Pulsed‐Dye Laser Treatment of Leg Telangiectasia: With and Without Simultaneous Sclerotherapy

Abstract

Thirty consecutive female patients with red leg telangiectasia less than 0.2 mm in diameter were treated with a Candela SPTL-1 Pulsed Dye Laser (PDL) tuned to 585 nm with a pulse duration of 450 microseconds at energies ranging from 6.0 to 8.5 J/cm2 delivered through a 5-mm spot size to the entire length of the telangiectasia. Seven patients with 25 patches of telangiectatic matting after previous sclerotherapy were also treated. Twenty-seven patients with symmetrical telangiectatic patches or a large "starburst" telangiectatic flair that could be divided into two separate treatment sites were treated at one site with PDL alone, and at the other site with a combination of PDL followed immediately by sclerotherapy (SCL) with Polidocanol 0.1-0.25 ml per injection site at a concentration of either 0.25%, 0.5%, or 0.75%. PDL treatment is efficacious for both essential telangiectasia and vessels that arise through the phenomena of telangiectatic matting. Sixty-five percent of vessels are completely faded with treatment. PDL alone has a remarkably low incidence of adverse sequelae. Treatment is most efficacious if all vessels larger than 0.2 mm in diameter, especially varicose and reticular feeding veins, are treated first. Treatment results are not affected by vessel location. And post-treatment compression of this type of vessel appears unnecessary. Combination PDL/SCL treatment appears to offer no advantage to sclerotherapy treatment alone and has a significant degree of complications when treatment is limited to red telangiectasia less than 0.2 mm in diameter with the laser parameters utilized.

Treatment of leg telangiectasia using a long-pulse dye laser at 595 nm

“…However, attempts at using the PDL to treat leg telangiectasia have until now been notably unsuccessful except for the smallest vessels, those measuring 0.2 mm in diameter or smaller [1]. For example, Polla et al [2] treated 35 leg telangiectasias with the Candela PDL using a 577 nm wavelength, 0.36-msec pulse duration, and 1-, 2-, and 3-mm-diameter spot sizes.…”

Pulsed Alexandrite Laser for the Treatment of Leg Telangiectasia and Reticular Veins

“…Dierickx et al 11 studied an 800-nm diode laser with a water-cooled sapphire tip (Star Medical Tech Inc, Pleasanton, Calif) for the treatment of leg telangiectasia. Telangiectasia less than 0.4 mm in diameter were treated with a 20-millisecond duration pulse at a fluence of 40 J/cm 2 . Approximately 25% of telangiectasia cleared after 1 treatment, 50% after 2 treatments, and 75% after 3 treatments, with vessels greater than 0.4 mm in diameter demonstrating better clearance than smaller ones.…”

“…[1][2][3] Although sclerotherapy remains the gold standard of treatment, its drawbacks include the discomfort and phobia of injections, postsclerotherapy hyperpigmentation, telangiectatic matting, and allergy to the sclerosing agent. 4,5 In addition, the success of the treatment depends on the technical skill and experience of the physician performing sclerotherapy.…”

Treatment of spider leg veins with the KTP (532 nm) laser—A prospective study

“…In our study, this group showed the best results, even though the KTP (532) laser method for treatment of spider leg veins cannot be considered ideal with a success rate of 33%. Sclerotherapy of spider leg veins with similar diameters is at least as important as laser therapy [26]. In 40%, a reduction in diameter compared to the initial situation was achieved and in 27%, no change occurred.…”