Laser Treatment (Small Veins)

What is a LASER?

Please–bear with us for two paragraphs!

Laser is an acronym for Light Amplification by Stimulated Emission of Radiation and described technically is:  “A device that emits light through a process of optical amplification based on the stimulated emission of photons.  Laser beams can be focused to very tiny spots achieving a very high irradiance.”

A watt is a unit of power.  Lasers are measured usually by mW and nW. 

  • An mW (milliWatt) is one thousandeth of a watt. 
  • An nW (nanoWatt) is one billioneth of a watt

All that being said, let’s just say a laser puts out a tiny beam of intense light really fast!

However, lasers are vitally important in aspects of our daily life from recording and playing DVDs and CDs, to printing computer data, to cleaning teeth, to surveying roads and they have become the gold standard in many surgical procedures.

Lasers in medical treatment

The use of lasers in medical treatment fall in two categories:  One are those lasers with fiber that are done within the vein itself.  Here, our discussion is regarding those lasers that are used for treatment through the skin of smaller veins and may in most circumstances require multiple treatment sessions.

In recent years, lasers have played an increasing role in medical and cosmetic treatments.  For cosmetic problems, lasers are also effective in treating vascular problems such as flushing/redness, as in Rosacea, red spots (hemangiomas), unsightly broken or dilated blood vessels, port wine stains, and telangiectasia.

To treat vascular lesions, including spider veins, the laser is directed at the red blood cell molecule.  When the beam of energy reaches its target, it is absorbed and converted into heat.  The heat destroys cells in the target area without affecting other cells around it.  This is possible because the specific laser light beam is “looking” for the target molecule that may not be present in the surrounding cells so it would have very little effect on them.  With the use of longer wavelength lasers, we can reach much deeper levels and affect much more significant changes than would be possible with most short wavelength lasers.  Over a few weeks, the vessel will disappear and all the blood will be removed by the body’s scavenging cells, which are the cells that engulf and digest debris and invading microorganisms.  

Who is a candidate for laser treatment?

There are no absolute reasons as to why one cannot undergo laser therapy.  However. one should:

  • Be in good physical health
  • Preferably a nonsmoker
  • Is realistic about the procedure and results
  • Has no disease of the blood vessels or problems with bleeding

All patients are evaluated prior to laser therapy.  Spider veins usually do not cause symptoms and are a cosmetic concern only.  For those who do have symptoms, further investigation is done to assure you do not have varicose veins or other underlying reasons for your spider veins.  Laser therapy is most effective for the very small spider veins and not used to treat varicose veins unless done with a laser fiber inside the vein (See Endovenous Laser Therapy) .

How should I prepare for laser treatment?

There are no major preparations required before the laser treatment that is directed through the skin.   A few common sense recommendations include avoiding sun exposure, aspirin, alcohol and do not smoke for a time preceding your laser treatment and this will be discussed with you at the time of your consultation.

On the day of the treatment you should avoid all creams, lotions and moisturizers on the area that is going to be treated.

You should wear comfortable clothing.

How long does it take?

For laser treatment of the veins treated through the skin, the amount of time varies.  The amount of time can vary from 15 minutes to one hour depending on the size of the area being treated as well as the severity of the problem.  Usually, more than one treatment may be needed to achieve the desired results.

Is laser therapy painful?

The majority of individuals do not require any type of anesthesia, but for those who are squeamish or anticipate pain, a topical anesthetic can be applied approximately one-and-a-half hour prior to the procedure.  You may feel a slight burning or stinging sensation as the laser penetrates your skin and many patients liken the feeling to a rubber band snapping on the skin.

However, because of the fact that we are all different and respond differently to stimuli, it is important to be aware that there may be discomfort associated with the use of some laser treatments.  We have seen this range from the patient who “feels nothing” at whatever level of energy is used to those who feel the discomfort even before the laser is fired.  Since most laser treatments will require a certain number of sessions, it is important for you to know your comfort zone.  All the possibilities will be discussed with you, you will be given every opportunity to ask questions and have them answered and given various choices that will provide you with a greater degree of comfort during the treatment.

How will I feel after therapy?

Soon after the procedure, you may feel a slight bump on the skin which will disappear in the next 2-4 hours.  The area may also appear slightly redder and occasionally may be bruised.  The skin above the veins will have a reddish, cat-scratch appearance.  This generally disappears over the next two days.

Patients are encouraged to resume all normal activities immediately.  .

How long is recovery?

Recovery times depend on the extent of the treatment and the individual’s capacity to heal.  Some redness or purple discoloration may persist for several weeks or longer.  The redness will gradually lighten to a pink tone and then to a lighter, more natural color.

The results of laser treatment for spider veins are not immediate.  After laser therapy the vessels underneath the skin will gradually change from a dark blue to light red color then eventually disappear in two to six weeks. 

The treated areas are noticeably clearer and in most cases the skin continues to improve with each successive treatment.

Are there any precautions after laser therapy?

After laser therapy, it is strongly recommended that you keep out of the sun for one month.  The pain is minimal and you may take any over-the-counter pain medications.  After treatment, there is no down time and you are encouraged to resume all of your normal activities immediately afterward.  If your leg veins were treated, healing can be aided by wearing support stockings and the strength of these will be recommended by your doctor.  

How often can therapy be repeated?

It is generally recommended that the treatments be spaced four to six weeks apart.  If new veins appear, additional treatments are required for optimum results.

What are advantages of laser over sclerotherapy?

  • It can be used to treat veins too tiny to enter with a needle
  • It can be used for spider veins that look like wagon wheels resulting from high pressure centers
  • Recovery may be more immediate
  • Downtime is slightly less
  • Laser therapy can be used on the face

What are disadvantages of laser over sclerotherapy?

