Q-Switched Ruby Laser Treatment for Postsclerotherapy Hyperpigmentation

BACKGROUND: One of the most common adverse sequelae of sclerotherapy is cutaneous hyperpigmentation. OBJECTIVE: We used the Q-switched ruby laser to treat postsclerotherapy hyperpigmentation. METHODS: Eight patients developed pigmentation lasting more than 1 year (1-2 years on average) after sclerotherapy treatment for reticular and telangiectatic veins in the legs ranging in size from 0.2 to 4 mm in diameter. All patients were treated with a Q-switched ruby laser at 694 nm, 4 mm beam size, and fluence range of 5.6-10.5 J/cm2. RESULTS: Ninety-two percent of lesions lightened after treatment. There was significant (75-100%) resolution of hyperpigmentation in 58% of treated areas, 25% improvement in 33% of treated areas, and no improvement in the remaining areas. CONCLUSION: Our impression is that given a choice of lasers, the Q-switched ruby laser provides the greatest efficacy for treating postsclerotherapy hyperpigmentation.