Laser to Remove Small Spider Veins in Legs?

Thank you for the question! In my practice, I offer sclerotherapy, endovenous laser ablation, and Clariven treatment to treat the affected veins. It's not a matter of one treatment being better than the other. Rather, the choice of treatment will depend on a size and location of your veins.  
In recent years, endovenous laser ablation (EVLA) has replaced traditional surgical method of treating varicose veins. This procedure uses laser to heat the veins instead of surgically removing them. The heat produces a steam bubble inside the vein, which destroys the vein walls, causing the affected vein to collapse. The body, in turn, naturally absorbs the dead tissue. 
Sclerotherapy tends to be one of the most popular and widely-used treatments these days. It uses a sclerosing solution that causes the vein to shrink. Usually, sclerotherapy takes only 1 to 2 sessions to achieve fading of the undesirable veins.  
Clarivein is a minimally-invasive procedure that utilizes a thin infusion catheter clinically proven to deliver faster results and guarantee up to 74% less pain than most other peripheral vascular treatments. 
An in-person exam with a board-certified plastic surgeon would be the best way to assess your needs and obtain expert medical advice. Best of luck! 

Unsuccessful cosmetic laser vein treatments require a thorough evaluation by a vein specialist.This is a very important thing to do as lack of success means that there are sources of venous insufficiency that may not have been treated during sclerotherapy such as "feeder veins" or truncal reflux at the saphenofemoral or saphenopopliteal junctions or segments of superficial veins (segmental reflux).Evaluation of the perforator veins in the thighs and legs is also warranted. See a physician certified by the American Board of Venous and Lymphatic Medicine. 

Most commonly, spider vein treatments, whether they be injection sclerotherapy or laser, usually require several cycles of treatments (2-3) 4-6 weeks apart and the veins tend to look worse before looking better.  If you have been through this process and your veins are worse then there are several options-increase the concentration or change the injecting solution, try a different laser, obtain a 2nd vein opinion or obtain a full venous evaluation with a venous reflux exam by a vein specialist.  It could be that there is an underlying reason (valvular reflux) for your veins failing to respond to standard therapy.

Greetings~

It's difficult to say exactly what to do with the vessels you have remaining or the new ones that may have come after treatment without seeing them first. Leg vein treatments, regardless of type, require multiple treatments and can definitely go through phases of uglier before they are prettier. If you are unhappy with your treatment thus far, perhaps try a different office or practitioner...they are not all created alike.

Don't give up.

Good luck~

Dr. Grant Stevens    

Unsightly leg veins can be treated with precise bursts of laser light, minimizing damage to the skin. The light energy is absorbed by the vein, clogging it, after which it is absorbed back into the body, disappearing from the surface of the skin. You can eliminate spider veins and varicose veins with VersaPulse® Laser. Immediately after treatment, the vein will actually appear darker, but shortly thereafter the vein will fade. Laser treatment of leg veins usually requires several visits.