What is the normal amount of time for reabsorption of superficial spider veins after laser treatment? 3 weeks post op.

Question

I had laser treatment for very small, superficial spider veins on my thighs and the inside of my left knee. It's been 3 weeks and they have not been reabsorbed yet. They also look worse, darker, but no redness around them. They are not infected. Is this normal? I am not overweight and I did not lift any heavy weight or run (I do hike and dance) after the procedure 3 weeks ago. I was told I didn't need to wear compression stockings, so I did not. Thank you.

Tif Siragusa, MD · Answer

I agree with Dr. Landi in that you have to be a little bit more patient. Sometimes these things can take even up to three months to disappear. One question I have is when you push on the veins, do they disappear and then come back when you release the pressure? If you do the veins are still open and those will not go anywhere. If you push on the vein and it stays dark then that means the vein was adequately treated and your body is absorbing it. I’d give it a few more weeks and any veins that still blanche when you push on them I would probably request sclerotherapy to treat those.

Raffy Karamanoukian, MD, FACS · Answer

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.

Best,
Dr. Karamanoukian
Realself100 surgeon

Best,
Dr. Karamanoukian
Realself100 surgeon

Ramandeep Sidhu, MD · Answer

Thank you for the question. So sometimes you need more than one treatment with laser to get rid of the spider veins and if they are big then laser doesn't work that effectively. Now if they blanch then they are still open and if they don't then they are probably thrombosed and just need more time to fade away.

John Landi, MD · Answer

It may take up to 6 weeks for spider veins to reabsorb following topical laser treatment.  If they do not resolve by 6 weeks then they most likely will not dissolve.  Sometimes more than one treatment is required.  My feeling is that is the veins are larger enough to be treated by sclerotherapy then this is the procedure of choice over topical laser.

Albert Malvehy, MD · Answer

The reason to use laser on the legs is that the veins are so small, the doctor cannot get a needle in to them to treat with sclerotherapy. The reason we don't use this as a first option is because it can require multiple treatments, which may be the case for you. Make sure you follow up with your provider.

Gary Nackman, MD, FACS · Answer

No need for you to worry from your description.  It can take much longer for the veins to resolve. Sometimes 2-3 months. IF any of the veins are large with trapped blood, you doctor might want to release the blood from the veins. It takes time for your body to resorb the blood and damaged veins.

Brian Heeringa, MD, FACS · Answer

I prefer sclerotherapy to topical lasers for spider veins.  What you are reporting sounds normal.  I typically tell patients to expect up to 6 weeks before they get maximum benefit and that the veins will often look worse initially after treatment before they begin to fade.  I personally find patients get better results when compression stockings are used after spider vein treatments, particularly in the legs where the venous pressure is higher.  I will also wait 6 weeks before treating the same area a second time.  
One way to tell if the treatment was effective or not at this stage is to press on the surrounding skin and if the veins blanch then the treatment was likely not effective.  Conversely, if the veins don't blanch with pressure then they will likely resorb with additional time.

Lisa Jenks, MD · Answer

I tell my patients that it can take up to six weeks for the veins to reabsorb, so you are still within the normal time frame.  I also make sure that everyone knows some veins are stubborn and may need to be treated with the laser a second or even third time.  However, I always wait at least six weeks in between treatments.

What is the normal amount of time for reabsorption of superficial spider veins after laser treatment? 3 weeks post op.

Answers (8)

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