Periorbital rejuvenation: reticular vein treatment

Treatment of periorbital veins with vascular laser: A systematic review and retrospective case series

INTRODUCTION

Vascular lasers may represent a promising treatment option for periorbital veins. This article aims to: (1) systematically review the literature on the safety and effectiveness of vascular laser treatment for periorbital veins and (2) assess safety and effectiveness through a retrospective case series.

METHODS

Systematic review: Articles that assessed the safety and effectiveness of vascular laser treatment for periorbital veins were included and quality assessed using the Downs and Black checklist.

CASE SERIES

Patient records were retrospectively reviewed from January 2020 to November 2023 to identify all patients who underwent laser treatment for periorbital veins. Outcomes assessment included percentage improvement, patient overall satisfaction and adverse effects.

RESULTS

Systematic review: Three articles were included, discussing treatment of blue, periorbital veins using a 1064 nm Nd:YAG laser. Patient Fitzpatrick skin Types I-IV were treated with high patient satisfaction rates and complete clearance of treated veins. Adverse effects included pain, erythema, mild oedema, urticaria and blister formation. Quality of included studies ranged from 7 to 14 out of 21 points.

CASE SERIES

Thirty-four patients with skin Types I-V were included. Blue and red periorbital veins were treated using 1064 and 532 nm wavelengths respectively. Mean percentage improvement was 4.8 (complete resolution) and patients' overall satisfaction was ranked 3 (completely satisfied). Adverse effects included erythema, oedema, and bruising.

CONCLUSION

Treatment of red and blue periorbital veins using 532 and 1064 nm vascular lasers appears a safe treatment option. The procedure has a short recovery time, with patients able to resume normal activities within 1 day of treatment.

Treatment of periocular and temporal reticular veins with 1064-nm Nd:YAG Laser

BACKGROUND

The periocular and temporal regions are important aspects of beauty. The presence of reticular veins in these areas is undesirable and can also interfere with injection of neurotoxins to treat squint lines. 1064-nm Nd:YAG laser shows promise as an effective treatment modality with long-lasting effects.

AIM

The aim of the study is to show that the long-pulsed, contact-cooled, variable spot-sized 1064-nm Nd:YAG laser is effective and safe, with good patient satisfaction and tolerability, and is able to achieve long-term results.

METHODS

A retrospective study of 35 consecutive patients seen over a 3-year period in a private cosmetic clinic affiliated to the University of Toronto for periocular and temporal reticular veins was conducted. They were all treated with 1064-nm Nd:YAG laser.

RESULTS

A total of 35 patients with an average age of 45.8 years old received treatment. 13 had lower eyelids treated, 9 had temples treated, 12 had both lower eyelids and temples treated, and 1 had both upper and lower eyelids treated. The first case of upper eyelid vein being treated with the 1064-nm Nd:YAG laser with great success after only 1 treatment is reported. 80% of the patients required only 1-2 treatment sessions. The average satisfaction score was 7.9 out of 10. The average pain score was 5.0 out of 10. 91% perceived the treatment outcome as excellent or good with the longest result lasting 33 months. There were 4 complications: 1 scabbing, 1 small burn, 1 skin darkening, and 1 teary eye.

CONCLUSION

The study showed that the use of the long-pulsed, contact-cooled, variable spot-sized 1064-nm Nd:YAG laser is effective and safe, with good patient satisfaction and tolerability, and is able to achieve long-term results.

Successful Treatment of Reticular Blue Veins of the Lower Eyelid by Long-Pulse Nd: YAG - Case Report with 8-Year Follow-Up

BACKGROUND:

Facial reticular blue veins are of esthetic concern. Most often these veins develop on the lower lids. The safest and most effective way of treatment is by vascular lasers.

CASE REPORT:

We report on a successful reticular vein treatment using a long-pulsed 1064 nm Nd: YAG laser. We present a follow-up of 8 years with constant esthetic improvement without unwanted adverse events.

CONCLUSION:

There was no relapse demonstrating the efficacy of Nd: YAG laser.

Discomfort during Periorbital and Lateral Temporal Laser Vein Treatment: A Double-blind Randomized Controlled Trial

BACKGROUND

Treatments for cosmetically unpleasing periocular and lateral temporal veins are limited. The purpose of this study was to test the hypothesis that the application of topical lidocaine before the cosmetic treatment of periorbital and lateral temporal veins with a neodymium-doped yttrium aluminum garnet (ND:YAG) laser will result in a significant reduction in subjective pain compared with placebo as assessed using a visual analogue scale.

METHODS

Twenty patients who required bilateral treatment of facial veins were randomly assigned to receive either placebo or 30% lidocaine gel applied topically over the veins, a split-body design. Both the investigator and the patient were blinded to the treatment. An ND:YAG laser was used to treat the veins. Patients completed a visual analogue scale to assess the pain on each side of the face. Data were analyzed using nonparametric data testing.

RESULTS

There was a 64.0% reduction in pain on the treatment side compared with the placebo side (P < 0.001). There was no significant difference in patient-assessed subjective efficacy between sides (P = 0.2). Complications were minimal and mild.

CONCLUSIONS

Patients undergoing periorbital and temporal vein ablation using ND:YAG laser should be offered topical lidocaine as the pain levels are moderate. The use of topical 30% lidocaine results in a significant reduction in pain levels.