Spider Veins

Tiny Veins on the Legs
  • Spider Veins
    In Spider Veins
    Spider Veins
Spider veins often respond well to laser treatment


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 by newer ways that irritate these big veins by using laser light or radiofrequency administered from inside the vein. Lasers administered through the skin are not very helpful for true 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 an irritating solution is injected into the veins) or by laser treatment. In general, the largest spider veins over 1-2 mm respond best to sclerotherapy injections, in my opinion. Most other 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 often necessary to treat the varicose veins and the larger spider veins. These tiny clusters of veins that often resemble bruises are called matts or matt telangiectasias. Matts should always be treated with lasers or left alone. Injecting matts once they have occurred may cause 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 hemoglogin 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.


After the first laser treatment, veins can look the same, better, or worse; although most people see improvement after a single treatment. However, after the second treatment, most people see a significant improvement. It usually takes 2-4 treatments administered 6 or more weeks apart to remove most of the veins. There is no need to wear compression stockings after laser treatment, and there are no restrictions following treatment.


To answer your specific questions or schedule a consultation, call Dr. Bernstein today at 610-645-5551.

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