This transillumination method allows the true course of the vein to be seen and marked, as the vein is dark against a light background. Using local anesthesia, the anesthetic is gently placed alongside and under the vein to be removed. The anesthetic is a very dilute concentration so that the entire length of the vein can be treated. Next, a series of small needle punctures is made through which portions of the varicose veins are gently pulled using a special instrument called the ambulatory phlebectomy hook. The vein is usually removed in one treatment.
Risks are less than for traditional vein surgery and the post-operative course is much less painful.
Although they can appear anywhere on the body, spider veins typically occur on the legs and face. Until recently, lasers were used primarily for facial veins, which are small, superficial and red. The legs have been difficult to treat with lasers because the skin is thicker and the blood vessels comprising the spider veins are deeper than those elsewhere on the body. With most lasers, penetrating through a tan is a risky procedure since the tan absorbs most of the laser energy and can burn the skin. But the newest lasers use wavelengths just beyond visible light to penetrate the skin without heating the pigment, thereby reducing the risk of burning or injury to the skin.