  • Laser cannot be used for deeper veins, the exception being the use of endovenous laser
  • Laser has more limitations on patients with dark skin and some dark-skinned patients can only be treated with sclerotherapy
  • Laser is more expensive than sclerotherapy

Intense Pulsed Light (PhotoDerm)

Even though the PhotoDerm is referred to as a laser, technically it is not.  The PhotoDerm is actually a multi-wavelength light source that uses different filters to treat various conditions.  The shorter wavelengths are absorbed by both brown and red pigments.  The longer wavelengths are more independent of brown pigmentation.

There are several benefits to PhotoDerm including:

  • Mild pain to no pain
  • Topical anesthetic is preferred (the longer wavelengths go deeper than superficial/topical numbing of the skin)
  • Little bruising or swelling (facial swelling resolves in less than 24 hours)
  • Little down time if any
  • Convenient, short appointments in your doctor’s office

What conditions can PhotoDerm treat?

Vascular and pigmented lesions, which are abnormal blood vessels located directly under the surface of the skin.  These give the skin a red color.  Many times there is sun damage and pigmentation that is improved as the vessels are being treated.  These areas of discoloration include:

  • Brown birthmarks
  • Seborrheic keratoses
  • Hyperpigmentation
  • Port wine stains
  • Rosacea
  • Spider veins on the face and legs

How does PhotoDerm work?

PhotoDerm pulsed light is first absorbed by red pigment (your tiny veins, or capillaries) and next by brown pigment (the melanin which is the dark pigment in your skin).  The ideal patient is very light skinned and has red vessels.  This allows the PhotoDerm to concentrate its full power to the red vessels rather than additionally heating of the skin due to the brown pigment (melanin) of the skin. 

PhotoDerm is a non-invasive treatment that uses intense pulsed light therapy to reduce melanin, which is the brown pigment of your skin such as sun spots, and it also can be used to decrease any brown pigment that might occur after sclerotherapy of your veins. 

It emits brief flashes of intense pulsed light, similar to a camera flash.  The light energy is delivered to your skin in pulses through a computer-controlled handpiece controlled by your doctor.  After your PhotoDerm treatment cycle, the treated area will gradually fade and slowly disappear.  It is relatively painless being described as a brief stinging sensation.

Chilled packs on the skin and other techniques prevent discomfort.  The entire procedure is brief, non-invasive and no needles are used at any time.

How should I prepare?

Just as with laser treatment, prior to undergoing intense pulsed light treatment you should not be exposed to the sun for one month prior to treatment and one month following treatment.  Recent sun increases your chances of side effects, such as blistering of the treated skin.  Treatment should not be performed on tanned skin.  The paler the skin the more effective the treatment.  During the winter is the best time to undergo PhotoDerm.

What are the side affects of a PhotoDerm treatment?

Generally, patients experience a sunburned feeling for a few hours.  During that time, they should apply a good moisturizer to keep skin smooth and supple.  The most common side effects include increased redness, burning and tingling at the treatment site.  However, this gradually subsides and disappears completely within a few hours.  Occasionally, there is a blister if a high energy wave was used to treat a complex condition.  As with any laser treatment, the treated area must be kept out of the sun in order to achieve optimum results.

How many treatments will I need?

This depends on the size, location, depth and color of your lesion.  Spider veins on the face and age spots generally do well with one or two treatments while darker or deeper birthmarks may require additional treatments.  Port wine stains, hemangiomas and leg veins usually experience satisfactory results from PhotoDerm treatments after four to eight treatment sessions.  Each session usually lasts 15-20 minutes and treatments should be spaced 4 to 8 weeks apart to allow your body to remove the maximum amount of pigment cells.  You will continue to see a lightening of your lesion after each treatment as the old, affected skin sloughs off leaving new skin in its place.

Many times we will alternate laser treatments with PhotoDerm treatments to get faster results of the bigger veins.

What results can I expect?

Most patients are extremely pleased with the final results of their procedures.  The improvement can be quite dramatic and every attempt will be made to achieve an optimum result for you.  However, no guarantee for complete success with this treatment can be made by any physician.  You will be given every opportunity to ask any and all questions and are encouraged to do so.

Veinwave treatment

Veinwave is a revolutionary treatment for thread, spider or broken veins on the legs or face.  This is especially useful for the very large capillaries or spider veins on the nose.  This thermo-coagulation technique is a complete solution being effective, totally safe and relatively painless with only minimal temporary bruising and producing immediate results usually with no side effects.

A fine needle is introduced over the vein and in most cases this site disappears instantaneously without bruising.  No bandaging is required.

Veinwave can be applied to any kind of skin complexion because it is not absorbed differently by different colors of pigmentation. It treats all spider veins on the legs and the feet as well as troublesome facial red veins.  We prefer the Veinwave for use on large facial veins.

Will my insurance company cover this procedure?

No.  This procedure is considered cosmetic and, threfore, is not covered by insurance.  A cost list will be provided to you at the time of your consultation so you will know fully what to expect.


We hope the information on these pages is both informative and helpful, but it is intended for education only.  Please do note that no web site, no matter how much information is shared, can replace a consultation with your doctor and a vascular specialist.  Medical technology and treatment are continually improving and evolving so before making any decision on treatment, it is always advisable to see your doctor first for a comprehensive evaluation of your vascular disease and other medical conditions.

At the Vascular Center of Wichita Falls, we work closely with your other physicians.  If you have concerns about your arteries or veins, contact us.  A referral is not necessary to make an appointment.