be called:

"5 year audit of number of visits and endovenous devices required for walk-in walk-out endovenous surgery for varicose veins under local anaesthesia"

M.Z. Boland, B.A. Price, M.S. Whiteley

Warning - Varicose veins coming from Pelvic Veins

This lady, who presented to The Whiteley Clinic with varicose veins, typifies a problem that we are seeing very commonly.

Although her varicose veins appear to be in the legs, when she was scanned by the expert Vascular Technologists at The Whiteley Clinic, it was found that all of her underlying leg veins were normal - and all of the visible varicose veins come from "hidden varicose veins" in the pelvis.

Left leg varicose veins - however scan showed the underlying causes was from Pelvic Veins only. Surgery to the leg varicose veins (Stripping, Laser, Radiofrequency, etc) would NOT have worked

Had this lady gone to a normal varicose vein clinic or seen a normal varicose vein surgeon, she would have more than likely had her normal leg veins treated (by stripping, laser, radiofrequency or foam sclerotherapy).

Using The Whiteley Protocol, our patients have a scan that identifies exactly where the vein come from - and we don't make any assumptions. Hence most of our scans take some 40 minutes or more (unlike most venous scans that are rattled off in 10 minutes or so - missing more difficult patterns like this).

Varicose veins down the backs of both legs - however scan showed the underlying causes was from Pelvic Veins only. Surgery to the leg varicose veins (Stripping, Laser, Radiofrequency etc) would NOT have worked.

The successful treatment of women with this sort of pelvic venous problem starts off by identifying it.

Pelvic vein problems almost always occur in women who have had at least on baby by normal vaginal delivery. Very occasionally the problem can be found in women who have had caesarian sections - and very rarely in women who have not had childbirth, or in men.

Visible veins on the upper inner thigh, next to the vulva, shows that pelvic veins are probably involved.

One of the "tell-tale" signs are women who have veins at the top and inner side of their thighs, next to their vulva (para-vulval veins) as above.

A pelvic duplex ultrasound scan performed by one of our experts then shows which veins are involved, directing treatment by X-ray, through a pin-hole only.

Once the pelvic veins are treated, the bulging veins on the legs can then be treated, knowing that the chance of them coming back again is minimal.

However, if a woman with this problem had undergone surgery using normal techniques (such as stripping, laser of radiofrequency) the veins would return very soon after treatment, as the underlying pelvic veins would have been missed. Unfortunaltely, this is what usually happens and is one of the reasons that so many women get their veins back again after treatment elsewhere.

For more information please see: www.vulval-varicose-veins.co.uk

New Clinical Grading for Varicose Veins of Vulva

Varicose veins of the vulva and vagina are thought to affect somewhere between 100,000 and 500,000 women in the UK, and countless more in the USA, Europe and the rest of the world.

The usual advice given to women with this problem is that "nothing can be done about it" or to wear tight supportive underwear.

However developments over the last decade at The Whiteley Clinic have shown that this condition can be treated with a combination of embolisation of the pelvic veins causing the problem and then foam sclerotherapy of the veins themselves.

In order to choose the right treatments, a grading system is needed to know how severe the veins are. The Whiteley Clinic grading system for varicose veins of the vulva has therefore was introduced in 2011 and has been recently published (2012).

	Description	Frequency seen at present
Grade 0	Normal – no varicosities nor venous reflux in vulva	Usual
Grade 1	No visible varicosities in vulva, but ultrasound proven reflux in vulval veins usually with para-vulval varicose veins seen on inner thigh	Common – 1 in 7 females presenting with leg varicose veins (1 in 5 of those post vaginal delivery)
Grade 2	Visible varicosities seen through mucosa of inner labia and lower vagina and ultrasound proven reflux in vulval veins.	Uncommon
Grade 3	Isolated varicosities seen on standing through skin of outer labia majora without a distortion of the general anatomy of the area	Very uncommon
Grade 4	Extensive varicosities of the labia, distorting skin and distorting the gross anatomy of the area on standing	Rare

If you want to see more about this scale, it was first published in:

The treatment of varicose veins of the vulva and vagina. by MS Whiteley
In: Greenhalgh RM (Ed.) Vascular and Endovascular Controversies Update. London Biba Publishing, 2012 p. 666-670


For more information about varicose veins of the vagina or vulva see: www.vulval-varicose-veins.co.uk

Barrie Price wins debate about perforator veins

Mr Barrie Price MS MD FRCS FCPhleb
Consultant Vein Surgeon and Fellow of The College of Phlebology
(www.collegeofphlebology.com)

On Tuesday this week, Mr Barrie Price of The Whiteley Cinic, won his debate at a major international medical conference.

