title: Long-pulsed dye laser treatment for facial telangiectasias and erythema: evaluation of a single purpuric pass versus multiple subpurpuric passes.
abstract: OBJECTIVE
  Subpurpuric treatments with the pulsed dye laser can be effective for treatment of vascular lesions, although less so than when purpuric fluences are used. Increased efficacy may be achieved by performing multiple passes at the time of treatment. We performed a split-face bilateral paired comparison of multiple low-fluence subpurpuric passes compared with a single high-fluence purpuric pass in the treatment of facial telangiectasias.
  
  
  METHODS
  Nine patients were included in the study. One cheek was chosen to be treated with four passes of a nonpurpuric fluence, and the contralateral cheek was treated with a single purpuric pass. Reductions in vessel density, diameter, arborization, and background erythema were evaluated 3 weeks after treatment.
  
  
  RESULTS
  We found a 43.4% reduction in surface area covered by telangiectasias on the cheek treated with a single purpuric pass compared with 35.9% on the cheek treated with four subpurpuric passes. The purpuric fluences produced greater reduction in vessel diameter and arborization, whereas the subpurpuric protocol was more effective in reducing background erythema. Purpuric fluences were also noted to produce more significant edema and transient hyperpigmentation in one patient.
  
  
  CONCLUSIONS
  The multipass subpurpuric approach to treatment with the pulsed dye laser is both cosmetically acceptable and effective, although purpuric treatments may be required to effectively eliminate larger-caliber, more highly networked vessels.
authors.affiliation: University of California, Los Angeles, CA, USA.
authors.forename: Shilesh
authors.initials: S
authors.lastname: Iyer
authors.forename: Richard E
authors.initials: RE
authors.lastname: Fitzpatrick
mesh_terms: D004890:Erythema / Q000473:pathology / Q000532:radiotherapy*; D005148:Facial Dermatoses / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D011693:Purpura / Q000473:pathology; D012720:Severity of Illness Index; D013684:Telangiectasis / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome