Treatment of face veins with a cryogen spray variable pulse width 1064 nm Nd:YAG Laser: a prospective study of 17 patients.

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.     

Laser Hair Removal with Alexandrite versus Diode Laser Using Four Treatment Sessions: 1-Year Results

BACKGROUND: Laser hair removal is the treatment of choice for hypertrichosis. The two most commonly used hair removal lasers are compared. OBJECTIVE: To present the results of a comparative study examining the role of wavelength, fluence, spot size, pulse width, and cooling systems on long-term results after a series of four laser hair removal treatments using the 755 nm alexandrite and 800-810 nm diode lasers. METHODS: The axillae of 15 untanned, type I-V patients were treated side by side four times at 4- to 6-week intervals with a 755 nm, 3-msec pulse width, cryogen spray-equipped alexandrite laser and an 800 nm, variable pulse width, cooled sapphire window-equipped diode laser. Each patient was pretested and treated with the maximum fluence tolerated at the largest spot size available for each laser (12 mm round/113 mm2 for the alexandrite and 9 mm for the diode). RESULTS: Evaluations were done at 3, 6, 9, and 12 months after the last treatment. Twelve-month results with the alexandrite and diode lasers achieved 85% versus 84% hair reduction. The fact that tan avoidance was strictly followed permitted the use of relatively high fluences (25-30+ J/cm(2)) even in type IV patients. For most patients, four treatment sessions using high fluences (30-40 J/cm(2)) with relatively large spot sizes (12 mm round for the 755 nm alexandrite and 9 mm for the 800 nm diode) resulted in 12-month hair reductions in the 90% range. CONCLUSION: Both the alexandrite and diode lasers in this 12-month study produced excellent long-term hair reductions.     

Prospective, Comparative Evaluation of Three Laser Systems Used Individually and in Combination for Axillary Hair Removal

BACKGROUND: Using the concept of selective photothermolysis, a variety of laser systems have been developed to remove unwanted hair. OBJECTIVE: To evaluate the relative efficacy, tolerability, and subject satisfaction of three different laser systems used individually and in rotation for axillary hair removal. METHODS: Twenty female patients (17 with dark-colored hair, 3 with red or light-colored hair) with Fitzpatrick phototype II skin received three treatments performed at 6- to 8-week intervals. Each axilla was divided in half to yield four distinct areas that were treated by the following lasers: (1) three sessions with a long-pulse 755 nm alexandrite laser, (2) three sessions with a long-pulse 810 nm diode laser, (3) three sessions with a long-pulse 1,064 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and (4) rotational treatment consisting of a single session by each of the three laser systems. Percent hair reduction and acute and long-term side effects were evaluated after treatment. Subjects completed questionnaires assessing tolerability and satisfaction. RESULTS: All subjects tolerated the treatments well, with only local, transient side effects seen. At the 3-month follow-up, the greatest average hair reduction was comparably similarly seen after the alexandrite laser at 59.3 +/- 9.7% and the 810 nm diode laser at 58.7 +/- 7.7%. The Nd:YAG laser and rotational regimens were less efficacious, with 31.9 +/- 11.1% and 39.8 +/- 10.1% hair reduction, respectively. Subjects with red or light-colored hair experienced 5 to 15% reduced efficacy with any laser system used. Subjects found the alexandrite and diode lasers to be equally tolerable, with only slight discomfort, and the Nd:YAG laser to be the least comfortable of the three systems. Overall, subject satisfaction of each treated site, in decreasing order, was (1) the 810 nm diode laser, (2) the alexandrite laser, (3) rotational therapy, and (4) the Nd:YAG laser. CONCLUSION: At the 3-month follow-up, the long-pulse alexandrite and 810 nm diode lasers demonstrated no statistically significant differences in efficacy, comparable efficacy and tolerability, and highest subject satisfaction. Rotational therapy with the three laser systems is not as effective as treatment with the alexandrite laser or diode laser alone but is statistically more effective than use of the long-pulse Nd:YAG system alone. Individuals with red or light-colored hair and Fitzpatrick phototype II skin have decreased efficacy of laser treatment than those with dark-colored hair and the same phototype.     

