Treatment of spider veins of the lower extremity with a novel 532 nm KTP laser.

BACKGROUND AND OBJECTIVES: This study investigated a novel, high-power, 532 nm frequency-doubled Nd:YAG, KTP laser with contact cooling for the treatment of spider veins of the lower extremities. STUDY: Twenty female subjects with Fitzpatrick skin types I-III, were treated to 79 sites using the 532 nm wavelength of a dual-wavelength 532/1,064 nm laser (Excel V, Cutera, Brisbane, CA) with a 5 mm-diameter spot, fluences ranging from 13 to 15 J/cm(2) , and a pulse-duration of 40 milliseconds. Two treatments were performed 12 weeks apart. Photographs were taken at baseline and 12 weeks following the final treatment. Improvement was assessed by two independent physicians reviewing photographs in a blinded fashion using a 5-point improvement scale. RESULTS: All subjects demonstrated improvement resulting in a median improvement of 2.5 (one-sample Wilcoxon signed rank test, 95% CI: 1.9-2.9, P = 0.000). The reviewers were highly consistent (kappa of 0.85), and highly accurate (kappa of 0.85) in identification of "after photograph" and they were highly consistent in grading improvement. Subjects and the treating physician reported "significant" to "very significant" (∼51 to 100%) improvement in 75% and 69% of subjects, respectively. Post-inflammatory hyper-pigmentation was seen in 2% of sites (1/64). No serious adverse effects reported. All subjects tolerated the treatments well (mean pain score of 2.9/10). CONCLUSION: Treatment of spider veins of the leg with a novel 532 nm KTP laser was found to be safe and effective, with minimal discomfort and adverse effects in Fitzpatrick skin types I-III.

Minimally ablative resurfacing with the confluent 2,790 nm erbium:YSGG laser: a pilot study on safety and efficacy.

BACKGROUND: The 2,790 nm Er:YSGG wavelength has a lower water absorption coefficient than the 2,940 nm Er:YAG, but a higher coefficient than the 10,600 nm CO(2) laser. This allows ablative resurfacing with mild thermal coagulation, which may increase clinical efficacy while reducing patient downtime. OBJECTIVES: To evaluate the efficacy and safety of the confluent 2,790 nm Erbium:YSGG (Pearl™, Cutera) laser for facial rejuvenation. STUDY DESIGN/MATERIALS AND METHODS: Eleven subjects (mean age 50, skin types I-III) with mild to moderate photodamage and wrinkles had two facial treatments with the 2,790 nm Er:YSGG laser using a fluence of 3.5 J/cm(2), pulse duration of 0.4 msecond, and 20% overlap. Treatments were performed 6 weeks apart. Pre-auricular biopsies from five subjects were evaluated at baseline and 6 weeks after the final treatment. Data from blinded photo assessments and subjects' self-assessment of improvement were analyzed 6 weeks after the final treatment. Additionally, long-term safety and efficacy were evaluated 2 years after the final treatment. RESULTS: Histologically, 80% of subjects had new collagen formation in the dermal grenz zone, and 60% had increased epidermal thickness. Almost all subjects (91%) showed improvement in tone/texture, 82% of subjects showed improvement in dyschromia and fine lines, and 54% showed improvement in wrinkles 6 weeks after the final treatment. Subjects' self assessment indicated "significant" to "dramatic" improvement in dyschromia (91% of subjects) and tone/texture (82%) 6 weeks after the final treatment. All subjects saw "mild" to "significant" improvement in fine lines and wrinkles. At the 2-year follow-up visit, 57% of the overall improvement achieved at 6 weeks was maintained. No adverse events were reported throughout the study. CONCLUSION: Ablative resurfacing with the 2,790 nm Er:YSGG laser demonstrated visible improvement in photodamage with good tolerability and minimal downtime. Subjects were highly satisfied, especially with respect to dyschromia, skin tone, and texture.