Treatment of Face Veins with a Cryogen Spray Variable Pulse Width 1064 nm Nd:YAG

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Dermatologic Surgery

Volume 28 Issue 3 Page 244 - March 2002

Treatment of Face Veins with a Cryogen Spray Variable Pulse Width

1064 nm Nd:YAG Laser: A Prospective Study of 17 Patients

Sorin Eremia, MD* and Cindy Y. Li, DO

background.Through the 1990s laser treatment of leg veins has been a

challenge. Newer, longer wavelength lasers with variable pulse width

have shown promising results for both telangiectasia and reticular

leg veins. Experience with these lasers for treatment of facial

telangiectasia and periorbital reticular veins is scant.

objective.To our knowledge this is the first prospective study to

evaluate a variable pulse width, cryogen spray-equipped 1064 nm

Nd:YAG laser for the treatment of facial telangiectasia and larger

periorbital reticular veins.

methods.Seventeen volunteers, ages 32-67 years, skin types I-IV, with

facial telangiectasia and reticular periorbital/temporal veins were

treated once with the Nd:YAG laser at fluences of 125-150 J/cm2 with

a 6 mm spot size and pulse widths of 25 msec for small vessels and 75-

100 msec for reticular veins. Patients were examined 1 week and 1

month after the treatment. Pre- and posttreatment 35mm photographs

were taken. Improvement was judged by two experienced physicians,

both visually on patients and by comparison of pre- and posttreatment

photographs. Results were graded as percent resolution, in five

groups: 0, 0-25, 25-50, 50-75, and 75-100.

results.All 17 patients completed the study. Thirty-two sites were

treated (24 cheek, nose, and chin telangiectases, and 8 periorbital

reticular veins). Greater than 75 improvement was observed in 97 of

the treated sites. Greater than 50 improvement was observed in 100 of

the treated sites. Notably, 100 of the facial reticular veins treated

have essentially 100 resolution. Pain during treatment was variably

perceived by patients, but occasionally sufficient for patients to

express reservations about additional future treatment. Transient

erythema and edema were common, but fine crusting was rare. Small

areas of purpura were also quite rare.

conclusion.The cryogen spray-equipped 1064 nm Nd:YAG laser was

remarkably effective and safe for skin type I-IV patients. It is an

excellent tool for treatment of facial telangiectasia with minimal

risk of purpura. For the first time we appear to have a simple, safe,

and effective treatment for 1-2 mm periorbital reticular veins. The

use of topical anesthesia may be needed for some patients.