A Comparative Study of Nd:YAG Laser Versus Combined Sequential Delivery of Intense Pulsed Light and Nd:YAG for Treatment of Lower Extremity Talangiectasia and Reticular Veins

Abstract

elangiectasias and reticular veins of the lower limbs is one of the most commonly reported cosmetic complaint especially in women. Telangiectasia are dilated venules and arterioles measuring less than 1 mm in diameter while reticular veins are 1-4 mm in diameter. They are mostly asymptomatic but some women have symptoms of pain and edema especially with prolonged standing and the severity of these symptoms is totally out of proportion to the size of the involved veins. The eradication of telangiectasia and reticular veins has been understudy for many years where sclerotherapy proved to be the gold standard for treating leg veins but for patients who are allergic to sclerosant material or needle phobic another treatment method had to emerge. Lasers are presently available to achieve this goal. Laser therapy has offered effective and non-scarring treatment modalities to patients with vascular lesions including telangiectasia. In vascular lesions the targeted chromophore is oxyhemoglobin and deoxyhemoglobin. There are three peaks of absorption for oxyhemoglobin and deoxyhemoglobin, they are at 524 nm, between 577nm and 585 nm and at 1064 nm. The most commonly used laser devices for these treatments include the 532 nm potassium titanyl phosphate (KTP), 595 nm pulsed dye laser (PDL), the 755 nm alexandrite laser, intense pulsed light (IPL), and the 1064-nm neodymium yttrium-aluminum-garnet laser (Nd:YAG). Their mechanism of action is