Laser Treatment for Small Facial & Leg Veins

What to expect

1. 01

   Doctor-led vein consultation

   Vessel size, colour, depth and pattern are assessed. Leg-vein patterns suggesting underlying venous reflux are identified — these require a different pathway (ultrasound and venous referral, not laser). Skin type and pigment risk are reviewed.

2. 02

   Treatment planning

   Suitability for long-pulsed 1064 nm Nd:YAG laser is confirmed, or referral for ultrasound assessment of suspected reflux. Where appropriate, combination treatment with polidocanol microfoam sclerotherapy is discussed — the evidence base supports better clearance with combined laser + sclerotherapy than with laser alone for selected leg veins.

3. 03

   Long-pulsed 1064 nm Nd:YAG laser delivery

   Long-pulsed 1064 nm Nd:YAG laser pulses are delivered to selected superficial vessels. Energy is absorbed by haemoglobin, heating the vessel wall to collapse the vessel and fade it gradually. Settings — fluence, pulse duration, spot size — are individualised for vessel size, depth, body location and skin tone.

4. 04

   Cooling and aftercare

   Cooling may be used for comfort. Compression may be advised after leg treatments. Strict sun protection (SPF 50+ daily) is recommended to reduce post-inflammatory pigmentation risk, particularly in medium-to-darker skin types.

5. 05

   Staged sessions and review

   Many facial vessels respond in 1–2 sessions; leg veins often require multiple sessions spaced several weeks apart. Review points allow combination treatment (sclerotherapy + laser) to be staged in where this would improve clearance.

Results timeline

• Immediately after treatment Mild redness, swelling or temporary darkening of the treated vessel; light bruising can occur (more common on legs). Most patients return to normal activities the same day.
• Days to 2 weeks Facial vessels begin to fade visibly. Leg vessels may darken or develop crusting that settles within 1–2 weeks. Sun protection is important through this window.
• 4–8 weeks Review point for staged plans. Facial vessels often clear substantially after 1–2 sessions; leg veins typically require additional sessions and combination with sclerotherapy may be added where appropriate.
• 3–6 months Cumulative clearance from a staged course becomes visible. Leg-vein response is generally slower than facial-vessel response.
• Long-term Treated vessels usually do not return, but new vessels can form over time due to genetics, hormonal change, ageing, sun exposure or progression of underlying venous disease. Daily SPF and venous-health management slow the rate at which new vessels develop.

Frequently asked questions

• What's the difference between this treatment and vascular spot laser? +

  This page covers larger superficial vessels — facial spider veins, leg telangiectasia and selected reticular veins up to about 3 mm, often treated in combination with sclerotherapy. The vascular spot laser page covers discrete vascular lesions — cherry angiomas, Campbell de Morgan spots, small haemangiomas and individual facial broken capillaries. Both use long-pulsed 1064 nm Nd:YAG, but the indication, planning and number of sessions differ. The right pathway is confirmed at consultation.
• Are all veins treatable with laser? +

  No. Laser works best on small superficial vessels — facial capillaries, small spider veins, and leg telangiectasia or reticular veins up to about 3 mm. Larger or reflux-fed veins typically need a different pathway, often involving ultrasound assessment and venous referral. A doctor-led assessment determines suitability before any treatment is offered.
• Can laser treat bulging varicose veins? +

  Usually no. Bulging rope-like varicose veins are typically related to deeper venous disease (great or short saphenous reflux) and require ultrasound assessment plus a different treatment pathway — most often endovenous ablation or surgical management, not surface laser. Treating the wrong vein with the wrong modality leads to poor clearance and early recurrence. If reflux is suspected at consultation, we recommend the appropriate referral pathway first.
• When is combination laser + sclerotherapy better than laser alone? +

  For selected leg-vein patterns, the evidence supports better clearance with combination treatment than with Nd:YAG alone. A large randomised controlled trial showed dramatically improved outcomes when 1064 nm Nd:YAG laser was performed after polidocanol microfoam injection, with three-year follow-up. A 2025 systematic review of 1,991 patients across 26 studies reached the same conclusion for many patterns. We discuss whether laser alone, sclerotherapy alone, or a combined approach is most appropriate for your specific vein pattern at consultation.
• Is laser vein treatment painful? +

  Most patients feel brief snapping or stinging sensations. Nd:YAG can be moderately uncomfortable, especially on the legs where vessel density and skin sensitivity are higher, but is usually well tolerated. Cooling may be used for comfort. No general anaesthetic is required; for sensitive patients or larger areas, topical numbing can be discussed at consultation.
• When will I see results and how many sessions will I need? +

  Facial vessels often fade visibly within weeks and many respond in 1–2 sessions. Leg veins improve more slowly and typically require multiple sessions spaced 4–8 weeks apart, sometimes combined with sclerotherapy. Reticular veins and matting are often the hardest to clear and may need a longer staged course. The treatment plan is individualised at consultation based on vessel pattern, size and location.
• Is laser vein treatment safe for darker skin types? +

  Long-pulsed 1064 nm Nd:YAG is the safest vascular wavelength for melanin-rich skin because it bypasses much of the epidermal melanin and targets deeper haemoglobin. Treatment is still individualised and conservative for Fitzpatrick IV–VI — longer pulse durations, lower fluences, and a test-spot approach. Patients in this group are often reviewed through our Skin of Colour Clinic pathway. Strict sun protection after treatment is particularly important to reduce post-inflammatory pigmentation risk.
• Can veins return after laser treatment? +

  Treated vessels usually do not return. However, new vessels can form over time due to genetics, hormonal change (pregnancy, oral contraception), ageing, sun exposure, or progression of underlying venous disease. This is the underlying tendency to form vessels — not a failure of the original treatment. Daily SPF, compression where appropriate, and management of venous health slow the rate at which new vessels develop.