Laser Treatment for Spider Veins — FAQ

Spider veins, also known medically as telangiectasia or venulectasias, are tiny red, blue or purple thread-like veins near the surface of the skin that often take on the appearance of a spider's web. These perpetually dilated and visible veins, caused by increased pressure to the veins, can develop on any part of the body, including the face, but most often appear on the thighs, calves, ankles or buttocks.

The gold standard treatment for spider veins is laser therapy. Here are some frequently asked questions about the procedure.

About Laser Treatment for Spider Veins

What happens during laser therapy?

Laser vein treatment, which is done in a doctor's office or clinic and under local anesthesia, usually takes less than an hour. The procedure uses a focused beam of light to target the vein that is selected for treatment, and because the beam is focused it is careful not to affect nearby skin, tissue and veins. As the laser heats up the vein is destroyed, then, over a period of four to six weeks, the vein is reabsorbed by the body and disappears.

What type of laser is used to treat spider veins?

The most common laser used to treat spider veins is the Nd: YAG laser system. It is a hand-held device and also has a cooling tip to minimize discomfort during the therapy.

How does the laser work?

The Nd: YAG laser pierces the skin and penetrates the superficial blood vessel. The heat generated from the laser coagulates the blood inside the vessel, causing it to collapse and seal. Over the next few weeks, the vessel will disappear and all the blood will be removed by the body's scavenging cells. The newer laser treatments allow the delivery of a precise dosage of energy to each blood vessel without injuring any nearby structures.

Is laser therapy painful?

As mentioned, a local anesthetic is used to numb the area. During treatment, however, you may feel a slight tingling sensation as the laser fires. Most current day lasers have a cooling system that prevents the tip of the laser from getting too hot and resulting in burns or damage to the area.

What preparations should I take before treatment?

There are no major preparations required before the laser treatment, but you will want to avoid sun exposure, aspirin, alcohol and smoking for at least a week prior to the procedure.

As for the day of treatment, avoid all creams, lotions and moisturizers on the area that is going to be treated. Also, wear comfortable clothing that allows easy access to the body part(s) being treated.

How do I know if I am a candidate for laser vein treatment?

All individuals are evaluated prior to laser therapy. Spider veins do not cause symptoms and are of a cosmetic concern only. For those who have symptoms, further investigation is done to ensure that they do not have varicose veins. Laser therapy is most effective for the very small spider veins and not used to treat large varicose veins.

What is the time between treatments?

It is generally recommended that the treatments be spaced four to six weeks apart. If new veins appear, additional treatments are required for optimum results.

What are side effects of laser therapy?

The skin above the veins will have a reddish, cat-scratch appearance. This generally disappears over the next two days.

What are potential complications of laser therapy?

The risks associated with laser vein therapy are minimal. Your eyes will be shielded during the treatments. Most facilities use state-of-the-art cooling systems, thus the treatments are low risk and relatively pain-free.

How many treatments are needed?

Depending on the size and number of veins, two to six treatments will be needed. The treatments are usually done 4-6 weeks apart. Those with a tendency towards vascular problems will most likely require additional treatments.

Is laser treatment for spider veins curative?

There is no cure for spider veins. Although treatment does not prevent the development of new spider veins, the removal of existing veins can dramatically improve the appearance of the affected area, providing a more youthful, healthy look and an even color pattern to the skin. Spider veins can be recurrent and thus, more treatments will be required in the future.

What other conditions does laser treat?

In addition to the leg spider veins, the laser can provide non-invasive skin treatments for the face. It is also used to remove unwanted hair even from patients who are not always good candidates for laser hair removal, such as those with darker or tanned skin.

What is the cost of spider vein removal with laser?

Spider veins are only of cosmetic nuisance and not covered by medical insurance or Medicare. The average cost for laser therapy may vary from $200 - $400 per session.

After Treatment

What to expect after laser therapy?

Soon after the procedure, you may feel a slight bump on the skin; it should disappear hours after treatment. The area may also appear slightly redder and occasionally may be bruised.

Are there any precautions after laser therapy?

After laser therapy, it is strongly recommended that one keep away from the sun. Healing can be facilitated by wearing support hose. The pain is minimal and one may take any over the counter pain medications. After treatment, there is no downtime. You can resume all of your normal activities immediately afterward.

When can you go back to work after laser therapy?

Patients are encouraged to resume all normal activities immediately. Final results may not be apparent for several months. Most patients are satisfied by the results in a very short time.

How long does it take for the results to become evident?

The results of laser treatment for spider veins are not immediate. After the laser therapy, the vessels underneath the skin will gradually change from a dark blue to light red color, then eventually disappearing in two to six weeks.

Most patients report a high degree of satisfaction with the procedure and relief at no longer having to hide unsightly veins. The treated areas are noticeably clearer and in most cases the skin continues to improve with each successive treatment.

The majority of spider veins will disappear within two to four weeks, and in some cases even longer.

Laser Versus Other Treatments

What are other methods of treating spider veins?

The most conservative approach for treating spider veins is to wear properly fitting support hose (also called compression stockings). These stockings can generally be purchased at any pharmacy and come in various styles and colors. The stockings may be worn below or above the knee. They also come in different compressions varying from 18 to 20 mmHg and up to 40 to 50 mmHg. Unfortunately, once the spider veins have developed, they do not disappear even with wearing stockings.

Other conservative treatment approaches include losing weight if you are overweight, exercising regularly (especially walking), avoiding prolonged periods of sitting or standing, and elevating your legs while sitting and sleeping. For those who tend to stand up for prolonged periods, time outs should be taken to rest the feet.

If conservative treatment does not achieve satisfactory relief of symptoms or if the appearance of the veins is bothersome, other treatments may be offered, depending on your overall medical condition. Depending on the size and location of the veins, other treatment techniques include:

  • Sclerotherapy: This procedure involves the injection of a liquid or foam chemical directly into the vein with a small needle. The chemical, called a sclerosant, irritates the veins and causes it to collapse. Over time, the vein turns into scar tissue that fades away. The procedure is usually done in a clinic, is relatively inexpensive, and has little downtime. Most individuals require a couple of sessions to treat all the spider veins. Side effects of sclerotherapy may include slight swelling, bruising, and redness and itching at injection sites. If the solution leaks out of the vein, pain and darkening of the skin occurs.
  • Intense Light Therapy: This newer technique of treating spider veins uses intense pulsed light that can be used to selectively damage or destroy abnormal veins including small spider veins and small vascular birthmarks. Unlike laser, the intense light therapy is more suited for vascular lesions slightly deeper in the skin. This treatment may be recommended when sclerotherapy or laser therapy does not effectively treat the superficial vein. Two to four treatments may be required depending on the number and size of the lesions.
  • Surgical ligation/stripping: Spider veins are almost never treated with surgery. Surgery is only reserved for the large varicose veins.

What are advantages of laser over sclerotherapy?

  • it has much fewer side effects
  • It is less traumatic to the surrounding skin compared to sclerotherapy
  • It takes a much shorter time to complete laser treatment
  • It is less painful than sclerotherapy
  • Recovery is immediate
  • Downtime is almost zero
  • Laser therapy can even be used on the face

What are disadvantages of laser over sclerotherapy?

  • laser can not be used for more deeper veins
  • laser is slightly more expensive than sclerotherapy

Reviewed February 14, 2017


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