CLaCS (Cryo-Laser and Cryo-Sclerotherapy) is an innovative, non-surgical treatment for spider veins and small varicose veins, developed by Dr. Kasuo Miyake in São Paulo, Brazil. This technique combines transdermal laser therapy, sclerotherapy, cryotherapy, and augmented reality imaging to enhance treatment precision and patient comfort.

What is the ClaCS Method and How Does it Work?

The ClaCS method is based on the simultaneous application of several technologies to varicose veins. The name “Cryo-Laser and Cryo-Sclerotherapy” gives a clue about the method: A combination of cryotherapy (dermal cooling), laser and sclerotherapy. This combined approach consists of four steps and each step is planned to enhance the effect of the other:

Vein Mapping (Imaging): First, a special infrared vascular imaging device is used to map the capillary network under the skin. In this way, the deeper “feeder” veins that feed the visible varicose veins are detected. This step ensures that the treatment is aimed at the right target and reduces the risk of varicose veins recurring in the future.

Cryotherapy (Cold Application): During the procedure, a strong stream of cold air of about -20°C or a cooling device is applied to the skin. Cryotherapy has two important effects: first, it numbs the application area, almost completely eliminating the sensation of pain; second, it reduces the diameter of the vein by creating a contraction (spasm) in the vein wall. This narrowing increases the effectiveness of the laser and injection procedures and facilitates the treatment by slowing down the blood flow.

1. Laser Application (Transdermal Laser): Accompanied by cooling, a special Nd:YAG 1064 nm wavelength laser beam is applied to the varicose veins through the skin. The laser energy is delivered in low doses and this controlled application provides a partial shrinkage and closure of the targeted vein. While in capillary laser treatment alone, there may be a risk of side effects on the skin if high energy is delivered, in ClaCS, the risk of side effects is minimized thanks to the use of low-dose laser and simultaneous cooling. The laser step weakens the vessel wall and prepares the vessel for the next step, sclerotherapy.
2. Sclerotherapy (injection): In the last step, again under cryotherapy, a sclerosing agent is injected into the shrinking vessel with very fine needles. Unlike conventional methods, the drug used for sclerotherapy in the ClaCS method is a non-toxic high-density glucose (sugar water) solution. The use of 72-75% hypertonic dextrose solution instead of chemical agents such as polidocanol eliminates the risk of allergic reactions and tissue necrosis. This injected solution adheres to the inner surface of the vein, which has already been weakened by the laser, and ensures complete closure of the vein. The patient hardly feels these injections as the cryotherapy continues.

With the combined effect of these four steps, the targeted varicose vein is completely destroyed from the inside out and enters the process of being absorbed by the body and disappearing. The innovative aspect of the ClaCS method is that by applying these complementary procedures at once, it both increases the effectiveness and shortens the treatment time. For example, a capillary network that is too large to be successfully treated with laser or needle alone can be successfully destroyed thanks to the simultaneous applications of ClaCS. As a result, a larger area can be treated with fewer sessions for the patient.

For whom is it suitable and for whom is it not?

Who can the ClaCS method be applied to? It is especially ideal for patients with aesthetically disturbing capillary varicose veins (spider and reticular veins) on their legs and superficial vein dilatations not exceeding 3-4 mm in diameter. Patients with red, purple or green thin veins with a spider web appearance on the skin can achieve successful results with ClaCS. This method is preferred for individuals who have more cosmetic complaints that become apparent when they stand up but do not have large raised veins. It is suitable for both men and women; it gives satisfactory results especially in patients who are looking for aesthetic varicose vein treatment and who want a non-surgical solution.

ClaCS should be used in patients without advanced venous insufficiency (venous valve leakage). If the patient has severe leakage in the deep or superficial main veins (for example, in the great saphenous vein) and this condition causes large varicose veins, it is recommended to eliminate this problem with classical treatments (such as endovenous laser, radiofrequency, surgery). After the problem in the main veins is solved, ClaCS can be applied for the remaining capillary varices. Therefore, before ClaCS, a Doppler ultrasound is performed to evaluate whether there is a serious underlying varicose vein disease.

Who is ClaCS not recommended? ClaCS alone is not sufficient for patients with prominent and severe varicose veins larger than 4 mm in diameter. In such cases, traditional non-surgical varicose vein treatment methods (intravenous laser, foam sclerotherapy, treatment with adhesive, etc.) are more suitable; ClaCS can be used as a complement for small capillaries remaining after these treatments. In addition, varicose vein treatments are often postponed during pregnancy; therefore ClaCS is not recommended for pregnant patients. Breastfeeding mothers should also be treated with a doctor’s approval, and elective varicose vein treatments are usually postponed until the end of breastfeeding. In addition, patients with active skin infections or wounds in the treatment area may not undergo ClaCS until they heal. In our Istanbul varicose veins doctor clinic, each patient is evaluated in detail to determine whether they are suitable for ClaCS and the most accurate treatment plan is created individually.

Differences and Advantages of ClaCS from Other Varicose Veins Treatments

The ClaCS method has many important differences and advantages compared to traditional varicose vein treatments:

• A Non-Surgical and Painless Method: ClaCS does not require any surgical incision; the procedure is in the category of completely non-surgical varicose vein treatment. It is applied without even requiring local anesthesia, ensuring the comfort of the patients. Thanks to the strong cooling, pain and soreness are almost never felt during the procedure. Many patients are surprised at how comfortable the treatment is and state that they do not even notice the needle sticks.
• More Effective Result with Combined Technology: In cases where laser and sclerotherapy individually are limited, the combination strategy of ClaCS prevails. The laser weakens the vessel from the inside, the injection closes it completely, and cooling enhances the effectiveness of both procedures. Thanks to this synergy, even large capillaries that cannot be treated with a single method can be eliminated with ClaCS. Capillary varicose veins over a large area can be completely treated in fewer sessions, which means both time savings and cost advantages for the patient.
• Fewer Side Effects, Faster Recovery: Bruising and skin blemishes, which are common after conventional needle treatments (sclerotherapy), are minimal after ClaCS. The side effects of laser and sclerotherapy are minimized in this method; for example, permanent skin discoloration (hyperpigmentation) is almost never seen. The risk of tissue necrosis is eliminated because the sclerosing solution used is harmless to the body. The risk of clot (thrombus) formation is also much lower than with conventional methods. Patients do not experience any significant side effects other than mild redness in their legs after treatment and these minor effects disappear in a short time.
• No Compression Socks Required: Another comfortable aspect of ClaCS treatment is that there is no need to wear compression stockings after the procedure. After classical sclerotherapy, it may be necessary to wear compression stockings for weeks to help the veins close and prevent complications. However, after ClaCS, there is no need to apply external pressure on the veins; this provides great comfort to patients, especially in summer months.
• It can be applied in all seasons: In many varicose vein treatments, especially laser and needle treatments, summer months are considered inconvenient or may be uncomfortable for the patient. It is a great advantage that the ClaCS method can be safely applied in all seasons. Since the risk of skin staining after exposure to intense sunlight is minimal, aesthetic varicose vein treatment can be performed not only in winter but also in summer. Nevertheless, since laser application on very tanned skin can be risky, your doctor will recommend the most appropriate time according to the condition of the skin. In general, ClaCS allows patients to have their treatment whenever they want, without postponing it, as there are no seasonal restrictions in the planning.
• Immediate Return to Daily Life: The recovery time after the procedure is extremely short. The patient leaves our clinic on foot as soon as the treatment is over and can continue their daily activities on the same day. No leave or rest is required; there is no loss of labor force. In this respect, ClaCS provides great convenience to people with busy work or social lives.
• High Patient Satisfaction: The aesthetic results obtained with ClaCS are very pleasing. The majority of capillary varicose veins visibly disappear or fade in a single session. The full effect of the treatment occurs after a few weeks for the vein to be absorbed by the body and the legs have a smoother, healthier appearance. Most of the patients are pleased to get rid of their aesthetic concerns that they have been postponing for many years so easily.

