Laser treatment of surface varicose veins and spider leg veins in the past (including other treatments such as Intense Pulsed Light or IPL) were either totally ineffective, or at best, partially effective.
The problem was getting enough energy into the whole area of the vein. The posterior wall needs to receive enough energy to be damaged to achieve closure.
With the advent of infra-red treatments, in particular the Xeo Cool Glide laser by Cutera (also as it was known in its earliest form - the Excel laser), effective treatment became a reality.
There are a number of other infra-red lasers out in the market that have been touted for leg vein treatment. But a wide range of power settings needs to be available to seal the problem veins.
It is possible at lower energies to seal the spider veins associated with the blue reticular or larger varicose veins. But without sealing the larger vessels, either rapid recurrence occurs or sometimes a worsening of the appearance.
The Xeo Cool Glide NdYAG laser (with a 1064nm wavelength) has an adjustable beam with a wide range of energies and pulse widths which makes it extremely versatile for treating a wide range of vessel sizes and flows.
The excellent water-cooled gold-plated copper foot enables the treatment to be comfortable and to preserve the colour of the skin.
Usually two or three sessions are required. There is a limit to the size of the vessel that can be treated. Usually those beyond about 3mm diameter are too large to be effectively closed.
We will use this treatment in varicose veins and spider veins arising from the lateral vein system that are within the recommended treatment size.
Treatments are normally spaced six or more weeks apart. This allows time for the healing reactions within the vessels to settle down. If repeated too soon the treatment can be more uncomfortable.
It is recommended a compression stocking is worn for a few days after the treatment, more for comfort. But it also improves the sealing of the vessel.
Although there is no needle going through the skin as in sclerotherapy, which concerns some people, there is discomfort associated with the treatment. The cooling tip minimizes this. But there is still a hot pin-prick type of sensation with each shot. Adjusting the cooling times makes this quite comfortable.
At the treatment the veins can be seen to disappear as the internally-generated heat cases the vein to spasm. There may be some back-tracking of blood into the vessel for a while afterwards. As the longer-term swelling reaction occurs with the healing response the blood will be expelled again.
In the smaller vessels, especially the spider veins, a short-lasting swelling, very like a mosquito bit in appearance can occur and last for a short time after the treatment.
At times a little retained blood can be seen in the treated vessels. Frequently the body will deal with this over a number of weeks.
There can be a pink colouration occur along the treated vessel line for a few weeks after the treatment as the healing response occurs.
Laser treatment of surface veins is possible with the right laser and ensuring the right sized vessels are treated and that any associated feeding vessels that are compromised are also treated before.