Prior to the development of modern laser technology, the only treatment for superficial leg veins or spider veins was what is called sclerotherapy. This technique involves injecting a fine needle into these veins with a caustic solution that collapsed the veins.
As you can imagine, this is a very difficult procedure that requires great precision by the doctor injector. Missing the vein and/or injecting the solution into the surrounding skin could result in ulceration and permanent discoloration of the treated skin area.
For this and other reasons, lasers have quickly become the gold standard, first-line treatment for small leg veins within the past decade. A recent study of 57 women, all of whom had one of their legs treated with sclerotherapy and their other leg with laser treatment, showed equal efficacy of greater than 70% clearance of veins 6 months after their operation.
In this study, lasers were shown to be most effective on the small, superficial red or blue veins. Even more importantly, lasers were also deemed more effective on veins that were too small for the sclerotherapy needle, which is a victory in and of itself for those who are especially needle-phobic.
While external lasers work wonders for small leg veins, they actually do not work for varicose veins, the raised and nodular-appearing veins that bulge above the surface of the skin. Varicose veins generally indicate a problem that is deeper down within the legs, not just within the veins themselves.
Varicose veins need to be evaluated by ultrasound to determine the source of increased pressure within the veins. A vascular surgeon can then decide the best course of treatment, which may involve invasive surgery.
Prior to undergoing any spider vein laser treatments, I advise patients to avoid any blood thinners, including ibuprofen, naproxen and aspirin. Blood-thinning medication may cause more extended bruising following such a treatment.
I also recommend avoiding sun or tanning booth exposure at least 2 weeks before and after laser work to lessen risk of sunburns. Additionally, I absolutely do not perform laser spider vein treatment on woman who are pregnant or have a history of keloid scarring (i.e. scarring that has an excess of scar tissue).
Before the laser treatment begins, we apply a topical anesthetic to numb the skin over the spider veins. When the laser beams hits the skin over the veins, there is a snapping pain that lasts only for a millisecond. The anesthetic cream helps lessen that impact.
I also apply a cold aloe-based gel over the area of treatment to cool the skin. When the laser procedure begins, much heat is generated, but it is primarily directed at the interior of the blood vessel in order to collapse it.
After I treat an area of spider veins, I apply a cold compress to remove as much heat as possible from the skin surface. After removing the compress several minutes later, the treated veins have what is described as a “cat scratch” look, being slightly raised and red.
I then cover the treated veins with a light hydrocortisone cream, followed by a light compression that should be worn overnight if possible. I do not require ongoing compression of the legs, but I do recommend no prolonged standing or aerobic exercise for 3-4 days after the procedure.
After the laser has done its work, the real work of your body begins. The collapsing of the blood vessels give a signal to your body that some damage has occurred.
Your immune system sends in scavenger cells that start to remove the damaged blood cells and vessel structures. As a result, over the next several weeks, the collapsed veins will gradually disappear from view.
Despite the fact that laser treatments are quite effective, they generally need to be repeated after 4-6 weeks, as some blood vessels may reopen or not be completely reabsorbed by the first treatment. However, once a blood vessel is gone, it is gone permanently.
You may develop other spider veins over time if you are prone to them due to heredity, occupation or other events such as pregnancy. However, take comfort in knowing that these spider veins are more treatable now than ever thanks to this laser technology.
If you spent the summer looking at your legs and wishing those veins would go away, simply give us a call at (207) 873-2158 to schedule your free and confidential consultation to see if you are a candidate for this non-invasive and effective method of treating superficial leg veins. You can then be less self-conscious next summer in your shorts and bathing suits.