LEG TELANGIECTASIA TREATMENT WITH A 1.5 MS PULSED DYE-LASER, ICE CUBECOOLING OF THE SKIN AND 595 VS 600 NM - PRELIMINARY-RESULTS

Background and Objective: Preliminary results indicate that pulsed dye lasers (PDL) with 1.5 ms pulsewidth and 595 nm wavelength are effecti ve in the treatment of leg telangiectasia. The aim of this study was t o evaluate if the clinical results could be improved by a) an effectiv e skin cooling with ice cubes and b) the longer wavelength of 600 nm. Study Desgn/Materials and Methods: In 87 patients with vessels up to 1 mm in diameter, 257 single test treatments were performed using wavel engths of 595 and 600 nm, fluences of 16, 18, and 20 J/cm(2), a 1.5 ms pulse duration, and an elliptical spot of 2 x 7 mm. In 7 patients, th e skin surface temperature curve was measured after cooling with ice c ubes vs hydrogel dressings, and spot geometry and fluence were investi gated with and with out the gel dressing. Results: Vessel clearance wa s evaluated 6-8 weeks after treatment. 20 J/cm(2) were most effective (80% clearance >50%), and 18 J/cm(2) were more effective than 16 J/cm( 2) (66.2 vs 52.5% clearance >50%). There was a tendency towards better results with 595 nm, but the differences were not significant. Vessel s with a diameter <0.5 mm cleared significantly better than those with 0.5-1 mm (69.1 vs 31.9% clearance >50%). Hypo- and hyperpigmentation were seen in 32% of the patients. Cooling with ice cubes proved to be far more effective than with hydrogel dressings (temperature decrease approx 15 vs 5 degrees C). Additionally, the gel dressing caused an en ergy loss of approx 35% and an irregular spot geometry as shown on bur n paper. Conclusions: Treatment of leg telangiectasia with the 1.5 ms- PDL is safe and effective, especially in vessels smaller than 0.5 mm i n diameter; 595 nm and 18 J/cm(2) seem to be somewhat more effective a s 600 nm and 16 J/cm(2); and 20 J/cm(2) are even more effective, but p ersistent hyperpigmentation cannot yet be excluded due to insufficient follow-up time. Cooling with ice cubes is more effective and less exp ensive than gel dressings, and the short term clinical results are equ ivalent, even if the frequency of transient pigmentary changes is incr eased. (C) 1998 Wiley-Liss, Inc.