An In Vivo Trial Comparing the Clinical Efficacy and Complications of Q-Switched 755 nm Alexandrite and Q-Switched 1064 nm Nd:YAG Lasers in the Treatment of Nevus of Ota

BACKGROUND: Q-switched 755 nm alexandrite (QS alex) and Q-switched 1064 nm Nd:YAG lasers are effective in the treatment of nevus of Ota. Our previous in vivo study indicated that patients better tolerate QS alex than QS 1064 nm Nd:YAG laser. However, in terms of clinical efficacy and long-term complications, the study did not indicate which laser is superior. Although both machines may appear to be similar in effectiveness, the low number of treatment sessions may contribute to this apparent lack of difference. OBJECTIVE: The aim of this study was to compare the clinical efficacy and complications of QS 755 nm alex and QS 1064 nm Nd:YAG lasers in the treatment of nevus of Ota after three or more treatment sessions. METHOD: Forty patients were recruited for this study and all had received three or more laser treatment sessions with an interval of at least 2 months between each. Half of the lesion was treated with QS alex and the other half with QS 1064 nm Nd:YAG laser. The degree of lightening was assessed subjectively by the patient using a visual analog scale and objectively by two independent clinicians. Patients were called back to be examined for evidence of complications. RESULTS: In terms of subjective degree of lightening, QS 1064 nm Nd:YAG laser was found to be significantly more efficacious than QS alex (P = 0.018). Both clinicians also found QS 1064 nm Nd:YAG laser to be more effective, but statistical significance was only detected in one, not both of their scores (P = 0.005 and 0.414 for observers 1 and 2, respectively). More patients that received QS Alex developed complications (4 for QS alex and 2 for QS Nd:YAG), but the difference was not statistically significant. CONCLUSION: QS 1064 nm Nd:YAG laser appears to be more effective than QS alex in the lightening of nevus of Ota after three or more laser treatment sessions. However, the majority (55%) of the patients reported no differences in results between the two lasers, and only one of the two observers noted statistically significant improvement of QS 1064 nm Nd:YAG over QS alex.     

Clinical,histologic, and ultrastructural evaluation of tattoos treated with three laser systems

We examined the response of tattoo pigments treated with three commercially available lasers: Q-switched ruby, Q-Switched neodynium:yttrium, aluminum, garnet (Nd:YAG), and the alexandrite. Tattoos applied to hairless guinea pigs and treated with the aforementioned lasers were evaluated clinically, histologically, and ultrastructurally. Clinical evaluation showed red brown, dark brown, and orange pigment responded best to the Nd:YAG laser (1064 nm). The alexandrite laser was most effective for removing blue and green pigment, the Q-switched ruby laser was most effective for removing purple and violet pigment, and the NdYAG laser (532 nm) removed red pigment the best. Black pig ment was lightened equally with the Nd:YAG laser (1064 nm) and (532 nm) and the alexandrite laser (755 nm). No clinical scarring was observed; however, some colors turned black after treatment. Histologic and ultrastructural examination showed epidermal and dermal damage to be most evident after treatment with the Nd:YAG laser. Our study shows that certain tattoo pigments respond better to different laser systems. © 1994 WiIey-Liss, Inc.     

Nd:YAG laser (1064 nm) irradiation for lower extremity telangiectases and small reticular veins: efficacy as measured by vessel color and size.

