The use of LASER technology to target surface blood vessels is well established and whilst it is primarily used to target unwanted facial veins it also has a place in treating certain leg veins as well.
WHAT SORT OF LEG VEINS CAN BE TREATED BY LASER?
LASER technology can be used to treat leg veins in 2 very different ways:
(1) Large and deep Varicose Veins can be treated by passing a laser fibre through the skin and using Ultrasound imaging to accurately place the fibre inside of the target Varicose Vein. The Laser is then activated and the resultant heat can shut down and seal off the large vein. This procedure is called Endovenous Laser Therapy and is used to treat Varicose Veins that previously needed to be surgically removed. For more information visit Endovenous Laser Therapy
(2) Very small spider veins can be treated by applying a Laser beam directly onto the surface of the skin. The Laser used generates an intense light beam of a specific wavelength that is preferentially attracted to blood cells in the leg vein and not absorbed much by the overlying skin. If laser light is concentrated it results in heat and if enough heat is produced inside a blood vessel then the vessel can be destroyed. This is called Surface Laser treatment.
WHEN ARE SURFACE LASERS USED FOR LEG VEINS?
The vast majority of Spider Veins on the legs are treated most effectively by micro injections in a procedure called Sclerotherapy. For more information visit the Sclerotherapy page.
Surface laser treatment is reserved for either the smallest of spider veins that are too small to inject or in occasional patients who are needle phobic and can’t bear the thought of an injection of any sort.
WHY CAN’T ALL SPIDER VEINS BE TREATED BY LASER?
Spider veins on the face respond very well to Laser treatment but spider veins on the legs are less responsive. This is because spider veins on the legs tend to be situated deeper below the skins surface, have thicker vein walls and are often associated with larger veins that create more pressure inside the leg vein.
If too much heat is applied to the skin in an attempt to shut down larger leg spider veins then skin damage in the form of blistering and pigmentation can occur.
WHAT TYPE OF LASER IS USED FOR LEG SPIDER VEINS?
If the leg spider veins are bright red a number of vascular lasers can be used including EXCEL V (532 nm), Pulse Dye Laser (585nm or 595nm) and Copper Bromide (578nm). If the leg spider veins are slightly larger and blue in colour then a 1064nm laser is preferred as it better concentrates heat in the less oxygenated blood.
Skin cooling is very important in treating leg spider veins especially if skin colour is darker. The EXCEL V is well suited to treat leg spider veins as it has both 532nm and 1064nm wavelengths and contact cooling to protect the skin.
IS SURFACE LASER TO LEG VEINS PAINFUL?
Certainly laser treatment can be felt and is typically characterised as like a heated pin scratching the surface of the skin. This is quite tolerable especially if adequate skin cooling is used. Interestingly most new patients expect Laser treatment to be painless and surface injections to be painful, however patients who have had both surface injections and surface laser, usually find the laser is more uncomfortable than the micro injections.
WHAT HAPPENS AFTER SURFACE LEG VEIN LASER?
The skin will feel like mild sunburn and will look red. A cold pack is used for 10-15 minutes after treatment and then a soothing cream such as Centella or Aloe Vera is applied. Unlike after sclerotherapy stockings are usually not recommended.
Normal activity can be resumed immediately after but strenuous exercise and swimming is best avoided for at least 48 hours as the skin can be sensitive. Care needs to be taken with direct sun exposure after laser treatment and depending on how much skin reaction occurs it may need to be avoided for up to 2 weeks. Tanning should be avoided for 4 weeks after treatment. Some brown pigmentation can occur after laser treatment and this can take several weeks to breakdown.
HOW MANY TREATMENTS?
The number of treatments will depend on the extent of the spider veins and the level of improvement desired. Typically 3-4 laser treatments can be required. It is not uncommon that surface laser is used in combination with sclerotherapy. Usually the sclerotherapy is done first to target larger feeding veins and then laser is used later to tidy up residual small surface veins.
WHAT IS THE COST OF SURFACE LEG VEIN LASER?
There is no Medicare rebate for the laser treatment of leg spider veins and GST of 10% is applied by the government. The usual cost is $363 ($330 + gst) per treatment session.