The Charing Cross symposium is the biggest vascular conference in the UK - and one of the major Vascular events each year in the world.

The debate was between Professor Charles McCollum and Barrie Price. Professor McCollum was arguing for the popular assertion that below knee perforating veins do not need to be treated, and treating them is pointless.

Barrie Price spoke engagingly and brilliantly explaining his own experience, The Whiteley Clinic research and also the mechanism of action of perforators as outlined in The College of Phlebology book "Understanding Venous Reflux - The Cause of Varicose Veins and Venous Leg Ulcers".

The debate became quite heated as it became clear that Barrie Price's assertion that these perforating veins are very important in varicose veins, venous eczema and the formation of venous eczema - and that the treatment of these perforating veins is actually essential. Indeed the failure of most venous surgeons to do so is one of the major reasons that varicose veins keep coming back again and that patients with venous leg ulcers spend years in bandages rather than being cured by surgery.

When the audience was asked to vote, it came a a huge surprise to traditional vascular surgeons (who generally do not treat perforators) that 2/3rds of the audience voted for Barrie Price and his arguments.

This year, both Barrie Price and Mark Whiteley were invited to speak and write chapters in the Charing Cross book (see previous blog post). In addition, Judy Holdstock and Charmain Harrison from The Whiteley Clinic were asked to teach on The Office Based Vein Course at the same meeting.

3 Chapters in Charing Cross Vascular Text book

Mark Whiteley and Barrie Price from
The Whiteley Clinic wrote 3 of the chapters

The book "Vascular and Endovascular Controversies Update" has been released at the Charing Cross International meeting that is currently underway in London.

Mark Whiteley and Barrie Price of The Whiteley Clinic have written 3 of the chapters:

• Perforating Veins: I prefer radiofrequency and laser - pages 583-588
  M S Whiteley
• Debate: Treating calf perforators is pointless - Against the motion - pages 602 - 608
  B A Price
• The treatment of varicose veins of the vulva and vagina - pages 666 - 670
  M S Whiteley

In his chapter on varicose veins of the vulva and vagina, Mark Whiteley announces for the first time:

1. The observation that haemorrhoids (piles) arise from pelvic vein reflux, making them amenable to treatment by vein techniques
2. The Whiteley Clinic grading system for vulval venous reflux

Vaginal, vulval and perforator vein treatments

Surgeons Mark Whiteley and Barrie Price, and vascular technologists  Judy Holdstock and Charmaine Harrison - all from The Whiteley Clinic - will be teaching at the Charing Cross Office-Based Vein Practice course tomorrow.

Along with Dr Tony Lopez of The Imaging Clinic, Mark Whiteley and his team will be sharing their expertise in the diagnosis an treatment of:

• Varicose veins of the vagina
• Varicose veins of the vulva
• Incompetent perforating veins

Mark Whiteley and Barrie Price have also been invited to lecture on these subjects on Tuesday in the main Charing Cross meeting.

Mark Whiteley will be lecturing on:

• Perforating Veins - The place of radiofrequency and laser

and:

• Vulval disease treated by coil embolisation

Barrie Price will be heading the debate explaining the benefits of treating perforator vein reflux.

1 year of venous eczema being misdiagnosed as cellulitis

Venous Eczema of left ankle -
heading for venous leg ulcer.
Incorrectly treated as cellulitis
for a year

Venous Eczema of same left
ankle -
Incorrectly treated as cellulitis
for a year

This patient came to The Whiteley Clinic for a second opinion recently, unhappy that his "cellulitis" wasn't improving.

The man had had varicose veins for years, clearly seen in the photographs.

Last year, when his ankles started to swell and he started getting red patches around his ankles, especially on the left, he went to his family doctor who told him that he had "cellulitis" - and infection of the skin.

He was was treated over last summer and autumn with antibiotics - 8 weeks in total - and not surprisingly had no effect from these.

He was referred to a consultant dermatologist who gave him steroid cream - which once again made no difference (as we would expect).

Eventually the patient themselves heard about The Whiteley Clinic and referred himself.