BACKGROUND: Laser treatment of lower extremity telangiectases and small reticular veins has remained difficult because of vessel color, diameter, depth, and associated high-pressure flow. Traditionally, larger-caliber blue leg veins do not respond well to laser treatment. Nd:YAG laser (1064 nm) irradiation is absorbed by oxyhemoglobin and reduced hemoglobin and is associated with greater depth of penetration than other previously studied vascular lasers. OBJECTIVE: To evaluate a millisecond contact-cooled 1064 nm Nd:YAG laser for the treatment of telangiectases and small reticular veins. METHODS: Twenty-one lower extremity sites, with Fitzpatrick skin types I-IV, received two laser treatments separated by a 4 to 6-week period. Blue and red vessels, ranging in size from 0.25 to 4.0 mm were treated. Pulse durations of 10-50 msec were utilized at fluences of 90-187 J/cm2. Three months after the last treatment, patients were evaluated for vessel improvement and complications. RESULTS: Seventy-one percent of lower extremity vessels had improvement graded as significant. All vessel colors and sizes were successfully treated. The only complication at 3 months was postinflammatory hyperpigmentation. CONCLUSION: 1064 nm Nd:YAG laser irradiation with associated contact cooling is a safe and effective treatment for telangiectases and small reticular veins of the lower extremities.     

Comparative Evaluation of Long-Pulse Alexandrite and Long-Pulse Nd:YAG Laser Systems Used Individually and in Combination for Axillary Hair Removal

BACKGROUND The 755-nm alexandrite and the 1,064-nm Nd:YAG lasers are both utilized for hair removal. Advances in laser technology have led to the development of dual-wavelength treatment for increased efficacy.
OBJECTIVE The objective was to evaluate the safety and efficacy of combining 755- and 1,064-nm wavelengths for axillary hair removal.
METHODS Twenty patients received three treatments at 4- to 6-week intervals in four axillary quadrants. The left upper axilla was treated with the alexandrite laser, the left lower axilla with the Nd:YAG laser, the right upper axilla with combination alexandrite and Nd:YAG laser, and the right lower quadrant with the diode laser. At 1- and 2-month follow-up visits, subjects completed questionnaires and were assessed for percentage of hair reduction.
RESULTS Eighteen subjects completed the study. The greatest reduction was seen with the alexandrite laser at 70.3% and combination of alexandrite and Nd:YAG laser at 67.1%. The diode laser was less efficacious at 59.7% and the Nd:YAG laser had the least improvement with 47.4% reduction. Subjects found the alexandrite and diode lasers to be the most tolerable and the Nd:YAG and combination treatment to be the most painful.
CONCLUSION Combination treatment of alexandrite and Nd:YAG lasers provides no added benefit over the alexandrite laser alone.     

Transcutaneous laser treatment of leg veins

Leg telangiectasias and reticular veins are a common complaint affecting more than 80 % of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585–600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800–983-nm diode lasers, and the 1,064-nm neodymium yttrium–aluminum–garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption properties of the target structure, (2) pulse stacking and multiple pass laser treatment, (3) combination of laser therapy with sclerotherapy or radiofrequency, and (4) indocyanin green enhanced laser therapy. Future studies will have to confirm the role of these developments in the treatment of leg veins. The literature still lacks double-blind controlled clinical trials comparing the different laser modalities with each other and with sclerotherapy. Such trials should be the focus of future research.     

Hair Removal Using Topical Suspension-Assisted Q-Switched Nd:YAG and Long-Pulsed Alexandrite Lasers: A Comparative Study

Background. The use of lasers for removal of unwanted hair has been shown to be effective in temporarily controlling hair growth. Several lasers are currently utilized for this purpose.
Objective. This study evaluates the short-term effectiveness and discomfort levels of the long-pulsed alexandrite laser and the topical suspension-assisted Q-switched Nd:YAG laser in a side-by-side comparison.
Methods. Fifteen subjects were treated in the bilateral hair-bearing axilla, using one treatment with the alexandrite laser for the right and two treatments with the topical suspension-assisted Nd:YAG laser for the left. Reduction in hair regrowth was measured at 2 and 3 months following the first treatment by comparing the terminal hair count to the baseline values. Patients rated their pain on a scale of 0–10 immediately following the first treatment at each site.
Results. The mean percentage reduction in hair regrowth 2 months following alexandrite laser treatment was 55% and 73% for the Nd:YAG laser-treated regions. After 3 months, alexandrite laser-treated patients showed a reduction of 19%, while Nd:YAG laser-treated patients showed a 27% reduction. Patients reported average pain values of 8 and 4 for the long-pulsed alexandrite and Nd:YAG laser sites, respectively. All differences were significant.
Conclusion. While the design of this study makes it difficult to compare the relative effectiveness of the lasers, both systems evaluated were shown to delay hair growth and provide patients with a satisfactory treatment.     

