Treatment of superficial vascular lesions with the KTP 532-nm laser: experience with 647 patients

Abstract

Superficial vascular lesions are a common dermatological diagnosis but are often difficult to treat. Numerous lasers (especially the dye laser) and intense pulsed light sources have been used, but there have been very few reports on the effectiveness of the potassium-titanyl phosphate (KTP) laser. We have extensive experience of this modality at our institution, and the purpose of this survey is to report on the safety and efficacy of the KTP laser. Using an in-house database, we retrospectively collected data from patients who had undergone treatment with the KTP laser for superficial vascular lesions. Patients of Fitzpatrick skin type I-IV were included. Exclusion criteria were Fitzpatrick skin type V, patients with obvious suntan and those on potentially phototoxic medications or minocycline therapy. Diagnoses included discrete or matted telangiectasia, strawberry naevus, spider angioma, rosaceal erythema, rosaceal telangiectasia, telangiectatic naevus, angioma, combined rosaceal erythema/telangiectasia, port-wine stain, venous lake haemangioma and hereditary haemorrhagic telangiectasia. Patients underwent an initial test treatment and further treatment at 6-week intervals as required. Clinical photographs were taken pre- and post-treatment, and outcome was graded by patient and physician. Adverse effects were recorded including scarring, hypo- or hyperpigmentation, marked swelling, blistering, scabbing and bruising. Six hundred forty-seven patients with 13 diagnoses on 9 different body sites were recorded. Four hundred eighty-six were female, and the median age was 39.5 years. Of the lesions treated, 33.7 % (n = 218) were discrete telangiectases and 31.8 % (n = 206) were spider angiomas. A 92.7 % of lesions were on the face. Four hundred thirteen (77.6 %) patients who had outcomes recorded at 6 weeks were graded as "clearance" or "marked improvement". Only 38 (5.8 %) patients experienced adverse effects, all of which were minor; the main adverse effect was swelling. Unlike the dye laser, there was only one case of bruising out of 647 patients. This is the largest survey of patients to have undergone KTP laser treatment reported in the literature. Our results show that the KTP laser is a safe and effective modality for the treatment of superficial vascular lesions.

The Comparison of the Efficacy and Safety of Q-Switched Potassium Titanyl Phosphate Laser and Long-Pulsed Neodymium-Doped Yttrium Aluminum Garnet Laser in the Treatment of Erythematotelangiectatic and Papulopustular Rosacea

“…Despite being a subtype of lpNd:YAG, KTP laser has a half wavelength allowing it to efficiently penetrate into superficial telangiectasias (1,4,13,17). Our results confirmed the better destruction capability of Q-switched KTP laser for superficial vessels in ETR patients.…”

“…KTP laser is effective for especially superficial vascular lesions due to its lower wavelength. However, although KTP allows for a slower, gentler heating, coagulation, and collapse of the vessel, it is not effective for deeper vessels (13). If high doses of energy are used to increase the penetration depth, this may cause bulla, scars, and depigmentation.…”

Successful treatment of angioma serpiginosum using a novel 532 nm potassium titanyl phosphate (KTP) laser

“…The pulse duration of potassium‐titanyl phosphate (KTP) frequency‐doubled Nd: YAG laser is longer than that of PDL, and at a wavelength of 532 nm, it is well absorption by hemoglobin . Some have already described its successful use in the treatment of superficial cutaneous vascular lesions where it was shown to be as effective and even better tolerated than the PDL . We herein describe the use of the 532 nm KTP laser in a patient with AS on the chest.…”

Update on the Management of Rosacea

“…Emitting light twice the frequency of Nd:YAG, KTP interacts with superficial chromophores, making it quite useful for superficial vessels and with less healing time. [112][113][114][115][116][117] Although beneficial for such lesions, such low wavelengths have the disadvantage of interacting with melanin and are limited to lighter skin tones due to the risk of post-inflammatory hyperpigmentation. With minimal discomfort, KTP can target vessels 1−3 mm below the skin surface, and increasing pulse widths enable treatment of vessels of larger diameter.…”

“…The efficacy, safety, and cost-effectiveness of both agents are well demonstrated in a number of well controlled randomized studies. 26 A few Brimotidine tartrate gel 0.5% [22][23][24] Azelaic acid 15% Pimecrolimus 1% cream [31][32][33] Pimecrolimus 1% cream [31][32][33] Permethrin 5% cream [34][35][36]38 Permethrin 5% cream [34][35][36]38 Oral Surgical (blade and radio) excision 121,136 Other natural Ingredients (botnicals and anti-inflammatories) 43 KTP laser [113][114][115][116][117] Cryosurgery Nd:YAG laser 125 Dermabrasion OnabotulinumtoxinA 151,152 Abbreviations: BP, benzoyl peroxide; ETR, erythematotelangiectatic rosacea; PPR, papulopustular rosacea; Nd:YAG, neodymium:yttrium-aluminum-garnet laser; Er:YAG, erbium:yttrium-aluminum-garnet; PDL, pulsed dye laser; IPL, intense pulsed light; KTP, potassium titanyl phosphate; FDA, US Food and Drug Administration. …”