Duplex ultrasound scanning at The Whiteley Clinic showed that he has venous reflux (varicose veins) causing swelling of the ankles (oedema) and skin damage. The veins will be easy to treat by The Whiteley Protocol under local anaesthetic.

When the ankles swell due to varicose veins or hidden varicose veins, or there is skin damage from this cause, then there is a high risk of the patient going on to develop venous leg ulcers.

Treatment with antibiotics or steroid creams do not change this. All such patients should be sent to a specialist vein clinic and have venous duplex ultrasound scan performed by a specialist.

Treatment of the underlying varicose veins (or hidden varicose veins) is performed under a local anaesthetic through tiny pin-holes and not only cures the venous eczema - but also stops any further deterioration, preventing leg ulcers.

For more information see: www.venouseczema.co.uk 



"Best for Legs" - Tatler Guide

See Tatler - Beauty and Cosmetic Surgery Guide 2012 - May 2012

I am absolutely thrilled to be included in the Tatler "Beauty and Cosmetic Surgery Guide - 2012".

This guide surveys the most sought out Doctors in the UK and is published in May.

This year's gide has just hit the shops and is included when you buy Tatler.

You can also buy Tatler and the Guides online at:

http://www.tatler.com/ 

College of Phlebology launched

The College of Phlebology at www.CollegeofPhlebology.com

The College of Phlebology has now been launched.

This portal about veins and venous conditions allows the public to find specialists to treat anything from Thread Veins, through Varicose Veins to venous Leg Ulcers.

Specialists who join are either:

• MCPhleb - which means they treat thread veins only
• FCPhleb - which means they treat varicose veins and other venous conditions also

For the specialists who join, there are teaching videos, forums, news and "Ask an Expert" sections behind the password protected area.

The aim of The College of Phlebology is to raise the profile of vein problems and varicose vein and other vein treatments, to try to encourage health care specialists to specialise in veins themselves or to refer to appropriately trained people.

It also aims to support those healthcare professionals who want to become Phlebologists and have a major interest in treating veins.

Finally, the College of Phlebology aims to provide the public with information, so that they don't end up having out of date treatments that are less effective or have worse results.

www.CollegeofPhlebology.com

Bad medical advice on Embarrassing Bodies

Screen shot of Embarrassing bodies, screened 9pm 26th March 2012.
Venous Eczema "treated" with steroid cream - but patient told it is due ot venous circulation and not offered a cure!!
See www.venouseczema.co.uk 

On Embarrassing Bodies - screened last night at 9pm - a patient was seen by one of the GP's with venous eczema of his leg.

He was correctly told that he had venous eczema and that this was due to "poor circulation" of his venous system - a simplified explanation of Venous Reflux or "hidden varicose veins".

However, despite the correct diagnosis and also the correct understanding of the cause being the underlying veins, the GP then suggested a treatment to help the skin (steroid cream) ..... but did absolutely nothing to correct the underlying "poor venous circulation" (the Venous Reflux or "hidden varicose veins").

As such, this patient will get a temporary improvement of the eczema, which will all come back again, and nothing to help the Venous Reflux as his leg deteriorates towards a venous leg ulcer.

The correct treatment would have been to refer the patient for a specialised venous duplex ultrasound scan, to find out which veins are causing the problem, and then to treat them under local anaesthetic by the most appropriate technique using The Whiteley Protocol.    

This would have resulted in the venous eczema disappearing, the brown stains starting to fade, and the pateint's leg would be less swollen and would continue to deteriorate.

As it has been left, this poor man my have a temporary relief from his eczema, but his leg will continue to deteriorate, get more brown and swollen ans eventually ulcerate.

For more information see: www.venouseczema.co.uk

To understand Venous Reflux and how it causes venous eczema and leg ulcers see "Understanding Venous Reflux"

Veinscreening.co.uk quoted in Sunday Express Magazine

Today, Mark Whiteley was quoted in the "S" Sunday Express Magazine ("Alive and Kicking" S Magazine, 2 5th March 2012, page 39).

This excellent article ran through several conditions affecting the legs and their treatment - including the need for a scan if you have leg thread veins to identify any "hidden varicose veins" underlying and causing the thread veins.

Mark Whiteley and www.thewhiteleyclinic.co.uk were quoted in the section on varicose veins, and the website http://www.veinsscreening.co.uk was recommended for people to go to, to find out if they need help from a specialist.

The Skin Reference Guide

A simple to use reference guide to common skin lesions and skin lumps and bumps.

