Skin pigmentation can impact the effectiveness of any laser; therefore the patient should have no sun exposure four weeks prior to treatment to guard against blistering and scarring.
Although discomfort is mild, some form of cooling may be used to increase the patient’s comfort. Cooling may be achieved through the use of ice, a cool air device or topical anesthetic. The duration and number of sessions will vary depending on the severity of the condition and the location. Many facial veins can be treated in one session; however, most conditions on the leg require three to five treatments to ensure all spider veins are treated. These treatments are spaced four to six weeks apart.
Many physicians use the “Double Injury” method when treating spider veins on the leg. This technique treats the spider veins with the Medilas D FlexiPulse laser, followed by an injection of sclerosing solution into the associated reticular or “feeder” vein. Laser energy is applied first through a hand piece that is extremely small and lightweight. The 5 Hertz system allows patients to be treated quickly. The laser can be set to pulse or continuous mode. Spot sizes are easily interchangeable and come in 0.5, 1.0 and 1.5 millimeter sizes. By injuring the veins with the laser first, the vein vasoconstricts and less sclerosant is required. The benefit of the “Double Injury” method over sclerotherapy alone is a quicker resolution and a significant decrease in the risk of staining. Staining appears as brownish discoloration on the skin. (See Alternative Treatment Options).