Many women fail to wear shorts in the summer or feel comfortable in a bathing suit at the beach due to the numerous red and blue veins on their legs. Until recently, the only viable treatment method was sclerotherapy injections that use a concentrated salt or detergent solution to irritate the lining of the vein. Now, laser therapy is emerging as an alternative or additional treatment for spider veins. A number of patients receiving sclerotherapy or undergoing varicose vein stripping develop lots of tiny veins at the treatment site, called matt telangiectasias. These matts are often too small to inject and often multiply after further injections. Laser treatment is a perfect option for these annoying veins.

Spider veins frequently occur in families where other members have had them. They almost always get worse or develop for the first time after pregnancy. They may be seen in association with varicose veins. Treatment of the underlying varicose veins, if present, is almost always necessary to prevent spider veins from returning once treated.

A number of lasers have recently been developed to treat spider veins on the legs. Although a common problem, these veins are extremely difficult to treat by laser, when compared to facial veins or other vascular conditions typically treated by laser. The newer lasers have longer pulses, higher energies, and cooling devices to protect the surface of the skin while the laser penetrates the skin to treat the veins.

Laser treatment of spider veins usually takes 2-3 treatments 6 or more weeks apart. The ideal patient has smaller veins and light skin. Tan or dark skin is more difficult to treat since the overlying pigment may take up the laser light, keeping it from the vein below and heating the surface layer. With continued improvement of vascular lasers and cooling devices, more people will be candidates for laser removal of those annoying spider veins.