Another option is to use surface laser to treat spider veins. There are a number of different laser and light therapies that are delivered in various wavelengths through the skin to treat the spider vein. The energy is absorbed by the hemoglobin in the blood causing a local reaction that heats the vein and injures the endothelium and other vascular wall structures. Subsequently the vein is reabsorbed and disappears from sight.
During laser treatment, a laser is applied to the skin over the spider veins. Laser energy causes the spider veins to coagulate and shrink. Laser therapy is most effective for very small size spider veins because it is unable to adequately injure the larger vessels. Most patients experience mild discomfort similar to having a small rubber band snapping against skin and treatments usually do not require sedatives, pain medications, or injections of local anesthetic.
Immediately following treatment, spider veins will be darker and more visible. Over two to six weeks, a percentage of the spider veins usually fade, thus more than one treatment is necessary. Retreating the areas requires a long treatment interval because the cumulative effect can cause skin necrosis or sloughing.
With both Sclerotherapy and laser therapy the post treatment skin can react unfavorably to sunlight in the healing phase, leading most practioners to caution against sun exposure either before or after treatment.
Many patients seeking treatment for spider and reticular veins are doing so due to their desire to obtain sun exposure (i.e. look good in shorts or a bathing suit), thus limiting treatment sessions to times when patients can reliably expect to keep their veins out of the sun before or after the treatment.
While there are certain small veins that respond well to surface laser treatments in certain patients, this therapy is not reliable across the gamut of spider veins encountered, and is not generally considered reliable for larger size veins. Thus most treating physicians see this as an adjunct to other methods to treat spider veins.