No existing through-the-skin lasers can offer consistent, satisfactory results in the treatment of spider veins on the legs. Only facial spider veins can be effectively treated with lasers. Over the past ten years, lasers have been used endogenously (from inside the vein) to treat large varicose veins with great success. This procedure is known as endovenous laser ablation treatment or Endolaser (EVLA, EVLT). For some spider veins, we do recommend the skin laser therapy combined with sclerotherapy to enhance the results of sclerotherapy.