It also has useful tips on treatments for each condition.

http://www.skinreferenceguide.co.uk/

Flying over Brighton with Phoenix Helicopters

This video was taken during one of my training flights with the Phoenix Helicopter Academy (http://www.phoenixhelicopters.co.uk/) earlier this year in an R44.

Phoenix does traing flights if you want to learn - or pleasure flights if you just want to sit back and have a great experience!!!

Whichever, it is the best feeling in the world :-)

Video of Toast of Surrey Awards

First time I've seen one of my own impromptu speeches!!

Mark Whiteley - Business Personality of the Year 2012

Last night, at the Yvonne Arnaud Theatre in Guildford, Mark Whiteley was awarded the Toast of Surrey "Business Personality of the Year - 2012".

The event, run by the Surrey Advertiser, is now in it's fourth year.

A full report of the event will be in next week's Surrey Advertiser newspaper.

Very good report from CQC on Whiteley Clinic

Congratulations to all members of The Whiteley Clinic on an excellent report from the CQC.

http://www.cqc.org.uk/sites/default/files/media/reports/1-101725934_The_Whiteley_Clinic_Limited_1-118339155_The_Whiteley_Clinic_Limited_20120220.pdf

Reflexology by Jade Davidson at The Whiteley Clinic, London

We are delighted to announce a new service for our London patients, starting March this year (2012).

The Whiteley Clinic specialises in providing the very latest local anaesthetic surgery for varicose veins and venous disease (such as leg ulcers, venous eczema, phlebitis etc). However a great many patients find the whole idea of surgery (even the latest keyhole surgery) quite stressful. 

To help reduce this stress and anxiety, we are very pleased to be able to offer the expertise of Jade Davidson, reflexologist from "Rosey Feet".

In conjunction with Mark Whiteley, Jade has developed a range of packages to help Whiteley Clinic patients through their local anaesthetic procedure, to relax after immediately after the operation and to sleep well the night before the operation.  

As this is a new service, it will only be available to our London patients in the first instance. If you would like to know more about this service, please download our leaflet by clicking below, or contact Jade directly at jade@roseyfeet.co.uk :

Click here to download information sheet and price list

Tatler March 2012

There was a lovely article in the current edition of Tatler (March 2012, p202) entitled "Tatler Treatments".

Amonst several excellent sections on the page, Mark Whiteley was featured for the treatment of excessive sweating.

The article is well worth the read.

http://www.tatler.com/magazine

Why not to use laser for Leg Thread Veins

I saw this young lady today who had been to a cosmetic clinic for removal of leg thread veins.

She had not been offered a Doppler or duplex ultrasound, and so the clinic had missed her underlying venous reflux ("hidden varicose veins") which contributed to her thread veins.

In addition, she had been treated with external Laser to the skin, which had failed to get rid of the majority of the thread veins, and had left her after healing for several months, with these very noticeable white scars on the skin.

Although external laser treatment is very good for thread veins of the face, which is above the heart and therefore there are no gravity problems associated with the thread veins and the facial skin is very resistant to heat as it is always exposed, the reverse is found for thread veins of the legs.

Thread veins of the legs are affected by gravity, especially if associated with underlying "hidden" varicose veins, and so it is essential to have a venous duplex ultrasound before any treatment is planned.



Once treatment is planned and the underlying veins are fixed, the thread veins of the legs should be treated with microsclerotherapy injections and NOT external laser, which can easily burn and scar the skin of the leg, which is far more sensitive to radiation and laser.

see: www.thread-veins.co.uk

"Shaving Foam" for Varicose Veins

In today's Times is an article on page 37 entitled ""Shaving Foam" treatment of varicose veins passes test".

Although a very good piece to attract interest and funding, the article states that the treatment of varicose veins "usually" consists of "stripping them out" under "general anaesthetic".

Well as anyone who has been following our work at The Whiteley Clinic will know, we were presenting prize winning research in 2005 showing such treatment to be inadequate (www.veinstripping.co.uk) and our work was even featured in the Mail in December 2010 in a feature entitled:

"Ladies, stop stripping .... (your varicose veins that is!)

 http://www.dailymail.co.uk/health/article-1335718/Ladies-stop-stripping---varicose-veins--A-leading-vascular-surgeon-says-outdated-procedure-replaced-laser-treatment.html

Therefore although Foam is a good procedure in minor cosmetic veins, or in some recurrent veins, it is only really useful when used in CONJUNCTION with other endovenous techniques such as endovenous laser ablation (EVLA), radiofrequency ablation (RFA), coil embolisation etc.

