Although spider veins don’t pose any health issues, you may want to remove them for cosmetic reasons. Sclerotherapy is the most popular treatment for spider veins, but laser therapy is another effective way to remove them.

Spider veins, or telangiectasias, are visible, tiny blood vessels mostly found in your legs.

Laser treatment for spider veins involves targeting the vein directly with a beam of light, which causes blood clots to form that block off and destroy the veins. Laser therapy is the second most popular option to treat spider veins.

In some cases, a combination of laser treatment and sclerotherapy may be best to remove veins completely. Here’s what to know.

There are a few types of laser treatment for spider veins:

  • Surface laser therapy: This type is often used to break down larger varicose veins, but it can also be used to treat spider veins. With this approach, your skin will be heated and cooled simultaneously to prevent burning.
  • Endovenous laser therapy (EVLT): EVLT is a newer approach that involves inserting a laser probe straight into the affected blood vessel. The intense heat breaks down the vessel internally. Since it’s more invasive, this method requires local anesthetic.
  • Intense pulsed light (IPL) therapy: While IPL isn’t technically considered laser therapy, its use of intense light makes it very similar to laser therapy. It works by targeting direct light to the vessels outside the skin.

There are also several types of lasers used to treat spider veins, including:

  • Argon lasers: These were one of the first used to treat spider and varicose veins, but they carry a higher risk of causing scarring and discoloration than other laser types.
  • Pulsed dye lasers: This type of laser is particularly useful for treating smaller spider veins. Due to their shorter pulses and integrated cooling device, they carry a lower risk of unintended burning, heat damage, and scarring.
  • Pulsed diode lasers: Like pulsed dye lasers, these have an integrated cooling device, making them less likely to cause burns or scarring. They also cause minimal inflammation compared with other types and are less likely to cause hyperpigmentation on darker skin.
  • Neodymium YAG (Nd:YAG) lasers: This type is particularly effective for spider veins but tends to cause more pain and discomfort than other lasers. Like pulsed diode lasers, Nd:YAG lasers are less likely to cause hyperpigmentation on darker skin.
  • Potassium-titanyl-phosphate lasers: This type has a limited penetration range, so it’s typically used on smaller areas, such as the face.

Before getting laser therapy, talk with a dermatologist about which type will be most effective for your needs. In some cases, they may recommend combining laser therapy with sclerotherapy or another vein removal method.

Once you have a plan in place, they’ll walk through your health history, lifestyle habits, allergies, and any medications and supplements you may be taking. Be sure to mention if you have a history of bleeding disorders or if you take any blood thinners.

If you’re getting EVLT with anesthetic, you might be asked to avoid eating or drinking for at least 8 hours before the procedure. You also may need to plan to have someone drive you home.

Depending on the procedure, you may be given a light sedative beforehand.

After laser treatment, you can typically resume your normal day-to-day activities almost immediately.

To soothe any pain or discomfort and aid in your recovery, your clinician may recommend:

  • using a cool compress to reduce swelling
  • keeping incision sites (if undergoing EVLT) out of water for at least 48 hours
  • avoiding sitting or lying down for long periods of time
  • keeping your legs elevated when sitting or lying down
  • not standing for long periods without moving
  • walking regularly several times a day
  • avoiding hot baths for a couple weeks
  • taking over-the-counter (OTC) pain medication as needed
  • stopping taking blood thinning medication until your doctor says you can resume it
  • heading to follow-up appointments as needed

If you had laser treatment for spider veins on your legs, you may also be instructed to:

  • wear compression stockings for a few days or weeks
  • avoid sitting or lying down for long periods
  • keep your legs elevated when sitting or lying down
  • not stand for long periods without moving
  • walk at regular intervals throughout the day

Depending on what type of laser treatment you get and the size of your veins, results may appear right away.

EVLT results may take longer, though. The veins may die off and disintegrate within several months to a year. But EVLT typically requires fewer sessions than other methods (in many cases, a single treatment is effective).

Laser treatment is most effective for smaller, delicate spider veins, such as those on your face.

Larger spider veins, such as those on your legs, may be difficult to remove with lasers alone. That’s because to eliminate the veins altogether, the “feeder vein” or origin vein must be eliminated, which can be trickier to target in the lower extremities.

But even for small veins on the face, you’ll likely need multiple laser treatment sessions to remove them completely (unless you get EVLT).

While the results of laser therapy are permanent, new spider veins may appear in the area.

Laser treatment vs. sclerotherapy

While laser treatment for spider veins continues to improve, sclerotherapy is still the gold-standard treatment for spider veins because it:

  • typically costs less
  • causes less pain
  • tends to produce better results more quickly

Still, laser therapy may still be ideal for those who:

  • want to avoid needles
  • are allergic to sclerosant
  • have capillary matting, which resembles bruising around the veins
  • have veins that are too small to be injected via sclerotherapy

Again, depending on the severity of your spider veins, a combination of both laser treatment and sclerotherapy may be most effective.

In general, lasers are a safe and effective way to treat spider veins. Aside from EVLT, laser treatment is noninvasive and requires minimal recovery time.

But like any procedure, laser therapy involves a risk of side effects, including:

  • blistering
  • crusting
  • swelling
  • spotting
  • infection
  • pain
  • bleeding
  • nerve damage
  • blood clots
  • changes in skin color
  • burns

Working with a qualified dermatologist who has experience working with your skin type can help to minimize your risk of side effects.

Is it painful?

Laser treatment is somewhat painful. Keep in mind that topical anesthetic is only minimally effective at reducing pain from laser treatment. If you’re concerned about pain, talk with a dermatologist about any additional pain-relieving steps you can take beforehand.

Will I need multiple treatments?

Many people experience significant improvements with one laser treatment. But to fully remove spider veins, you may need up to five or six sessions. The larger the spider vein, the more treatments you’ll likely need.

How long do results last?

Results are technically permanent as long as the “feeder vein” or origin vein is removed. This doesn’t prevent new spider veins from appearing in the future.

How much does it cost?

According to The American Society of Plastic Surgeons, one session of laser treatment in the United States costs about $300, though specific costs can vary widely by location.

Laser treatment is an effective method to treat and remove spider veins. It’s second only to sclerotherapy in terms of popularity and effectiveness. After the veins are targeted via laser light, they’ll break down and disintegrate over the course of several weeks.