
A continuación se revisarán las indicaciones y particularidades del láser para venas en piernas, desde el tipo de láser más eficaz al tipo de venas
En primer lugar… arañas vasculares, telangiectasias, varices… ¿son lo mismo?
Existe mucha confusión para la nomenclatura de este tipo de pequeñas venas dilatadas de las piernas. En función del tamaño hablaremos de:
- Venas telangiectásicas o arañas vasculares: <1 mm, color rojizo, en forma de red o estrellada (araña)
- Venulectasias: 1-2 mm, más violáceas.
- Venas reticulares: 2-4 mm: azuladas.
- Varicosidades (varices): >4mm, azul intenso-verdosas.
The History of Legal Sports Wagering in Canada Explored by Betlama
Canada’s relationship with sports wagering has undergone a remarkable transformation over the past several decades, moving from a tightly restricted, government-controlled framework to one of the most liberalized betting markets in the Western Hemisphere. The shift did not happen overnight. It was the product of sustained legal debates, constitutional tensions between federal and provincial authorities, and growing pressure from both consumers and commercial operators who recognized that billions of dollars in annual wagers were flowing to offshore and illegal bookmakers rather than into regulated domestic channels. Understanding how Canada arrived at its current position requires tracing a legislative history that stretches back more than half a century.
The Criminal Code Framework and the Era of Parlay-Only Betting
The foundation of Canadian gambling law is the Criminal Code of Canada, which has governed wagering activities at the federal level since Confederation. For most of the twentieth century, the Code treated nearly all forms of betting as criminal activity, with narrow exceptions carved out for pari-mutuel wagering on horse racing, which was permitted under federal supervision as far back as the late nineteenth century. The landmark legislative moment came in 1969, when the federal government amended the Criminal Code to allow provinces and territories to conduct and manage lottery schemes, including certain forms of sports wagering. This amendment, often described as the birth of regulated gambling in Canada, gave provinces the authority to establish their own gaming commissions and operate betting products within defined parameters.
However, the 1969 framework came with a significant constraint that would shape Canadian sports betting for the next five decades. Section 207(4)(b) of the Criminal Code explicitly prohibited single-event sports wagering, meaning that bettors could only place wagers on the combined outcomes of two or more events simultaneously — a format known colloquially as a parlay. The rationale at the time centered on concerns about match-fixing and the vulnerability of single-game outcomes to manipulation. Provincial lottery corporations, including the Ontario Lottery and Gaming Corporation (OLG) and British Columbia Lottery Corporation (BCLC), launched products like Pro-Line and Sports Action under this parlay requirement. These products attracted some participation, but the odds structures were notoriously unfavorable compared to what offshore sportsbooks offered, and the parlay requirement made recreational wagering considerably less appealing to casual bettors.
The consequence was predictable. Estimates from various industry analysts in the years leading up to legislative reform suggested that Canadians were wagering somewhere between fourteen and twenty billion dollars annually through offshore and gray-market platforms, none of which contributed tax revenue to provincial governments or operated under Canadian consumer protection standards. The parlay-only regime had effectively driven the market underground rather than containing it.
The Push for Single-Event Legalization and Bill C-218
Efforts to amend the Criminal Code and permit single-event wagering began gaining serious legislative momentum in the early 2010s. Multiple private member’s bills were introduced in the House of Commons, including Bill C-290 in 2011, which passed the House with broad cross-party support but died in the Senate without receiving a vote. The failure of C-290 was widely attributed to lobbying pressure from professional sports leagues, particularly Major League Baseball and the National Football League, which at the time opposed expanded sports betting legislation on the grounds that it threatened the integrity of their games. This position mirrored the stance those leagues were taking in the United States during the same period, where the Professional and Amateur Sports Protection Act of 1992 was still in force.
The turning point came in 2018, when the United States Supreme Court struck down PASPA in Murphy v. National Collegiate Athletic Association, opening the door for American states to legalize single-event sports betting. Within a relatively short period, dozens of US states moved to regulate the activity, creating a functioning commercial market directly adjacent to Canada’s border. The optics of American states generating hundreds of millions in tax revenue from legal sportsbooks while Canadian consumers continued to use offshore platforms became politically untenable for Canadian legislators.
Bill C-218, the Safe and Regulated Sports Betting Act, was introduced in November 2020 by Conservative MP Kevin Waugh. The bill proposed a simple but consequential amendment: removing the prohibition on single-event sports wagering from Section 207(4)(b) of the Criminal Code, thereby allowing provinces to offer single-game betting products through their existing lottery and gaming frameworks. The bill passed third reading in the House of Commons in June 2021 and received Royal Assent on June 22, 2021. The amendment came into force on August 27, 2021, and within days, provincial operators began launching single-event products. Ontario’s OLG launched its PROLINE+ platform almost immediately, followed by similar rollouts from BCLC and other provincial bodies.