Thus, as the research is fairly clear that in large varicose veins where the main vei to be treated is larger than 6 mm the results from foam sclerotherapy are far inferior in the medium to long term compared to these other endovenous techniques, the Times article should be considered with some caution.

Foam Sclerotherapy is an excellent treatment when used in combination with other endovenous vein treatments, but is rarely the optimal treatment when used alone.

Whiteley Clinic Research presented in Paris

This weekend, two members of The Whiteley Clinic presented their research at an international confernece in Paris.

Sophie Strong (pictured above) presented her work on the use of Laser Sweat Ablation (LSA) to treat Bromhidrosis (body odour of the under-arms - www.bromhidrosis.co.uk).

Vicki Smith, director of Absolute Aesthetics (a division of The Whiteley Clinic) presented her echnique and results for treating Xanthelasma (www.xanthelasma.co.uk).

Whiteley Clinic research being presented at IMCAS in Paris

The Whiteley Clinic and Absolute Aesthetics researchers are in Paris at the International Master Course on Aging Skin (IMCAS).

This year we have 6 research papers being presented:

Oral presentations:

• Early report on effectiveness of Laser Sweat Ablation (LSA) to treat Bromhidrosis - Sophie Strong
• Removal of Xanthelasma using advanced electrolysis - Victoria Smith

In addition, the team has 4 e-papers being presented:

• The removal of Dermatosis Papulosa Nigra using advanced electrolysis - Victoria Smith
• Optimising laser technique in Laser Sweat Ablation (LSA) - An in-vitro study using porcine skin - Sophie Strong, Mark Whiteley
• Endoscopic Laser Sweat Ablation (ELSA) - a new technique for the treatment of axillary hyperhidrosis and bromhidrosis - Mark Whiteley
• 2.5 year results of Laser Sweat Ablation (LSA) for axillary hyperhidrosis - Mark Whiteley

 

Last chance to vote



Last chance to vote - voting closes on 25th Jan 2012.

You can vote online through Facebook:

www.facebook.com/toastofsurrey

Venous Eczema cured with EVLA

I have just seen a 76 year old lady who came to see me in July last year with red itchy ankles and a little ankle swelling.

She had been to her GP who had been treating her with steroid cream and support stockings.

Although the steroid cream made the legs itch less, and the support stocking made the legs feel better when they were being worn, the red marks slowly worsened and spread.

The patient saw http://www.venouseczema.co.uk and thought she might have varicose eczema (or venous eczema).

She came to The Whiteley Clinic and had a duplex ultrasound scan in July 2011.

This scan showed her problem was indeed due to hidden varicose veins (or "Venous incompetence") which couldn't be seen on the surface.

In early December 2011 she had EVLA (Endovenous Laser Ablation) of the hidden varicose veins.

Today - 6 weeks after the treatment - the legs are back to normal.

There is no swelling at the ankles, the skin is normal colour with no itching. She has not used steroid cream nor support stockings since.

We see such cures regularly. When people have ankle discolouration, swelling or itching, they should have a duplex scan in a specialist clinic to check for curable hidden varicose veins before being consigned to a lifetime of steroid creams and support stockings that will help the symptoms but not cure the problem.

Mark Whiteley interviewed by US domain expert

 

Read the interview with Mark Whiteley about his internet strategy on:

http://fragerfactor.blogspot.com/2012/01/seller-schilling-meet-buyer-whiteley.html

Sapheon glue for Varicose Veins

At lunchtime today, I met Dr Rod Raabe, consultant radiologist and inventor of Sapheon "superglue" for the treatment of varicose veins.

Those of you who read my blog or websites will know that I have had some reservations about this and outline some of the questions that I would need answering before I would consider using it.

I must say that Dr Raabe is one of the most informed doctors I've met in the venous world with regards the mechanism of closing veins, and he was able to answer every single one of my questions.

Having chatted to him, I am convinced that the Sapheon system is likely to become a major technique in the local anaesthetic treatment of varicose veins.

Previously, my concerns had been that "gluing" the vein together from the inside might leave the wall intact, allowing the vein to reopen again in the future.

However research quoted by Dr Raabe answer this question fully. He was able to explain that the glue seems to cause the inside layer of the vein to heal across the vein lumen, effectively stopping the natural repair of the vein which would be along the vein.