755nm翠绿宝石激光联合800nm半导体激光治疗腰骶部多毛疗效分析

目的:回顾性分析755nm翠绿宝石激光联合800nm半导体激光治疗腰骶部多毛的临床疗效和安全性。方法:收集笔者医院2017年1月1日-2018年6月30日收治的100例腰骶部多毛患者病例资料,其中50例患者为单纯755nm翠绿宝石激光治疗;50例患者为755nm翠绿宝石激光联合800nm半导体激光治疗。分析两组患者的治疗效果、不良反应发生情况及对治疗效果的满意度。结果:相较于单纯755nm激光治疗,755nm翠绿宝石激光联合800nm半导体激光脱毛的有效率和治愈率显著高于755nm治疗组,两组比较有统计学意义(P<0.05);组间的VAS(视觉模拟评分法)疼痛评分比较,差异无统计学意义(P>0.05),但联合治疗组发生疼痛的次数显著低于单一治疗组(P<0.05);单纯治疗组出现2例色素沉着斑,联合治疗组无色素沉着斑出现,两组比较差异无统计学意义(P>0.05),两组均未出现色素减退斑及瘢痕;联合治疗组患者的总满意率显著高于单一治疗组(P<0.05)。结论:755nm翠绿宝石激光联合800nm半导体激光治疗腰骶部多毛临床疗效明显,安全性良好,疼痛感轻,值得广泛应用。     

532-nm Nd:YAG and 595-nm Pulsed Dye Laser Treatment of Leg Telangiectasia Using Ultralong Pulse Duration

BACKGROUND: Telangiectatic leg veins have been treated using lasers with variable success. OBJECTIVE: We aimed to examine the efficacy and tolerability of a 595-nm pulsed dye laser (PDL) and a 532-nm Nd:YAG laser using ultralong pulse duration to improve leg telangiectasias with a single treatment. METHODS: Ten subjects with leg telangiectasias up to 1.0 mm in diameter participated in the study. The telangiectatic patch was divided into two approximately equal adjacent areas. The first area was treated with a 532-nm Nd:YAG laser at a fluence of 20 J/cm2 and a pulse duration of 50 ms using a contact cooling device. The second area was treated with a 595-nm PDL at a fluence of 25 J/cm2 and a pulse duration of 40 ms using cryogen spray precooling. Each area was treated once only. Photographic evaluation was used for an assessment of response. RESULTS: Two of 10 subjects had less than 25%, 3 had 25% to 50%, 2 had 50% to 75%, and 3 had more than 75% improvement after single treatment with a 532-nm Nd:YAG laser. Similarly, 2 of 10 subjects had less than 25%, 2 had 25% to 50%, and 6 had 50% to 75% improvement with the 595-nm PDL. Hyperpigmentation occurred in one subject treated with the 532-nm Nd:YAG laser and two subjects treated with the 595-nm PDL. No blistering, crusting, hypopigmentation, or scarring were observed. CONCLUSION: Both lasers using ultralong pulse width improved leg telangiectasias after a single treatment with minimal adverse reactions.     

