Laser treatment of leg and facial telangiectasia

Background: Recent investigations have shown that lasers with longer pulse durations are more effective in the treatment of telangiectasia. Objective: We report on use of a 532-nm pulse diode laser and a dynamic cooling device in the treatment of both facial and lower-extremity telangiectasia. Methods: Treatments were performed by means of a 4-W, 532-nm pulse diode laser with pulse durations of 40 ms or 100 ms in a series of 77 patients with facial and/or lower-extremity telangiectasia measuring less than 1 mm in diameter. The dynamic cooling tip was used to protect the epidermis when fluences of 100 ms were applied. Patients who underwent treatment of lower-extremity telangiectasia were required to wear venous compression stockings for the first 5 days after treatment. A clearance rating scale was used to define the degree of clearance. Results: After 1 treatment, a clearance rate of greater than 90% of facial telangiectasia was demonstrated in 98% of patients. Among patients with lower-extremity telangiectasia, a clearance rate of greater than 50% was obtained after a single session in 38 treatments. Patient satisfaction was high, and minimal untoward sequelae were encountered. Conclusions: The 532-nm pulse diode laser has been primarily used for treatment of facial telangiectasia; however, it is also effective in treating lower-extremity telangiectasia involving vessels less than 1 mm in diameter. The use of a dynamic cooling device enables the application of fluences higher than those previously used.