Just as importantly, he told me that the ultrasound appearances of the vein after the operation seems to suggest that the vein does indeed fade away, suggesting that the body starts "ingesting" the vein after a few months.

This all raises my hopes that we will have another new system that will be successful in the long-term treating varicose veins endovenously and under local anaesthetic.

If this is the case, the Sapheon system will have major advantages as it does not use heat and therefore will not need injection of tumescent anaesthesia (local anaesthesia) along the length of the vein. This will make the procedure more comfortable and quicker.

As with all new techniques, research will eventually show us the place of Sapheon in the pantheon of new vein techniques.

However, basic science can often show us which ones are more likely to be successful and which ones are unlikely to be successful. Having spoken to Dr Raabe today I truly think Sapheon is likely to be a successful treatment, with results and reputation based on excellent basic research.

My only upset is that now I am going to have to rewrite the ending to my latest book on veins!!

Toast of Surrey - Finalists announced

Finalists announced in all categories and votes requested for "Business Personality" of the year.

Link: http://www.getsurrey.co.uk/business/s/2106431_toast_of_surrey_2012_finalists_revealed

Your vote is needed!!!

We are thrilled that Mark Whiteley has been shortlisted for "Business Personality of the Year" in the Toast of Surrey Awards. This was announced in the Surrey Advertiser today (13 Jan 2012).

To vote for Mark, please e-mail:

surreymarketing@trinitysouth.co.uk

and state you are voting for Mark Whiteley.

 

We are also delighted that The Whiteley Clinic has also been nominated for "Best Business with a turnover up to £5 million".

There are three companies in this category. With our continued expansion, development of new and better procedures for our patients, and with both doctors and patients travelling from all around the world to Guildford to either train or have our procedures, we hope that we will show well in the final.

Thank you all for your support.

Daily Mail Article - Varicose veins? Forget lasers and try a quick squirt of foam

On 10th January 2012, The Daily Mail in the UK ran an article:

"Varicose Veins? Forget lasers and try a quick squirt of foam".

This article featured a patient who had had been treated with Foam Sclerotherapy to her Great Saphenous Vein (GSV) - the cause of her varicose veins. The "General and Vascular Surgeon" who performed the procedure explained that they had done a study comparing laser (EVLA - endovenous laser ablation) with Foam Sclerotherapy.

He is quoted as say that the Foam Sclerotherapy is cheaper and just under half needed a second treatment as the first hadn't worked properly.

However, those of us who spend all of our time treating veins know the research that shows that in veins over 6 mm diameter, after 3 years most of the veins have re-opened again, causing the previous problems (varicose veins, skin damage, leg ulcers etc) to return.

With EVLA (laser) - if done properly as in The Whiteley Protocol - the closure of the treated vein in 99.9% at first procedure AND is PERMANENT.

Therefore the claims that Foam Sclerotherapy is cheaper and less painful in these large varicose veins can only be made because the study hasn't checked the results at 3 years and 5 years.

Many studies on Foam Sclerotherapy in these large veins have already been done, and so those of us who want the best long term results for our patients do not use Foam Sclerotherapy in vein larger than 3 mm.

It is always a concern to us vein specialists who are sought out by patients who have had multiple vein procedures that have failed in the medium to long term, to see articles like this that encourage people to have a procedure for a short term benefit when there is very good research to show it is not a good idea in the long term.

Foam Sclerotherapy does indeed have a place in the treatment for varicose veins, but as an additional procedure to laser (EVLA) NOT to replace it.

Mark Whiteley in The Times Newspaper

The Times Newspaper ran an article about Mark Whiteley of The Whiteley Clinic in their "Expert Advice" section, on Monday 3rd January 2012

The article was called "How to look and feel your best for 2012".

Under the section called "Get rid of broken veins", Sarah Vine detailed her experience of being treated by Mark Whiteley at The Whiteley Clinic in London.

She initially had duplex ultrasound scanning to check for the underlying cause of her "broken veins" or thread veins.

She was then treated using ultrasound guided Foam Sclerotherapy and Microsclerotherapy.

For more information, follow the link: http://www.thetimes.co.uk/tto/health/advice/article3273995.ece

College of Phlebology

The new College of Phlebology Blog has been launched today in the countdown to the arrival of the new College of Phlebology web portal about veins.

http://collegeofphlebology.blogspot.com/