Long-Term Results with a Multiple Synchronized-Pulse 1064 nm Nd:YAG Laser for the Treatment of Leg Venulectasias and Reticular Veins

BACKGROUND: The long-pulsed Nd:YAG (1064 nm) laser has been shown to be effective in the treatment of blue venulectasias and reticular veins. OBJECTIVE: The present study examined the clinical efficacy and long-term follow-up (12 months) of patients treated with the 1064 nm Nd:YAG laser technology. METHODS: Twenty-five female patients (mean age 37.6 years, Fitzpatrick skin types II-V) were treated with up to three treatment sessions at 6-week intervals on a 5 cm2 surface area of vessels utilizing the 1064 nm Nd:YAG laser with a circulating cooling device. Treatment parameters were vessel size 0.2-2.0 mm treated with a double pulse of 7 msec at 120 J/cm2 and vessel size 2.0-4.0 mm treated with a single pulse of 14 msec, fluence 130 J/cm2, with a spot size of 6 mm. Improvement was judged by double-blinded observer evaluation, macrophotographic imaging, optical chromatography, and a patient evaluation scale. RESULTS: Sixty-four percent of patients treated in the present study achieved 75% or greater clearing of vessels after a maximum of three treatment sessions. Optical chromatography revealed statistically significant decreased chromophore intensity (mean blueness reduction index of 41.2b-). Sixty-four percent of patients were greatly satisfied with the results of the laser treatment. Two patients manifested vessel recurrence when examined at 6 and 12 months, respectively. CONCLUSION: The 1064 nm Nd:YAG laser can produce effective long-term photosclerosis of blue venulectasia and reticular veins. The potential for recurrence should be recognized by the vascular laser surgeon.     

Successful Treatment of Spider Leg Veins with a High-Energy, Long-Pulse, Frequency-Doubled Neodymium:YAG Laser (HELP-G)

BACKGROUND: While sclerotherapy has been the standard treatment for spider leg veins for many years, recent advances have allowed lasers to be considered as a treatment option. OBJECTIVE: To study the efficacy of a frequency-doubled Nd:YAG laser at 532 nm with a 50 ms pulse width and chill tip device in the treatment of spider leg veins. METHODS: Forty-six patients with spider leg veins with a diameter of less than 1 mm or 1-2 mm were treated with a frequency-doubled Nd:YAG laser at 532 nm with a pulse width of 50 ms (VersaPulse HELP-G laser) while using a water-cooled chill tip device. RESULTS: Of patients with veins less than 1 mm in diameter, 60% had greater than 50% clearing after one treatment and 80% had greater than 50% clearing after two treatments. Of patients with veins 1-2 mm in diameter, 39% achieved greater than 50% clearing after one treatment and 67% had greater than 50% clearing after two sessions. CONCLUSION: Our results suggest that the frequency-doubled Nd:YAG laser with a pulse width of 50 ms and chill tip device offers an excellent alternative to sclerotherapy in the treatment of small spider leg veins.     

Meta-analysis of hair removal laser trials

Traditional hair-removal techniques have included shaving, waxing, chemical depilation, and electrolysis. All of these methods result in temporary hair removal. The theory of selective photo thermolysis led to the development of a variety of different laser systems. These lasers range from the short end of spectrum, with the 694-nm ruby laser, to the middle, with the 755-nm alexandrite and 810-nm diode lasers, and to the long end with the 1,064-nm Nd:YAG laser. We made a systematic review on the clinical trials with use of various laser sources for hair removal, so all clinical trials related to hair removal lasers in 1998–2003 were considered after elimination of heterogenite sources in data store. Trial results were synthetized on the basis of kind of laser. Our study clarified that hair reduction at least 6 months after the last treatment and hair reductions were 57.5, 42.3, 54.7, and 52.8% after three sessions for diode, Nd:YAG, alexandrite and ruby, respectively. We compared the result with use of analysis of variance method (Scheffes) and double comparison with use of Student’s t test. Our results clarified that diode laser is the most effective, and Nd:YAG has the least effect of hair removal.It seems that diode and alexandrite lasers are proper for hair removal, but as we need high fluence in the darker skin types and this is accompanied with higher complications, diode is advised for lighter skin, and we advised alexandrite laser for darker skin types.     

