Before Treatment: Sun Protection is mandatory.  We cannot treat recently sun-exposed or tanned skin.  When your melanocytes (pigment producing cells) have been recently "turned on" by sun exposure, there is risk of a suboptimal result.  Your face will be cleansed beforehand and photos will be taken.  No numbing is necessary.

During Treatment: Safety goggles will cover your eyes, and gel will usually be spread onto the skin. You will feel a cold piece of glass on the skin.  The laser pulses feel like a warm rubber band snap.  The cold glass helps to minimize discomfort. No topical numbing is necessary.

Immediately After Treatment:  Your skin may feel warm, and you may be more red and puffy than usual with some raised wheals of skin (small welts).  Visible blood vessels will usually be gone or greatly diminished.  It's rare to get bruising or blisters, but they can occur with larger vessels.    

Days following treatment:  Puffiness can get worse during the first 24-48 hours after treatment, and then it usually starts to fade.  Puffiness can be minimized by: holding ice packs or cool compresses on the treated areas (for no more than 10 minutes at a time), taking Tylenol (Acetaminophen), and taking Bendaryl (diphenhydramine) or another anti-histamine.

Months following treatment:  Usually 2-3 treatments spaced 6 weeks apart will achieve the optimum result.  The most dramatic result and swelling occurs with the first treatment because there is more "target" for the laser to treat.  Some patients are happy with 1 treatment.  To maintain the result, since blood vessels can grow back, usually touch up treatments are necessary every year or two.  Anything that causes flushing or continued sun exposure will make blood vessels grow back more quickly.  For the legs, compression stockings worn as much as possible will help keep spider veins from growing back.