Nd:YAG Laser (1064 nm) Irradiation for Lower Extremity Telangiectases and Small Reticular Veins: Efficacy as Measured by Vessel Color and Size

BACKGROUND: Laser treatment of lower extremity telangiectases and small reticular veins has remained difficult because of vessel color, diameter, depth, and associated high-pressure flow. Traditionally, larger-caliber blue leg veins do not respond well to laser treatment. Nd:YAG laser (1064 nm) irradiation is absorbed by oxyhemoglobin and reduced hemoglobin and is associated with greater depth of penetration than other previously studied vascular lasers. OBJECTIVE: To evaluate a millisecond contact-cooled 1064 nm Nd:YAG laser for the treatment of telangiectases and small reticular veins. METHODS: Twenty-one lower extremity sites, with Fitzpatrick skin types I-IV, received two laser treatments separated by a 4 to 6-week period. Blue and red vessels, ranging in size from 0.25 to 4.0 mm were treated. Pulse durations of 10-50 msec were utilized at fluences of 90-187 J/cm2. Three months after the last treatment, patients were evaluated for vessel improvement and complications. RESULTS: Seventy-one percent of lower extremity vessels had improvement graded as significant. All vessel colors and sizes were successfully treated. The only complication at 3 months was postinflammatory hyperpigmentation. CONCLUSION: 1064 nm Nd:YAG laser irradiation with associated contact cooling is a safe and effective treatment for telangiectases and small reticular veins of the lower extremities.