单用强脉冲光、长脉宽Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效比较

目的:观察单用强脉冲光、长脉宽1064nm Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效和不良反应。方法:联合应用590～1200nm强脉冲光(能量密度12～16J/cm2,脉宽3.0～5.0ms)以及长脉宽1064nm Nd:YAG激光(能量密度80～90J/cm2,脉宽10～20ms)治疗51例微静脉畸形患者;并与单独应用强脉冲光(能量密度13～20J/cm2)及长脉宽Nd:YAG激光(能量密度120～145J/cm2)治疗结果比较。结果:强脉冲光、长脉宽1064nmNd:YAG激光及低能量下联合使用治疗微静脉畸形的有效率分别为33.1%、40.3%和56.9%,瘢痕发生率分别为0%、10.7%和5.9%。结论:低能量下联合使用强脉冲光及长脉宽1064nm Nd:YAG激光提高了微静脉畸形的有效率,且不良反应小。     

优化强脉冲光联合长脉宽Nd∶YAG1064nm激光治疗痤疮瘢痕疗效研究

目的 观察优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗痤疮瘢痕及其伴发色素沉着、红斑、毛孔粗大临床疗效. 方法 痤疮瘢痕患者共162例,采用随机分组其中78例运用优化强脉冲光联合长脉宽Nd：YAG 1064nm激光治疗,48例运用优化强脉冲光治疗,36例运用长脉宽Nd：YAG 1064nm激光治疗.治疗参数：强脉冲光滤光片640nm,能量密度20～24J/cm2,脉宽4ms,脉冲3个,延迟时间30ms.Nd：YAG1064nm激光,9mm光斑治疗头,能量密度单脉冲58～64J/cm2,脉宽20ms.一疗程5次,每次间隔1个月. 结果 162例患者3种治疗方式ECCA评分差异有统计学意义（P＜0.05）;治疗方式中优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗组与优化强脉冲治疗组ECCA评分差异有统计学意义（P＜0.05）,优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗组与长脉宽Nd：YAG1064nm激光治疗组ECCA评分差异有统计学意义（P＜0.05）.痤疮瘢痕及其伴发色素沉着有效率71.19％（95％CI：59.40％～82.98％）,红斑有效率88.14％ （95％CI：79.91％～96.37％）,毛孔粗大有效率71％（95％CI：60.45％～81.97％）.所有患者治疗中未发现任何严重的副作用. 结论 优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗对痤疮瘢痕及伴有局部色素沉着,红斑,毛孔粗大等都有较好的疗效.     

Clinical Comparison of Sclerotherapy Versus Long-Pulsed Nd:YAG Laser Treatment for Lower Extremity Telangiectases

BACKGROUND: Sclerotherapy has traditionally been considered the gold standard of treatment for leg veins, but patient fear of multiple needle injections and side effects of treatment have fueled investigation into other treatment alternatives. As a result, vascular-specific laser and light sources have been developed in an effort to treat these vessels with minimal morbidity and improved efficacy. OBJECTIVE: To compare the clinical efficacy of leg telangiectasia treatment with sodium tetradecyl sulfate sclerotherapy to long-pulsed 1064 nm Nd:YAG laser irradiation. METHODS: A series of 20 patients with size-matched superficial telangiectases of the lower extremities were randomly assigned to receive two consecutive monthly treatments with injectable sodium tetradecyl sulfate on one leg and long-pulsed 1064 nm Nd:YAG laser irradiation on the other. Patients were evaluated by two masked assessors at each treatment visit and at 1 and 3 months after treatment to assess clinical improvement within matched sites. RESULTS: Leg telangiectases responded best to sclerotherapy in fewer treatment sessions than to long-pulsed 1064 nm Nd:YAG laser irradiation. The incidence of adverse sequelae was minimal and equivocal in both treatment groups. CONCLUSION: Despite recent advances in laser technology for treatment of lower extremity telangiectases, sclerotherapy continues to offer superior clinical effect in the majority of cases. Laser leg vein treatment appears to be most beneficial in patients with telangiectatic matting, needle phobia, or sclerosant allergy.     

