Treatment Options

Laser ablation

The Greater Saphenous Vein in the thigh is the vein that ‘feeds’ the varicose veins. Closing this vessel is required to treat abnormal veins further down the leg. Imagine a fire hose as it appears plumped up with water, and then, with the water off, the hose becomes flat. By closing the Saphenous Vein, we’re ‘turning off the water’ to the veins downstream, emptying and flattening them.

The procedure is relatively painless and takes about an hour. A small laser fiber is inserted into the Greater Saphenous Vein and threaded to its origin. Activation of the laser heats the lining of the vein, damaging it and causing it to close. Normal activities can be resumed immediately with the exception of heavy lifting or running (may resume in 72 hours)



VenaCure EVLT ProcedureAfter closing the saphenous vein, there are occasions when abnormal veins persist and further treatment is required. This may include one or more of the following:

1. Microphlebectomy

This is a minor surgical procedure, done under local anesthetic in the office. Tiny incisions are made along the course of the abnormal vein and it is removed. The incisions are so small they do not require sutures and generally heal with very little to no scarring.


Smaller veins (and some larger ones) are treated with the injection of a chemical directly into the problem vein. There are two chemicals which have been approved by the FDA for this type of therapy, polydocinol and sodium tetradecyl sulfate. These chemicals cause localized damage to the vein wall, causing it to collapse and scar closed. This is the treatment most commonly used for spider veins. Multiple treatments may be required depending on the size of the veins and the area being addressed.

3. Compression stockings

Compression stockings are an important part of any vein treatment. Although they will not cause varicose or spider veins to disappear, they can help prevent formation of further abnormal veins and can relieve symptoms of CVI, especially swelling. They are a valuable tool following any treatment for varicose or spider veins in that they encourage healing and vein closure by helping to keep pressures in the remaining open veins normal. We will have compression stockings available for purchase, or you are welcome to acquire them from a vendor of your choice.

Laser Treatment for Spider Veins

The Cutera Excel V is a dual wavelength (532 nm and 1064 nm) laser system that is used for the treatment of benign vascular, cutaneous and pigmented lesions, including telangiectasia & spider veins, as well as deeper skin conditions like hemangiomas and leg veins. Port wine stains & cherry angiomas can also be significantly reduced through this laser treatment. The procedure may even be an effective way to minimize the symptoms of painful chronic conditions such as rosacea and poikiloderma.

Many skin conditions manifest in the form of broken or abnormal blood vessels in the skin. The Excel V laser works by administering a unique high power green laser that is absorbed by the abnormal blood vessels in the skin. The laser heats the abnormal vessels causing the vein walls to collapse and seal shut. Over time, the vessels will no longer be visible.

For benign pigmented lesion treatments, the laser light is absorbed by melanin, the brown pigment in the skin. Pigmented cells are denatured, darken, rise to the surface, and flake off over a couple of weeks.

How Long Does It Take to Look Better?

The treated areas may look worse at first. Veins may look darker in color with some bruising for several days following treatment. Small amounts of blood may become trapped in the veins as they close down and leave dark spots or lines for a few weeks. Laser treatment often makes spider veins look like red lines that are scratch-like in appearance. Pigmented lesions will be expected to darken before they lighten. It may take a few weeks to see the full effect of a given treatment session. Sometimes one treatment session will be enough, but most patients will need two to five treatment sessions and some patients will need more. It is not usually possible to eliminate 100% of spider veins no matter how many treatments are performed. A 70 to 90% overall improvement is typical.

After an initial consultation, our Physician and/or Physician Assistant will determine if treatment with the Excel V laser is appropriate.