Ontario’s Open Market Model and Its National Significance
While Bill C-218 gave provinces the legal authority to permit single-event betting, it did not require them to open their markets to private commercial operators. Most provinces chose to maintain a government-monopoly model, routing all legal wagering through provincial lottery corporations. Ontario took a fundamentally different approach. In April 2022, Ontario launched an open, competitive, and privately operated online gambling and sports betting market regulated by iGaming Ontario, a subsidiary of the Alcohol and Gaming Commission of Ontario (AGCO). This made Ontario the first jurisdiction in Canada to allow licensed private sportsbooks to operate legally and accept wagers from residents.
The scale of the Ontario market quickly demonstrated the commercial viability of the model. In the first full fiscal year of operation, iGaming Ontario reported that registered operators collectively handled over thirty billion dollars in total wagers, generating more than one billion dollars in gaming revenue and contributing hundreds of millions in tax revenue to the provincial government. The number of active player accounts exceeded one million. These figures drew attention from operators, regulators, and policymakers across Canada and internationally. Platforms operating in the Ontario market, including both large multinational brands and regional operators, had to meet strict technical standards, responsible gambling requirements, and advertising restrictions set by the AGCO. For context on how the licensed market functions and what operators are required to demonstrate, resources like Betlama provide comparative information on regulated sportsbook offerings available to Canadian bettors navigating the legal landscape.
Other provinces watched Ontario’s experiment with considerable interest, though none had moved to replicate the open-market model as of the mid-2020s. British Columbia, Alberta, and Quebec continued to operate through their respective provincial corporations, though all had updated their platforms to offer single-event wagering following C-218. There were ongoing discussions in Alberta in particular about the possibility of introducing private operator licensing, given the province’s historically market-oriented approach to economic regulation.
Responsible Gambling Obligations and the Evolving Regulatory Environment
The expansion of legal sports wagering in Canada has not occurred without scrutiny. Alongside the commercial growth of the market, regulators, public health researchers, and advocacy organizations have focused increasing attention on problem gambling rates, advertising practices, and the accessibility of wagering to vulnerable populations. The AGCO introduced amendments to its Standards for Internet Gaming in 2023 that placed new restrictions on operator advertising, including prohibitions on the use of athletes and celebrities who have particular appeal to minors, and requirements that promotional messaging include responsible gambling information in a prominent and legible format.
The volume and nature of sports betting advertising became a specific flashpoint in the public debate. During the 2022 and 2023 professional sports seasons, Canadian broadcasters carried a substantial increase in wagering-related advertisements, prompting complaints from health advocates and several municipal governments. The federal government signaled interest in potential amendments to broadcasting regulations that would impose additional constraints on how and when gambling advertisements could appear on Canadian television and digital platforms, though no federal legislation had been enacted on this specific question as of early 2025.
Provincial self-exclusion programs, which allow individuals to voluntarily ban themselves from gambling platforms, were updated to extend coverage to online operators in Ontario’s iGaming framework. The GameSense program, administered through BCLC and adopted in various forms by other provincial operators, continued to provide resources for bettors seeking information about managing their gambling behavior. Researchers at several Canadian universities began publishing longitudinal studies examining whether the transition from parlay-only to single-event wagering, combined with the growth of mobile betting platforms, had measurable effects on problem gambling prevalence in the population.
Canada’s legal sports wagering landscape in the mid-2020s represents the outcome of a decades-long negotiation between federal criminal law, provincial jurisdiction over gaming, commercial market forces, and public health considerations. The transition from a parlay-only, government-monopoly system to a framework that includes open private operator markets in at least one major province marks a structural shift that few would have predicted when the Criminal Code amendments of 1969 first gave provinces authority over lottery schemes. Whether the Ontario model spreads to other provinces, and how regulators continue to balance revenue generation against harm minimization, will define the next chapter of this ongoing legal and social evolution.
¿Por qué aparecen estas dilataciones venosas en piernas?
En realidad todo este tipo de venas no son más que las manifestaciones de la enfermedad de insuficiencia venosa de los miembros inferiores, que afecta en mayor o menor medida al 80% de la población.
Existen una serie de factores de riesgo que condicionan mayor incidencia:
- Predisposición genética por antecedentes familiares
- Sexo femenino
- Edad avanzada
- Aumento de presión intra-abdominal (ej. obesidad).
- Embarazo
- Neoplasias
- Bipedestación prolongada
Todo esto condiciona una incompetencia de las válvulas venosas que impiden que la sangre retorne hacia abajo en su progreso hacia el corazón. Por lo tanto, cuando estas válvulas fallan la sangre se acumula y ocasiona las dilataciones.
Cuando la enfermedad por insuficiencia venosa es avanzada no sólo tendremos venas dilatadas sino que podemos llegar a tener síntomas: pesadez, dolor, picor… En casos extremos se puede ver afectación cutánea con pigmentación, eczema (dermatitis de estasis), tromboflebitis superficial, lipodermatoesclerosis (engrosamiento de la piel) o incluso ulceraciones con el consiguiente riesgo de infección.
