Manuel Carbonell: Combining Sclerotherapy and Laser Technology in Modern Vein Treatment
Manuel Carbonell, Director at the Center of Phlebology, shared a post on LinkedIn:
“Sclerotherapy remains the first-line treatment for spider veins in most international guidelines and consensus documents. However, every phlebologist has encountered those particularly resistant telangiectasias: fine residual vessels that persist despite technically successful sclerotherapy.
In these cases, an interesting complementary strategy is what could be described as laser after sclerotherapy — the use of transdermal laser as an adjunctive tool for treating residual or refractory spider veins following sclerotherapy.
In my experience, one device that offers several practical advantages for this approach is the Blue Laser by ORLIGHT.
Beyond its portability and ease of use in daily practice, it also represents a relatively affordable option for physicians compared with larger and more complex laser platforms.
According to publicly available manufacturer information, the device has also received FDA clearance for specific dermatologic and vascular indications.
More importantly, the real challenge is not the device itself, but proper patient selection, understanding the underlying venous pathophysiology, and integrating different treatment modalities in a rational and evidence-based way.
Perhaps the future of aesthetic venous treatment will not depend on defending a single technique, but on learning how to combine sclerotherapy, laser technology, and hemodynamic management into increasingly personalized strategies.”

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