What is the role of laser therapy in the treatment of varicose veins and spider veins (telangiectasia)?

Updated: Feb 28, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

Transcutaneous pulsed dye laser and intense-pulsed-light (IPL) therapy has proven effective for the tiniest surface vessels (eg, those found on the face), but this modality is not generally useful as primary therapy for treatment of spider veins of the lower extremity. This is true for several reasons.

Because of the physics of light absorption, delivering an ablative dose of thermal energy to the vessel without damaging the overlying skin is difficult. The degree of patient-to-patient variability of light absorption in the skin is high. Even an experienced practitioner may inadvertently cause painful skin burns that can lead to permanent hyperpigmentation or hypopigmentation.

For most patients, the laser pulses are significantly more painful than the 30-gauge needles used for microsclerotherapy.

Most spider veins have associated feeding vessels that must be treated by some other means before the tiny surface vessels are amenable to laser or IPL treatment.

Dudelzak et al report successful treatment of facial spider veins (telangiectasias) with a 980-nm diode laser. No complications were reported. [15]


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