Site Navigation
Featured Articles
Transcutaneous Laser Ablation
Target Veins
This technique is generally excellent in treating small spider veins (telangectasias). These veins usually range in size from 1-3 millimeters in diameter. They can be blue, purple, or even almost black in color and are very superficial (near to the surface of the skin). They can cause symptoms including burning, itching, spontaneous bleeding, and swelling.
How it Works:
Heat generated from laser light is passed through the skin using a hand held wand or similar device. When the light strikes the vein, it superheats it and causes the blood to clot and the vein to "shrivel-up". The process does not require that the skin be punctured or cut. The skin itself is not burned because the wave length of the light in most vein treatment units is such that it only heats items that are colored (have pigment). Most Caucasian skin lacks much pigment therefore it is not burned. The vein on the other hand is deeply pigmented blue and purple and most of the laser energy is focused there. Most African American, Hispanic, and Asian skin coloring is too dark for this type of treatment. They simply will not tolerate the discomfort and there is too much skin damage.
Treatment Technique
The patient's skin is usually treated with a topical anesthetic cream such as lidocaine cream. This needs to be in place for 15-20 minutes to take effect. Occluding the area (covering it with plastic wrap) helps to enhance the numbing effect. A cold pack is then applied to the area to be treated for 1-3 minutes. This further numbs the skin and decreases any discomfort associated with the treatment. Patients and providers should always wear 'laser safety glasses' when the laser is in use.
The laser is then turned on and the appropriate settings are entered by the provider. There is a usually a guide light that can be seen by the user to help aim the laser. The laser is then fired and heat is delivered to the vein being treated. The recommendations are usually for the laser to be fired sequentially along the course of the vein to accomplish complete destruction. In other words, it is kind of connecting the dots along the vein.
Treatment Tolerance
If good topical anesthetic is used and the laser settings are not too high, then tolerance is excellent. Most people experience a mild prickling sensation as the laser is fired. Some report it feeling like a small needle poke. Occasionally a patient will find it too uncomfortable to tolerate. Many providers find the lidocaine cream too messy and time consuming and therefore only use the cold pack. This is usually adequate anesthesia by itself. Treatment length will vary based on the number of veins to be treated. Most patients can tolerate 30-45minutes of treatment.
Post Treatment Care
No gauze or bandages are needed as there is no bleeding or holes in the skin. Most providers will require patients to wear compression socks for 7-10 days following treatment to help the treatment be successful and to help minimize any swelling that may occur. Some patients will begin to see results in just a few days, but it may take 4-8 weeks for the bulk of the veins to resolve following treatment. A check up with the provider is usually scheduled for 2-4 weeks.
Results:
Excellent. 70-80% of the veins treated should resolve after just one treatment. A second or third treatment may be necessary for complete elimination. Smaller spider veins will stay gone as long as there is no larger vein feeding into them that has been overlooked.