Background: Spider leg veins are a common aesthetic problem in females. The standard treatment is sclerotherapy but lasers have been used for decades to solve this problem as well.
Aim: To review recent advances in laser physics and its tissue interactions with skin vessels. The different laser types used to treat spider leg veins are discussed, including their advantages, limitations and possible adverse effects.
Method: The international literature on laser therapy for spider leg veins has been reviewed with particular emphasis on the last decade. Results: Recent developments in laser technology allow a more selective and well-tolerated therapy.
Efficacy has also improved. Most studies report a greater than 75% improvement in spider leg veins as a realistic goal for laser therapy.
Clinic response depends upon wavelength, fluence, pulse width and pulse duration, cooling and the diameter and colour of spider leg veins. Conclusions: Sclerotherapy remains the gold standard treatment for spider leg veins.
Nevertheless, laser therapy has become increasingly efficacious and convenient. Laser selectivity has been improved by technological progress.
The ideal laser, however, has yet to be invented.