¿Cómo se realiza el diagnóstico?
El diagnóstico es principalmente clínico, en primer lugar observando el calibre de las venas dilatadas, la presencia de alteraciones cutáneas e interrogando al paciente sobre los síntomas referidos.
Existen además una serie de casos en los que deben hacerse pruebas de imagen tales como la ecografía doppler, para detectar posibles alteraciones importantes en el sistema venoso safenofemoral:
- Venas reticulares o varicosidades >2-4mm o muy prolongadas.
- Presencia de venas en “estallido de estrellas” en zonas clave como alrededor de la rodilla, zona gemelar o zona del tobillo.
- Síntomas relevantes de insudiciencia venosa.
- Alteraciones cutáneas relevantes
- Historia personal o familiar de trombosis venosa profunda/tromboflebitis
En todos estos casos el pacientes será referido a la consulta de Angiología y Cirugía Vascular para correcta valoración.
¿Cuándo podemos tratar las venas o arañas vasculares de piernas con láser?
El láser es una excelente opción de tratamiento para venas de calibre fino, principalmente aquellas de <4 mm. Otra de las alternativas para esas arañas vasculares o venas reticulares sería la escleroterapia: introducción de sustancias dentro de las propias venas dilatadas para conseguir su cierre.
Las ventajas del láser para venas en piernas, sobre alternativas con la escleroterapia en venas finas son las siguientes:
- Puede tratar vasos más finos (<1mm) que son difíciles de abordar con aguja.
- Buena opción para pacientes con fobia a las agujas o malas experiencias previas.
- Menor incidencia de complicaciones como pigmentación, inflamación, etc.
- Alternativa en pacientes con alergia a las sustancias esclerosantes.
¿Qué láser se emplea para el tratamiento de las venas de piernas?
Existen distintos tipos de láser vascular. En el caso de las arañas vasculares de piernas tenemos que utilizar un láser que consiga suficiente energía a suficiente profundidad como para calentar la venita que estemos tratando hasta coagularla por completo o hacerla desaparecer. En función del calibre podemos emplear los siguientes láseres.
- Arañas vasculares muy finas <1mm: en este caso nos sirve casi cualquier tipo de láser vascular como el láser KTP, láser de colorante pulsado o láser de Neodimio:YAG. Además también se puede emplear luz pulsada.
- Venas más gruesas de 1-4mm: para venas algo más gruesas la mejor opción será el láser de Neodimio:YAG ya que penetrará más (hasta 2,5-3mm) consiguiendo buena fluencia a mayor profundidad y llegado por tanto a las venas reticulares.
Por lo tanto, el láser para venas en piernas más versátil será el láser de Neodimio:YAG, si bien otras alternativas de láser vascular se pueden utilizar en venas muy finas.
¿Cómo se realiza el tratamiento?
Debemos tener en cuenta una serie de consideraciones pre-tratamiento, durante el tratamiento y post-tratamiento.
- Pre-tratamiento:
Hay que evitar estar bronceados, ya que la melanina de la piel puede confundir al láser para calentar correctamente el vaso a tratar. Además conviene evitar fármacos que alteren la coagulación como los anti-inflamatorios (ej. ibuprofeno, aspirina)…
- Durante el tratamiento:
El tratamiento con láser no suele ser muy doloroso. Es normal emplear un método de enfriamiento como aire frío o pieza fría de contacto, para proteger las capas más superficiales de la piel. En general se tratarán todas las venas susceptibles una, a una, sin solapar los disparos.
- Post-tratamiento:
Conviene evitar la exposición solar, mantener cierto reposo en los primeros días, con piernas elevadas si es posible e, incluso, llevar medias de compresión (sobre todo cuando se ha combinado la escleroterapia con láser). Las venas tratadas habrán desaparecido por completo o bien quedarán con una coloración oscura grisácea para ir resolviéndose con el paso de las semanas. Es habitual requerir más de una sesión para conseguir los mejores resultados.
REFERENCIAS:
- Meesters, A.A., Pitassi, L.H.U., Campos, V. et al.Transcutaneous laser treatment of leg veins. Lasers Med Sci 29, 481–492 (2014). https://doi.org/10.1007/s10103-013-1483-2
- Raetz J, Wilson M, Collins K. Varicose Veins: Diagnosis and Treatment. Am Fam Physician. 2019;99(11):682–688.
- Asiran Serdar Z, Fisek Izci N. The evaluation of long-pulsed Nd:YAG laser efficacy and side effects in the treatment of cutaneous vessels on the face and legs [published online ahead of print, 2019 Nov 15]. J Cosmet Dermatol. 2019;10.1111/jocd.13208. doi:10.1111/jocd.13208
- Ianosi G, Ianosi S, Calbureanu-Popescu MX, Tutunaru C, Calina D, Neagoe D. Comparative study in leg telangiectasias treatment with Nd:YAG laser and sclerotherapy. Exp Ther Med. 2019;17(2):1106–1112. doi:10.3892/etm.2018.6985
