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Vascular laser treatments
Lasers used in vascular treatments
Port wine stain laser removal
Telangiectases laser removal
Spider angioma laser removal
Cherry angioma laser removal
Pyogenic granuloma laser treatment
Venous lake laser treatment
Hemangioma laser removal
Vascular malformation laser removal
Varicose vein laser treatment
Pigmented skin lesion laser removal
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Actinic keratoses laser treatment
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  Spider angioma laser removal

Spider angiomas are acquired vascular lesions. They are named after their manifestation and have a spider-like formation and look to them. Since they have a bearing on one’s appearance there is a large demand for the cosmetic laser correction of this visually scarring condition.

These types of angiomas are different from congenital vascular lesions and malformations. Apart from the spider and cherry angiomas, acquired vascular lesions include telangiectases, pyogenic, granuloma, venous lake and leg vein abnormalities. These vasculatures are marked by varying extent of blood vessel ectasia.

Selective photothermolysis is the fundamental practice in the treatment of these acquired lesions, which includes cherry and spider angiomas as well. This methodology first originated in the 1980s and since then various types of lasers and light sources have been effectively administered in the treatment of vascular lesions like spider angiomas. Some of the most common treatment methods include:

  • Wavelengths between green and yellow
  • Near infrared lasers
  • Broadband light sources

Though these have certain drawbacks, they form the standard treatment procedures for vascular lesions. However, the treatment of acquired vascular lesions is mostly optional, congenital forms must be detected and treated early. Spider angioma and cherry or strawberry angiomas are commonly acquired lesions and respond well to laser corrections.

The clinical characteristics of spider angioma

The spider-like formation in this type of angioma is caused by a focal arteriole that superficially branches out like in the tentacles of a spider. The main arteriole is an abnormal segment of the superficial vascular plexus that is directly linked with enlarged superficial tubular appendages. The tubular diameter is around 0.1–0.5 mm.

The spread of the lesion is generally in singular forms and occur in the face, neck, chest, and other areas of the body that are tanned by the sun. Multiple formations occur in liver diseases or HHT.

Treatment of spider angioma

The laser treatment of spider angioma is a two-pronged process that involves:

  1. Closure of the main supplying arteriole
  2. Successive correction of the superficial offshoots that branch out from the focal arteriole

The depth of the vasculature that is to be corrected is roughly 300 microns. The method used is diascopy that plugs the supply to focal arteriole. After the diascopy, one or two single laser pulses are administered to the spot, combined with a top up to the superficial branches. This makes these branches ready for laser application. Each and every branch should be laser treated to prevent relapse.

The standard PDL devices are ideal for the central arteriole, since the resultant scarring is limited to a restricted area. Pulsed-dye laser treatment also shows effective results but with the following settings:

  • Fluences between 8 and 10 J/cm2
  • Spot size of 5- or 7-mm
  • Dynamic cooling device (DCD) settings of 30–40/20–30

The first laser application may be followed up by another session in some cases. Whether more laser sessions are required should be adjudged after 4–6 weeks of the first laser treatment.


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