Which is the better treatment for spider veins: Sclerotherapy or laser treatments?
Intense pulsed light (IPL) therapy is used by medical practitioners to treat various skin conditions. Although sclerotherapy is generally considered the gold standard in the treatment of leg spider veins and reticular veins, IPL may be used in some cases. The treatment is not strong enough to remove larger varicose veins. Both spider veins and reticular veins can create unsightly red and purple discolorations to appear on the surface of the skin. Other popular procedures that use IPL therapy include hair removal, treatment of sun-damaged discoloration, removal of facial veins, and rosacea treatment.
Spider and reticular veins of the legs are veins that have blood pooling, which causes the veins to enlarge and become more visible. This pooling can be triggered by genetic factors, pregnancy, injuries, prolonged standing, and/or aging. Spider veins and reticular veins appear as red, blue or purple lines on the skin surface. Once spider or reticular veins develop, they will not go away without treatment. However, since these types of veins do not generally constitute a serious clinical health risk, insurance companies consider treatment to be a cosmetic procedure and thus rarely cover its costs.
Intense pulsed light therapy involves delivering pulses of light to the target areas. IPL emits a band of light, while a laser utilizes a single wavelength of light. Because IPL is a band of light it may be useful in targeting spider veins of different depths and sizes. When treating spider veins, the light is used to heat the blood inside the vein, causing injury to the vein wall. The goal is to cause a heat-induced injury to the vein wall such that the vein shrinks and slowly dissolves over a period of a few weeks.
Intense pulsed light therapy is most effective for patients with light-colored skin who are not tan. Small veins tend to respond better than larger veins. IPL may be of most use to treat matting, tiny red spider veins that can occur following sclerotherapy. It also can be used to treat post-sclerotherapy pigmentation. The intense pulsed light procedure takes approximately 15 to 30 minutes. There can be discomfort during treatment. It is important that cooling techniques be used while the pulses of light are delivered in order to maximize comfort and safety of the procedure. Patients should always wear goggles during treatment with intense pulsed light therapy in order to avoid eye injury.
Multiple sessions of IPL are usually necessary for the best results, but patients need not take time off work or cease daily activities during treatment. It is suggested, however, that IPL patients avoid excessive sun exposure that will lead to sunburn or a tan during the treatment phase. Utilize DoctorQA’s database to find a vein expert near you if you are considering intense pulsed light therapy.
Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology