It is a medical technique to treat the combination of telangiectasias and the associated causative reticular veins (“feeder veins”) of the leg. It employs the features: AR viewing of the feeder veins; application of transdermal laser energy to the feeder veins and overlying telangiectasias; injection of the feeder vein and surface telangiectasias with a Dextrose 75% -D75 (or other sclerosant agents at the physician discretion); and skin temperature protection and numbing of the skin with application of a flow of cold air throughout the procedure. A photograph is taken before and after the procedure in all patients. In CLaCS, the skin and the sclerosing agent are cooled by a cold air blower; skin cooling decreases pain both during laser and injection sclerotherapy. Low initial temperature also helps to protect the skin. The purpose of CLaCS technique is to achieve efficacy through the synergy between the transdermal laser, injection sclerotherapy, and skin cooling. The transdermal laser has the ability to perform selective photo-thermolysis (penetrate the skin, without damage, and injure the vein). The following is the detailed description of the CLaCS technique.

Proper photo documentation is crucial for medical documentation as well as results follow-up for the entire treatment. A photograph should be made with an at least semi-professional machine—digital single-lens reflex (DSLR) —with an external flash. The flash head should be rotated 180 degrees and directed to the ceiling, which should be white. This way, using the automatic mode of the camera, we can obtain high-resolution photos without the need for photographic experience or expensive medical photodocumentation software/hardware. Tethering photography with Lightroom (Adobe) can be used to provide before and after comparisons. Patients frequently forget how the lesion looked prior to treatment; showing the It is strongly recommended at least 20 pre-treatment photos; with the CLaCS technique, 40 pre-treatment photographs on average are taken, with and without AR. Only the pre and post photo documentation can provide objective evidence of the outcome. Neither the patient nor the doctor can appreciate the improvement without the use of photography. Figure 1 depicts an example of pre and post photos.
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