The effects of 1064 nm laser on red telangiectasias using pulse shape modulation

Abstract

The effects of 1064 nm laser on red telangiectasias using pulse shape modulation Dear Editor, Facial and leg telangiectasias are common cosmetic concerns for both men and women of all skin types and ages. To date, various treatments for these issues, particularly leg telangiectasias, have frequently failed or resulted in negative side effects. 1 Among these, lasers, electrosurgery, sclerotherapy or surgical removal were used. Each technique has its own set of benefits and drawbacks. Sclerotherapy, for example, is effective for large vessels but not a good option for small vessels. It is performed by injecting a sclerosing agent into the vessel and this may cause endothelial damage, thrombosis, vessel wall necrosis and subsequent fibrosis. 2 Surgical removal of facial telangiectasias has been suggested, but this technique requires a 2 mm incision under local anaesthesia. It is considered technically difficult to perform with high variability in results depending on the surgeon's expertise. For example, laser treatments that use Neodymium-doped yttrium aluminum garnet (Nd:YAG), potassium titanyl phosphate laser, pulse dye, diode or intensive pulsed light technology penetrate the skin at different wavelengths (depending on the technology) to break the oxyhaemoglobin (Hb-O2) and damage the vessel wall. 3 Nd:YAG laser at 1064 nm has good tissue penetration and can treat vessels up to 3-4 mm in diameter.It is suitable for skin types I-VI with or without tan 4,5 and for the treatment of vessels of the lower limbs. 6 Long-pulsed Nd:YAG laser has been used in treating larger and deep-seated leg/facial veins. [7][8][9] To achieve the best therapeutic outcome during laser-induced photothermolysis of vascular skin lesions, dynamic changes are crucial. The temperature threshold for rapid photoinduced thermal damage is around 70 • C. Therefore, identifying markers to show when this temperature threshold has been reached is important. The presence of Met-haemoglobin (Met-Hb), which is produced when haemoglobin (Hb) undergoes photoinduced oxidation, indicates that the temperature has risen to this threshold. 10 Met-Hb formation has already been shown to increase the effectiveness and safety of laser treatment.Numerous studies have shown that heat causes Hb modification in the blood vessels. 11,12 This change is the outcome of oxidative processes converting Hb and Hb-O2 that result in Met-Hb formation. This is a distorted haeme protein, and its denaturation is one of the first events that can be seen when blood is heated. 13 Met-Hb precipitates via haemachromeThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

A retrospective 10 years‐ experience overview of dye laser treatments for vascular pathologies

“…These devices were typically suggested as an alternative when all other nonsurgical local therapies failed. [8][9][10] Moreover, FPDL is often used in combination with other treatments for treating vascular-dependent lesions. Lasers used to treat vascular lesions include FPDL, Nd:YAG lasers, intense pulsed light devices and CO2 lasers.…”

Clinical evidence of 595 nm pulse dye laser treatment for viral warts on hands and feet

“…Moreover, although it has been demonstrated in the literature that, the long‐pulsed Nd:YAG laser was used for the treatment of HPV lesions, 21 and that it was also able to induce a selective photothermolysis for blood vessels, 22 some studies demonstrated that there is no significant difference in the effectiveness between both laser types 23 ; the study of Ibrahim and colleagues showed that PDL and Nd:YAG laser are effective and safe modalities in recalcitrant plantar warts treatment with tolerable side effects 24 . Specifically, CO 2 , PDL, and Nd:YAG are the laser modalities most studied for wart treatment, and of these, PDL has the most favorable adverse effect profile 25,16 …”