Conditions

Red Leg Veins (Spider Veins)

Laser Light or Radiofrequency

Unwanted veins on the legs come in all shapes and sizes. Varicose veins are large, bulging, blue veins that are often painful. The best ways to get rid of these are by surgically stripping them out, by sclerotherapy injections, or newer treatments that irritate these big veins by using laser light or radiofrequency administered from inside the vein.

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Results of Treatment

After the first laser treatment, veins can look the same, better, or worse; although most people see improvements after a single treatment.

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About Red Leg Veins (Spider Veins)

Unwanted veins on the legs come in all shapes and sizes. Varicose veins are large, bulging, blue veins that are often painful. The best ways to get rid of these are by surgically stripping them out, by sclerotherapy injections, or newer treatments that irritate these big veins by using laser light or radiofrequency administered from inside the vein. Lasers administered through the skin cannot effectively remove true varicose veins. Generally much smaller than varicose veins, spider veins are often red or blue and come in a variety of sizes. These veins can be removed with either sclerotherapy injections (where a solution is injected into the veins) or by laser treatment. In general, the largest spider veins respond best to sclerotherapy treatment, while the smallest spider veins respond best to laser treatment.

Up to a third of people getting sclerotherapy injections, and many of those having vein stripping, develop tiny clusters of spider veins FOLLOWING these treatments. Sclerotherapy and veins stripping are necessary to treat varicose veins and larger spider veins, so acquiring the smaller veins following treatment can be a necessary evil. These tiny clusters of veins, that often resemble bruises, are called matt telangiectasias or ‘matts’. Matts should always be treated with lasers or left alone. Injecting matts once they have occurred often causes them to multiply. In addition, matts are so small in diameter that injecting them can often lead to complications. About half of the people I see for laser treatment of spider veins have had sclerotherapy injections. About half of those coming to me who have had sclerotherapy are coming to treat matt telangiectasias that developed following sclerotherapy injections.

It is very important when treating spider veins by laser that the person to be treated isn’t tan. Tan or dark skin is much harder to treat without hurting the skin. Lasers are attracted to the hemoglobin in blood vessels on the legs AND to melanin pigment in the skin. Although lasers have cooling devices to protect the surface of the skin where melanin pigment resides, melanin can still absorb enough laser light to hurt the skin. Melanin is designed to absorb light, and the veins we are aiming at with the laser are below the surface of the skin. Therefore, if people are dark skinned or tan, I often pre-treat the skin with creams and lotions to lighten the surface layer above the veins. More darkly pigmented skin may require treatment with a Nd:YAG laser as opposed to the typical pulsed-dye or KTP vascular lasers.

After the first laser treatment, veins can look the same, better, or worse; although most people see improvement after a single treatment. This is because treatment damages the veins but requires a second treatment to remove them completely. After the second treatment, most people see a significant improvement. It usually takes 2 treatments administered 3 months apart to remove most of the veins. There is no need to wear compression stockings after laser treatment as one does following sclerotherapy injections, and there are no restrictions to activity following treatment.

Red Leg Veins FAQs

WHY DID I GET SPIDER VEINS?

Spider veins are extra veins that connect to the deeper veins in one’s legs and arise due to hormonal and other influences on vein growth. They are ‘extra’ veins were weren’t born with. Pregnancy and heredity are both major causes of lower extremity spider veins. Although more common in women, spider veins also occur in men.

CAN I PREVENT SPIDER VEINS?

Spider veins result from hormonal causes, heredity and from other factors affecting the deeper veins from which they come. There is no way to prevent them.

WHAT HAPPENS IF YOU REMOVE THESE VEINS; DO I NEED THEM?

Spider veins occur later in life, and people do just fine without them prior to their arrival. In fact, the skin is better off without these extra veins that serve no useful purpose.

WHAT ARE VARICOSE VEINS AND HOW ARE THEY REMOVED?

Varicose veins are dilated veins where the valves within the veins, that prevent backflow of blood in the wrong direction, become poorly- or non-functional. As a result, these veins become dilated and can lead to circulation problems, pain and ulcerations. Treatment often requires surgical removal  (vein stripping) or destruction of the vein from the inside by injecting sclerosing solutions that injure the lining of the vein or radiofrequency or laser treatments that injure veins by heating them internally (endovenous ablation) resulting in their destruction.

HOW MANY LASER TREATMENTS WILL I NEED TO TREAT MY SPIDER VEINS?

We use vascular lasers such as the V-Beam Perfecta®, V-Beam Prima® and Excel-V® to treat spider veins. These lasers protect the top of the skin by cooling it while heating the veins below the surface. Generally a minimum of 2 laser treatments are required at 3 month intervals to remove the majority of veins. Small veins caused by sclerotherapy injections (matt telangiectasias) are sometimes more difficult to remove and may require more than 2 treatments.

HOW LONG BETWEEN LASER SPIDER VEIN TREATMENTS?

Leg veins, or spider veins, are treated at 3 month intervals.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF LASER TREATMENT?

Laser treatment of spider veins immediately makes them disappear and are replaced with a linear hive reaction long the vein or turn darker blue or purple from bruising inside the vein. A few days after treatment the veins look like cat scratches with a tiny, string-like scab appearance on the skin, but often without a scab one can feel. These marks can last for a few weeks after treatment, so it’s best to treat spider veins before the summer. Sun-exposure can create temporary pigmentation along treated veins if they are exposed soon after treatment.

DOES LASER TREATMENT OF SPIDER VEINS HURT?

Treatment of spider veins stings but isn’t very painful for most people. Some dislike it more than others, but we don’t ever need, or use, numbing cream when treating them.

HOW DO I CARE FOR THE TREATED AREA?

People apply petrolatum (Vaseline® or Aquaphor®) to the treated areas a few times a day, for 1-2 weeks after treatment.

WHAT ARE MATT TELANGIECTASIAS?

Matts are tiny clusters of veins resembling bruises that usually result from sclerotherapy injections, vein stripping or even trauma. They may require more laser treatments than standard spider veins for removal, and often multiply if treated with sclerotherapy injections.

Why Worry About Those Small
Imperfections That Can Be So Easily Erased?