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Can laser treatments cause burns to the skin?

How common is it for the patient to have burns on their skin after laser treatment to treat varicose veins? It seems like there is a lot of heat involved in these procedures, how can I make sure that I do not receive major burns in the process?

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Doctors Answers (7)

If you are having laser treatments for superficial spider veins you can be burned if the equipment is not set properly. The best treatment for these veins is sclerotherapy. Laser treatment is best used to close off deeper veins. This treatment is called endovenous laser therapy.

Ultrasound mapping shows whether your saphenous vein is deep enough to avoid skin burns. Tumescent anesthesia is placed between the skin and the vein to be treated in order to numb the vein and protect the skin. As long as there is at least 2-3 mm of space to place the anesthetic, thermal ablation is safe when performed by an experienced practitioner.

It's uncommon to rare for the patient to have burns on their skin after laser treatment to treat varicose veins. If a burn occurs it is very minor, like a bad sunburn to a dime sized area. Your concern is realistic, I would simply share it with your doctor to ask him to use extra care, but I would not be overly concerned because it is very unlikely.

Laser treatments can cause burning to the skin if the vein that is being treated is too superficial. It is recommended to treat only veins that lie within the sheath also known as fascia (layer of tissue below the skin). If the vein is less than 1-2 cm deep the risk of a burn injury increases.

Burns are possible with treatments using lasers or radiofrequency (RF) devices in many different procedures but should be very rare. In nearly a decade of treating varicose veins in our practice, we have not seen a single incidence of a burn. The reason that burns are very unlikely is that the laser energy (wattage) is low but is still very effective since all of the laser energy is delivered directly into the center of the vein as a small pin-point of heat. This method is designed to treat the inner lining of the vein without significantly elevating the external temperature of the vein. As part of the procedure, a tumescent fluid of mostly saline and low dose lidocaine is placed around the vein as an anesthetic. This also helps to compress the vein and to provide some additional cooling. The temperature immediately outside of the varicose vein on treatment with the laser should not increased sufficiently to harm any surrounding tissue. An ultrasound is used to monitor the procedure and the placement of the tumescent fluid around the vein. During the procedure, the laser is turned-on and the fiber optic catheter delivers energy to the fiber tip as it is slowly pulled back to treat the length of the vein (about 5-10 minutes). There are a few injections along the length of the vein before the laser treatment, and the actual laser portion is painless.

I certainly appreciate your concerns. While laser does treat with high temperatures, the vein is surrounded by a "sleeve" of cool local anesthesia which acts as a buffer zone. In experienced hands, this is a simple process done in the office. The vein is typically deep enough away from the skin and the surgeon will also inject additional local (small amount anesthetic in a lot of fluid called tumescent) between the vein and the skin. If you seek out a vascular trained surgeon who specializes in laser ablation procedures, who has performed many of these cases, it is a very safe procedure with few problems.

If performed correctly there will be no burns.

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