Lasers and Leg Veins

I am frequently asked by patients about the use of Laser for the treatment of leg veins, so I want to briefly explain how our vein clinic utilizes Laser in the treatment of venous disease and hopefully provide some clarity on this important topic. 

There are two distinctively different uses of Laser in the treatment of diseased Leg Veins:

• Inside the vein – this is used to treat large varicose veins.
• Outside the vein – this is used to treat small surface veins.

At The Leg Vein Doctor, we use only the “inside the vein” method of Laser treatment.  Medically this is referred to as Endovenous Laser Therapy (ELA, ELVA, ELVT) and it is specifically used for the ablation of the larger primary varicose veins.  A tiny fibre-optic thread is passed up inside the vein and as it is slowly withdrawn the Laser energy burns the inside wall of the vein.  Extensive research over the last decade now supports EVLT as the preferred method of treatment for primary Saphenous vein incompetence as it is more than 99% reliable and not plagued by the high recurrence rates seen with surgical “stripping” of varicose veins.  

The treatment of small surface veins, known as spider veins or Telangiectasia is optimally performed by the use of Sclerotherapy.  This is often done under either direct vision or magnification. Sclerotherapy is regarded as the “Gold Standard” for the treatment of surface veins on the leg.

But there are no absolute rules and so surface Lasers sometimes do have an important role in the treatment of certain types of surface vein disease, particularly on the face.  Surface Laser is also the preferred method of treatment for some types of vascular malformations. Certain complications of Sclerotherapy such as matting and post sclerotic pigmentation often respond better to surface laser.
As a general rule however, treatment of surface veins on the leg respond far better to Sclerotherapy than to surface Laser. It is important to understand what type of laser your practioner will be using for your treatment prior to starting.