Long-pulsed Nd : YAG laser: does it give clinical benefit on the treatment of resistant telangiectasia?

Updates and Best Practices in the Management of Facial Erythema

Facial erythema is a common dermatologic complaint. There are many medical and procedure-based treatments to help reduce the appearance of unwanted facial redness. The authors review a variety of treatment options and techniques to reduce facial erythema and prominent facial veins including topical medical therapies, a variety of lasers, light- and energy-based devices as well as the use of neuromodulators and sclerotherapy. The benefits and potential pitfalls of each procedure modality are also highlighted.

The evaluation of long-pulsed Nd:YAG laser efficacy and side effects in the treatment of cutaneous vessels on the face and legs

BACKGROUND

Long-pulsed Nd:YAG lasers have been used for the treatment of cutaneous vascular lesions on face and leg veins.

OBJECTIVE

To report our experience with long-pulsed Nd:YAG lasers for the treatment cutaneous vessels on the face and legs.

MATERIALS AND METHODS

A total of 145 patients with cutaneous vessels on the face and the legs were included in this study. All patients received two treatment sessions, first at the beginning and second after four weeks. Patients were evaluated three times: first at the beginning of the therapy, and second and third after the four weekly follow-ups. The laser settings of each treatment session were recorded. The physician's assessment of treatment efficiency was taken by comparing gross photograph and clinical evaluation. The grade of improvement, as the percent of reduction in the severity of veins after laser treatment, was determined as follows: <25% improvement (mild); 25%-50% improvement (moderate); 51%-75% improvement (good); and >75% improvement (excellent). The side effects were also recorded.

RESULTS

Of the 145 patients who completed the study, 63.6% of patients had vessels on the face, and 36.4% had them on the legs. After the first session, 82.8% of patients have good improvement (51%-75%). After the second session, 78.6% of patients have excellent improvement (>75%). The clinical improvement after the second treatment session was significantly higher than the first treatment session (P ˂ .05). There were no statistical differences between the treatment areas (P ˃ .05). The most common side effect was erythema in 12.4% (P ˃ .05).

CONCLUSION

The Nd:YAG laser is an effective and safe treatment option for the treatment of cutaneous vessels on the face and the legs.

Comparison of efficacy between long-pulsed Nd:YAG laser and pulsed dye laser to treat rosacea-associated nasal telangiectasia

BACKGROUND

Rosacea is characterized by erythema on face, especially erythema and linear telangiectasia on the nose. Currently, various vascular lasers are used for treatment, and among them, are long-pulsed Nd:YAG(LPNY) and pulsed dye laser (PDL).

OBJECTIVES

This study compared the efficacy of LPNY and PDL in treating rosacea-associated nasal telangiectasia.

METHODS

Patients with rosacea who showed erythema and telangiectasia on the nose were included. Each patient was treated with PDL on the left side of the nasal bridge, and LPNY on the right side, three times with 4-week intervals. At the end of the treatment, two independent dermatologists evaluated overall treatment response compared with baseline.

RESULTS

The physician's assessment of treatment concluded that good improvement was seen in six PDL and seven LPNY patients, and excellent improvement five PDL and four LPNY patients. There was no significant difference (p = 0.62, 95%CI) between the groups. Overall improvement was similar; however, LPNY induced a greater response in thick, dilated vessels, while erythema with mild telangiectasia was more responsive to PDL.

CONCLUSION

Both LPNY and PDL are effective in treating rosacea-associated nasal telangiectasia. If LPNY is used properly to avoid side effects with careful consideration, it can also be used as a good modality.

One-year follow-up of a TRASER clinical trial for the treatment of nasal telangiectasias

OBJECTIVES

To evaluate the long-term efficacy of treating nasal telangiectasias with the TRASER device.

METHODS

Subjects from the TRASER efficacy analysis clinical trial were invited for a 1-year follow-up. Standardized photographs were taken to compare to baseline. The same clinical trial evaluator graded the subjects' current vessel clearance using the 5-point telangiectasia scale. The data was compiled and analyzed.

RESULTS

Of the subjects with available follow-up data, 44% maintained "complete vessel clearance," 44% dropped down one grade to "almost complete vessel clearance," and 11% dropped down to "moderately clear vessel clearance." All showed clinically significant improvement in nasal telangiectasias from baseline.

CONCLUSIONS

The TRASER effectively treats nasal telangiectasias with minimal to mild recurrence at 1-year follow-up. Lasers Surg. Med. 50:61-63, 2018. © 2017 Wiley Periodicals, Inc.

Successful treatment of facial telangiectasias using a micropulse 1,064-nm neodymium-doped yttrium aluminum garnet laser

OBJECTIVES

To evaluate the safety and efficacy of a microsecond 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of facial telangiectasias.

METHODS

Subjects ages 35-70 with Fitzpatrick skin types I to III and facial telangiectasias underwent two treatments with a micropulse (0.65 ms) 1,064-nm Nd:YAG laser. Treatments were spaced 30 days apart, with a final evaluation 60 days after the second treatment. Evaluation included digital photography and an assessment of the degree of improvement on a scale from 1 to 5 by the subject and a nontreating investigator.

RESULTS

Twenty subjects (18 women, two men) with Fitzpatrick skin type II and III completed the study. The nontreating investigator rated the objective clinical response as total clearance (100% clear) in 10% (n = 2) of subjects, significant clearance (≥50% clear) in 75% (n = 15), and some clearance (0-49% clear) in 15% (n = 3). None of the subjects was rated as having no clearance or worsening. In terms of subjective clearance reported by subjects, 80% (n = 16) reported significant clearance, with the remainder reporting some clearance. No adverse events were reported.

CONCLUSION

The micropulse 1,064-nm Nd:YAG successfully treated facial telangiectasias with a high degree of patient satisfaction, minimal discomfort, and no adverse events.