For varicose veins on the leg, patients are known to undergo treatments like a combination of sclerotherapy, ambulatory phlebectomy, and intravascular laser or radiofrequency closure.

Lasers are known to be very functional in taking care of treating vessels of less than one to two millimeter in diameter which is resistant to sclerotherapy and telangiectatic matting, which can happen in cases of post sclerotherapy. What is seen is that sclerotherapy is the one basic standard of treatment for leg veins and telangiectasias.

For leg veins, it was not until the development of pulsed dye lasers in the decade of the 1980s that good results were obtained. Work on longer wavelength, longer pulse duration pulsed lasers, and light sources has had a very positive effect on this line of treatment.

What is laser therapy?

The basic requirements for a laser source for reducing leg veins are a wavelength which in a way is better absorbed by the hemoglobin than the surrounding chromophores and its full penetration into the entire blood vessel to be treated. It is necessary to pass on the quantum of enough energy to damage the vessel without any kind of harshness to the skin over it. Also, t his must be administered over an exposure time long enough to coagulate the vessel and its lining without causing any harm to the tissue outside of it.

The decision regarding the wavelength and pulse duration for its administering is connected with the variety of the muscle and the dimensions of the target vessel. It is a fact that vessels which have more depth need longer wavelengths for adequate penetration into them. Also, the pulse duration needs to correspond with the size of the vessel diameter. The more is the dimension, the longer the time for which the beam needs to be tuned in.

Types of laser therapy

Endovenous laser treatments deals in the treatment of varicose veins with an optical fiber. In this, the optical fiber is placed within the vein and laser beam is tuned into this. Due to this, the vein contracts and the optical fiber is slowly and carefully taken out of the vein. One can experience thrombophlebitis, pain, edema and even infection with this.

EVLT is the same as ELT, but this is a trademark name which is owned by Diomed. In this, the 810 nm laser is the basic laser fiber wavelength. With time and new developments, other fibers with differing wavelengths have come into the picture. During this process, a catheter with a laser fiber is placed into the great saphenous vein or the small saphenous vein via a small opening. This treatment takes about an hour or two and is done usually without using any method of sedation.

Foam sclerotherapy or ambulatory phlebectomy is sometimes done at the time of the procedure or within the one to two weeks for treatment of branch varicose veins.

For details, contact: Center for Cosmetic Dermatology. Phone: 717-741-5512.