The new-generation, high-energy, 595 nm, long pulse-duration, pulsed-dye laser effectively removes spider veins of the lower extremity

Background and Objectives: Lower-extremity spider veins are a cosmetic problem that poses formidable clinical difficulty for laser removal. They are significantly harder to remove than facial telangiectasias. A new-generation, pulsed-dye laser (PDL), capable of administering pulses that clinically behave like true 40-millisecond pulses has been developed, by doubling the number of sub-pulses comprising each laser pulse. Study Design/Materials and Methods: Fifteen subjects with Fitzpatrick skin types I-III were enrolled in the study and treated to 35 sites. Subjects were treated three times at 2 6-week intervals using an average fluence of 20.4 J/cm(2), a 3 x 10 mm spot, and a dynamic cooling device to protect the epidermis. Digital photographs were taken before initiating treatment and 8 weeks following the final treatment. Results: Mean improvement scores using a 4-point scale as rated subjectively by the treating physician were 0.92 (< 25%), 2.7 (similar to 40-50%), and 3.6 (similar to 65-75%), 6 weeks following 1st and 2nd treatments and 8 weeks following the 3rd and final treatment, respectively. Improvement was also determined by three physicians, rating digital photographs and blinded as to which photographs were pre- or post-treatment. They rated improvement as mild (0-25%) in 10.5% of photographs, moderate (26-50%) in 15.2%, marked (51-75%) in 38.1%, and excellent (76-100%) in 6.3%. There was no textural change in any treatment site. Conclusions: The new-generation, high-energy, 595 nm, long pulse-duration, PDL effectively removes lower-extremity spider veins in subjects with skin types I-III.