不同类型皮肤激光脱毛效果与并发症的探讨

目的 探讨半导体激光和长脉冲翠绿宝石激光对不同类型皮肤脱毛的效果与并发症.方法 将1103例（1760部位）按皮肤类型随机分为两组;一组使用半导体激光治疗,波长810 nm,脉宽400 ms,方形光斑12 mm×10 mm;另一组使用长脉冲翠绿宝石激光治疗,波长755 nm,脉宽20 ms,光斑直径12.5 mm,2次治疗间隔时间均为50～60 d.结果 两种治疗方法对不同类型的皮肤进行脱毛治疗,效果无明显差异,但对深肤色者,半导体激光治疗的并发症发生率低.结论 两种激光对不同类型皮肤脱毛效果相似,但半导体激光对深色皮肤的脱毛更安全.     

Comparison and sequential study of long pulsed Nd:YAG 1,064 nm laser and sclerotherapy in leg telangiectasias treatment

BACKGROUND AND OBJECTIVES: Millisecond pulsed 1,064 nm Nd:YAG lasers have been developed for the treatment of leg telangiectasias. To date there have been very few side by side comparison studies of laser versus the gold standard sclerotherapy in treating small leg veins. This study aims to compare a long pulsed Nd:YAG laser with contact cooling to sclerotherapy for treating small diameter leg telangiectasias by evaluating objective and subjective clinical effects. STUDY DESIGN/PATIENTS AND METHODS: Fourteen patients were selected with leg telangiectasias ranging from 0.5 to 2 mm at four comparable sites. One site was treated with long pulsed Nd:YAG alone, the second received sclerotherapy alone, the third laser then sclerotherapy, and the last one sclerotherapy then laser. The patients were followed up at 3 months after the last treatment. Photographs were taken pre-operatively and at 3 months after the last session. They were used for objective and comparative analysis. Statistical analysis was performed using Friedman's test controlling for subject. RESULTS: Improvement was tabulated from the photographic assessment on an improvement scale from 0 (no change) to 4 (greater than 75% clearing). There were clinical improvements in the laser group than sclerotherapy without statistical significance. Side effects were minimal and included hyperpigmentation. CONCLUSIONS: This pilot study demonstrates that the Smartepil LS long pulse Nd:YAG 1,064 nm laser can yield results similar to sclerotherapy in the treatment of small leg telangiectasias. Combination of both methods could increase response to treatment.     

A split-face study: comparison of picosecond alexandrite laser and Q-switched Nd:YAG laser in the treatment of melasma in Asians

To evaluate efficacy and safety of picosecond 755 nm alexandrite laser as compared to 1064 nm QS-Nd:YAG laser for melasma treatment in Asians. Twelve patients received 4 sessions of treatments at 1-month interval in a split-face manner. The right side of each patient’s face received 755 nm picosecond laser, and the other side received 1064 nm QS-Nd:YAG laser. Zoom handpiece of 755 nm picosecond laser at fluence of 0.88–1.18 J/cm² was applied. The treatment protocol used for 1064 nm QS-Nd:YAG laser was 8 mm spot size at fluence of 2.0 J/cm² initially followed by 6 mm spot size at fluence of 3.5 J/cm², and finishing with 4 mm spot size at 3.2 J/cm². For both 755 nm picosecond laser and 1064 nm QS-Nd:YAG laser, the endpoint was mild erythema and swelling without petechiae. Objective evaluation with visual analogue score was conducted by two independent physicians. Subject self-assessment for each patient was conducted as well. Statistical results showed that higher pigmentation clearance rate was achieved at the 755 nm picosecond laser side after the second treatment. At the 3 months follow-up, greater clearance was observed at the 755 nm picosecond laser side compared to the 1064 nm QS-Nd:YAG side. 755 nm alexandrite picosecond laser has been observed to achieve a faster and better clearance rate for melasma compared to 1064 nm QS-Nd:YAG laser. We conclude that the 755 nm picosecond laser could be a safe and effective modality for melasma treatment in Asians.