In summary, the difference of the ClaCS method compared to other varicose vein treatment methods is that it provides maximum effect with minimum discomfort by cleverly combining multiple technologies. With its painlessness, fast healing process, few side effects and successful results, ClaCS is becoming one of the most preferred aesthetic varicose vein treatments by Istanbul varicose vein doctors and patients.

ClaCS Process: Before, During and After

Pre-Procedure: After the decision to undergo ClaCS treatment, a preliminary evaluation of the patient is performed. The specialist will examine the patient’s legs and, if necessary, check the condition of the deep veins with Doppler ultrasound. This evaluation is important for the detection of large-scale varicose veins, if any, and for their treatment first. Once the areas to be treated with ClaCS have been identified, the patient may be asked to discontinue any blood thinners (unless your doctor advises otherwise). No special preparation is required on the day of the procedure; the patient can eat normally and come in. It is just a good idea not to apply any cream, lotion or self-tanner to the legs before the treatment. Coming to the clinic in comfortable clothes also makes it easier after the procedure.

Application Moment: ClaCS treatment is usually performed in a clinical office setting, without hospitalization. The patient lies on an examination table or bed. The area to be treated is cleaned with antiseptic solutions. First, the varicose veins under the skin are mapped with the help of a device that emits special infrared light; during this process, the room lights can be reduced so that the superficial and deeper problematic veins can be reflected on the screen and seen by the doctor. The cryotherapy system, which blows cold air through the device, is then activated and keeps the target area cold throughout the treatment. Wearing goggles, the doctor starts to shoot the 1064 nm laser device through the skin to the target veins. The patient may feel a slight heat, but thanks to the strong cold, there is usually no pain. Immediately after the laser treatment is completed, a glucose solution is injected into the veins in the same area with very fine-tipped syringes. The needle insertions are so small that there is usually no bleeding or pain, and the procedure is extremely comfortable as the cooling continues. The entire area to be treated is scanned in this way. The procedure takes about 20-40 minutes, depending on the extent of the area to be treated; it can take up to 1 hour if large areas or both legs are treated. Since capillary varicose veins on most of one leg can be treated in a single session, repeat sessions are usually not necessary. However, in patients with very extensive capillaries, it is also possible to schedule the treatment in 2 or 3 sessions a few weeks apart. This depends entirely on the patient’s needs and the doctor’s recommendation.

After the Procedure: As soon as the ClaCS application is completed, the patient can stand up and walk normally. There may be mild redness in the treated area and a pale purplish color where the vein passes in the form of a very thin line; this is a temporary condition caused by the effect of the intravenous solution and usually disappears within a few days. There is no need to apply any bandage after the procedure. It is not recommended to wear compression stockings because they are not needed. If the patient wishes, he/she can return to work the same day or continue his/her daily routine. There is no obstacle to sports, but it may be useful to restrict excessively heavy exercises or activities such as sauna and hot bath for the first 24 hours. Although there is no specific prohibition on sunbathing, avoiding direct sunlight in the first weeks after treatment will help mild bruising to disappear more quickly. If it is summer and the legs are to be exposed, the use of sunscreen with a high protection factor may be recommended to protect the skin. The full effect of ClaCS treatment occurs within a few weeks; the body metabolizes and destroys the closed vessels. After about 4-6 weeks, the doctor will check the results and evaluate the results. If necessary, additional injections can be given as a touch-up or the remaining small vessels can be intervened. Most patients happily continue their daily lives after the procedure without any serious complaints.

