Currently, the flashlamp-pumped pulsed dye laser is the treatment of choice in vascular lesions. Laser treatment is also indicated in the case of ulceration. Ulceration of hemangiomas can be quite painful and can impair functional abilities. When treated with laser, ulcers will often heal more quickly. Typically many treatments are required to achieve the desired effect.
Laser only helps with the superficial component of the hemangioma.
Surgical intervention in the treatment of varicosities and venous malformations is controversial. One might consider surgery for either significant cosmetic deformity or the symptoms of pain, heaviness of the leg, bleeding or infectious complications. Venous stripping, ligation, excision or sclerotherapy are contraindicated unless the surgery involves the superficial system and the underlying deep system is normal or demonstrates only mild to moderate reflux. Inadequate evaluation prior to excision increases surgical complications. Symptomatic superficial varicosities can be removed without harm and with benefit to the patient when an adequate pre-operative examination is performed.