Use of a variable long-pulse alexandrite laser in the treatment of facial telangiectasia.

BACKGROUND: The alexandrite laser selectively targets melanin and hemoglobin. We used the alexandrite laser with variable pulse widths to treat facial telangiectasia. METHODS: Nineteen patients were enrolled in this study, which consisted of two parts: a series of test spots over a range of pulse durations (3-80 ms) and treatment over a larger area based on the pulse width-specific outcomes from the test spots. The final follow-up visit was 12 weeks after irradiation. RESULTS: The 40-ms pulse width achieved the optimal balance of pain tolerance, epidermal tolerance, and vessel reduction. Mean fluence was 88 J/cm(2), with a 6-mm spot. Overall, a 48% reduction in vessels was noted after one treatment. Side effects were minimal. CONCLUSIONS: In fair-skinned patients with large telangiectasia, the alexandrite laser is a good option for vessel reduction.

Low-fluence 1,064-nm laser hair reduction for pseudofolliculitis barbae in skin types IV, V, and VI.

PURPOSE: To evaluate the efficacy of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser using lower than traditional fluences (22-40 J/cm(2)) for treatment of pseudofolliculitis barbae (PFB). METHODS: Twenty-two patients with PFB refractory to conservative therapy received five weekly treatments over the anterior neck using a 1,064-nm Nd:YAG laser at 12 J/cm(2). Pulse duration was 20 ms with 10 mm spot size. Topical anesthesia was not used. Treatments were completed 15 minutes after patient arrival. Patients presented for 2- and 4-week follow-up. Ten evaluators used a Global Assessment Scale (GAS) to assess dyspigmentation, papule counts, and cobblestoning by comparing baseline to 4-week follow-up visit photographs. Hair and papule counts were performed on five patients and compared with the GAS. Investigators recorded adverse effects using a visual analog and side effects scale. RESULTS: Eleven patients demonstrated 83% improvement on the GAS (p<.01). There was a mean reduction of 59.5% in dyspigmentation (p<.03), 91.2% in papule count (p<.01), and 75.6% in cobblestoning (p<.02). Patients reported 1 out of 10 on both adverse effects scales. CONCLUSION: Low-fluence 1,064-nm laser treatment achieved significant temporary reduction in PFB. Subjects noted minimal pain without topical anesthesia.