Treatment of Facial Telangiectasia Using Long- Pulsed Nd:YAG Laser

Facial telangiectasia, commonly known as spider veins, are dilated superficial dermal blood vessels that represent a frequent cosmetic concern. Conventional therapies such as sclerotherapy, electrocautery, and intense pulsed light have limitations, while vascular lasers, particularly long- pulsed Nd:YAG, offer deeper penetration and reduced risk of pigmentary changes, making them suitable for treatment in darker skin types. This study aims to evaluate the efficacy, safety, and tolerability of long-pulsed ۱,۰۶۴-nm Nd:YAG laser in the treatment of facial telangiectasia. This prospective interventional-based study was conducted at Erbil Dermatology Teaching Center, Iraq. Thirty-four patients with facial telangiectasia were enrolled. Demographic and clinical data were recorded, and baseline assessments included telangiectasia quantification using a novel Telangiectasia Area Involvement Score (TAIS) (range ۰–۷). All patients underwent up to four treatment sessions of the affected areas with a long-pulsed ۱,۰۶۴-nm Nd:YAG laser (spot size ۲ mm, fluence ۱۴۰ J/cm², handpiece ۲ mm, frequency ۲ Hz, and pulse duration ۲۰ ms with dynamic cold air cooling) at two-week intervals. Clinical outcomes were evaluated by changes in TAIS scores, and adverse events were documented after each session and at follow-ups. The treatment endpoint was defined as a change in vessel coloration, disappearance, or inability to refill. The study population (n=۳۴; mean age ۴۲.۸ ± ۹.۹ years; ۷۳.۵% female) demonstrated high treatment tolerance, with no cases of poor tolerance or serious adverse effects. Immediate reactions at ≤ ۱ hour were limited to erythema in all of the patients, which resolved spontaneously with cold air cooling. Post-treatment adverse reactions at ۱ hour to ۱۴ days were minimal and were limited to transient erythema only (۷۶.۵%), burning/stinging (۸.۸%), or erythema and burning (۱۴.۷%), all of which resolved within ۴۸ hours with symptomatic care. These reactions steadily decreased across the treatment sessions. Complete clearance of telangiectasia was achieved in ۵۸.۸% of patients, while ۴۱.۲% showed partial reduction after treatment. There was a statistically significant progressive reduction in mean telangiectasia grades, from ۰.۹۹۱ ± ۰.۰۹۹ at baseline to ۰.۱۲۴ ± ۰.۰۲۴ after the fourth session (p < ۰.۰۰۱). Long-pulsed ۱,۰۶۴-nm Nd:YAG laser is a safe and effective modality for facial telangiectasia, achieving high clearance rates with minimal, transient side effects.

کلیدواژه ها:

Facial telangiectasia ، Nd:YAG Laser ، Vascular lesions