Frequently Asked Questions

Is ClaCS treatment painful?
No, ClaCS is an almost completely painless treatment. Thanks to the intense cooling (cryotherapy) applied during the procedure, the heat of the laser and the insertion of the needle are not felt. The vast majority of patients report feeling only a slight pressure or coldness and no significant pain. Since the glucose solution used in ClaCS does not cause the burning sensation that can occur with traditional sclerotherapy, the comfort of the procedure is very high.

Is the ClaCS method safe? Are there any side effects?
ClaCS is an extremely safe method if the right patient is selected and if it is performed by a specialized physician. The sclerosing agent used is non-toxic and the risk of allergy is low. Since the laser energy is applied in low doses, the risk of burns or permanent damage to the skin is minimal. The most common side effect is temporary mild bruising or redness, which resolves in a short time. Serious complications such as tissue necrosis or deep vein thrombosis are almost never seen compared to conventional methods. ClaCS is a proven technique that has been successfully applied worldwide for nearly 20 years.

How long does the procedure take and is one session enough?
The duration of ClaCS treatment depends on the extent of the veins to be treated. Generally, one session is completed between 20-40 minutes. If more than one leg or very large areas of capillaries are to be treated, the session may be longer. In most cases, it is possible to achieve satisfactory results with a single session, because with ClaCS it is possible to treat a large area in the same session. However, in some patients, for example if there are dense capillaries in both the thigh and calf, your doctor may recommend splitting the treatment into 2 sessions. The sessions are usually scheduled a few weeks apart. After the first control, the remaining veins can be reviewed and an additional application can be made if necessary. In short, the number of sessions is determined according to the patient’s condition and in many patients, the non-surgical varicose vein treatment ClaCS is completed in one go.

Will there be any scars or stains on the legs after ClaCS?
No permanent scarring is expected after ClaCS. Since no surgical incision is made in the procedure, no scarring occurs. Although light brown skin spots may sometimes occur after laser applications, this risk is minimized in ClaCS. Since the needle insertions into the capillaries are very small, they do not leave a visible scar. In some patients, discoloration in the form of a slight brown streak at the site of the treated vein may be observed for a few weeks; this is a temporary stain caused by blood clotting in the vein and the body clears it over time. Extensive bruising is rarely seen after ClaCS.

Can I return to my normal life immediately after the procedure and what should I pay attention to?
Yes, you can return to your daily life immediately after the ClaCS treatment. No hospitalization is required at the end of the procedure; you can walk out and return to work. There are no special restrictions on the first day, except for preferring activities that do not require you to stand for a long time. Unless your doctor recommends otherwise, taking a short walk after the procedure will improve your circulation. Avoiding applications such as extremely hot showers, saunas or solarium for a day or two is useful for the rapid resolution of mild redness that may occur. It is also recommended not to expose the treated area to excessive sun exposure and to use sunscreen if necessary. Apart from these, care after ClaCS is quite easy. Most patients continue their daily lives without wearing compression stockings, without the need for painkillers and without rest breaks.

Take the First Step Toward Healthy and Beautiful Legs

Would you like to say goodbye to spider veins on your legs and confidently wear skirts or shorts again? With the innovative ClaCS method, this is now possible. Thanks to ClaCS — a cutting-edge aesthetic vein treatment — you can achieve smooth and healthy legs without surgery. At our clinic, our experienced team of vein specialists in Istanbul uses state-of-the-art technology to create a personalized treatment plan just for you. We are committed to providing a safe, science-backed, and comfortable treatment experience that earns the trust of our patients.

Don’t wait — take the first step and book your appointment today! During your consultation with our expert doctor, the most suitable treatment plan for you will be determined, and all your questions about ClaCS vein treatment will be thoroughly answered. Reclaim the healthy legs you’ve been postponing and boost your quality of life — call us now or fill out our online appointment form. Remember, early intervention in vein treatment not only improves your appearance but also prevents potential future complications. Free yourself from the burden of varicose veins with ClaCS — a safe, fast, and effective non-surgical solution. Take the first step today for healthier legs!