As explained in part one of this article, varicose and spider veins in the legs are more often than not symptomatic of an underlying venous condition such as chronic venous insufficiency (CVI). Therefore, patients afflicted with spider and/or varicose veins need to get them checked out by a specialist professional, particularly if they are accompanied by pain, swelling or changes in the color and consistency of the skin. In addition, the bulging, twisted appearance of varicose veins and the prominence of some spider veins are cosmetically unpleasant, which can affect self-confidence and quality of life.
Laser therapy is a common solution for the removal of unwanted veins, with topical laser treatment suitable for spider veins and endovenous laser treatment commonly used to treat serious, deeper varicose veins. The first article detailed the laser procedure itself while this second part examines its efficacy and safety.
The Efficacy and Safety of Laser Treatment
No vascular intervention for the treatment of varicose veins is risk-free or guaranteed to be totally effective, but endovenous laser treatment, if deemed suitable by the vein specialist, is often the favored remedial option. In terms of efficacy, a 2009 meta-study from the Journal of Vascular Surgery concluded that 94 out of 100 laser procedures were successful, meaning that the target vein was permanently closed by the procedure.
Where initial treatment is unsuccessful, the patient may be required to return for a second procedure. Sclerotherapy, whereby a FDA approved, liquid chemical is injected into the vein, may also be advised, depending on a number of factors.
In cosmetic terms, the patient should not expect the treated vein to disappear immediately and completely. Rather, as their body gradually absorbs the tissue of the closed vein, the vessel will become gradually less prominent with initial results becoming apparent weeks following the treatment.
Since the 1980s, when pulsed dye lasers (PDLs) were first developed, simple laser therapy has been proven reasonably effective in eliminating small (1-2mm diameter) spider veins. As laser technology has evolved, increased pulse duration and wavelength has led to even more success as the required energy is delivered to the site where it can be absorbed more efficiently by the vessel wall, and not the surrounding tissues to cause damage. However, since spider veins are often caused by elevated pressure from the deeper varicose and reticular veins, it is crucial that these are treated first. Otherwise, new spider veins will soon appear either at the site or close by.
Are There Any Side Effects From Laser Therapy?
EVLA has been in use for over 20 years now and, over this time, has been proven to be both a safe and effective means to ablating unsightly varicose veins. Serous complications are very rare but there is a very small risk of developing Deep Vein Thrombosis (DVT), a potentially dangerous blood clot. However, a DVT is more likely to occur during surgical stripping, which also requires general anesthetic and an overnight stay in hospital; and after excessive injection of a sclerotherapy agent by an inexperienced Phlebologist or other health provider.
More common potential side effects of EVLA include pigment changes, which we address effectively by removing the trapped blood; inflammation of the venous wall (thrombophlebitis), which is often asymptomatic and short-lived; numbness, caused by temporary nerve irritation, and a sensation of ‘tightness’ along the length of one or more veins, often caused by trapped blood.
Some patients report some mild pain or a tingling or a burning sensation a few days after the procedure, although these are often adequately managed by over-the-counter analgesics and anti-inflammatory medication, they are often short-lived and minimal.
Although no safety concerns have been raised to date about the laser devices used in EVLA or simple laser therapy, patients should be aware that new technology is introduced all the time and some laser-emitting devices have not been around for long enough to assess any long-term side effects. However, the endovascular laser machines effective range of reach is but a few millimeters, which is unlikely to pose any long-term effects.
The Spring of Youth Medical Group offers laser treatment for the treatment of both spider veins and varicose veins. Please speak to our vascular specialist about our range of cosmetic therapies. You can visit www.springofyouthmedical.com or call us on (228) 875-0885.