Clearing large and small spider leg veins by laser may now be more effective and comfortable for the patient. "It looks like laser may turn out to be an equally good alternative to sclerotherapy, which hasn't been the case until now," said Arielle Kauvar, M.D., associate director of the Laser and Skin Surgery Center of New York and assistant professor of dermatology at New York University. The improvements are attributed to lasers equipped with a skin cooling device that provides a millisecond spray of low-temperature cryogen just before each laser pulse. With that quick freeze of the skin surface, higher laser energies can now be administered deeper than before, and surrounding tissue is not at rishk of damage. Being able to go deeper with a laser at a higher temperature means larger diameter veins can be cleare more completely. The goal is to deliver high energies resulting in complete healing of the vessels without exposing the surface of the skin to those high temperatures. Because the alexandirte laser has a longer wavelength and can penetrate deeper, a much wider range o vessel sizes can be treated. including some of the blue spider viens and some smaller, feeder veins. Following the treatment with the alexandrite laser, the veins are totally destroyed. These veins should not reappear. That isn't to say new veins will not develop in that area or other areas' but it would not be a reappearance of the same veins.