title: The new-generation, high-energy, 595 nm, long pulse-duration, pulsed-dye laser effectively removes spider veins of the lower extremity.
abstract: OBJECTIVE
  Lower-extremity spider veins are a cosmetic problem that poses formidable clinical difficulty for laser removal. They are significantly harder to remove than facial telangiectasias. A new-generation, pulsed-dye laser (PDL), capable of administering pulses that clinically behave like true 40-millisecond pulses has been developed, by doubling the number of sub-pulses comprising each laser pulse.
  
  
  METHODS
  Fifteen subjects with Fitzpatrick skin types I-III were enrolled in the study and treated to 35 sites. Subjects were treated three times at 6-week intervals using an average fluence of 20.4 J/cm(2), a 3 x 10 mm spot, and a dynamic cooling device to protect the epidermis. Digital photographs were taken before initiating treatment and 8 weeks following the final treatment.
  
  
  RESULTS
  Mean improvement scores using a 4-point scale as rated subjectively by the treating physician were 0.92 (<25%), 2.7 (approximately 40-50%), and 3.6 (approximately 65-75%), 6 weeks following 1st and 2nd treatments and 8 weeks following the 3rd and final treatment, respectively. Improvement was also determined by three physicians, rating digital photographs and blinded as to which photographs were pre- or post-treatment. They rated improvement as mild (0-25%) in 10.5% of photographs, moderate (26-50%) in 15.2%, marked (51-75%) in 38.1%, and excellent (76-100%) in 6.3%. There was no textural change in any treatment site.
  
  
  CONCLUSIONS
  The new-generation, high-energy, 595 nm, long pulse-duration, PDL effectively removes lower-extremity spider veins in subjects with skin types I-III.
authors.affiliation: Laser Surgery and Cosmetic Dermatology Centers, Bryn Mawr, Pennsylvania, USA. dermguy@hotmail.com
authors.forename: Eric F
authors.initials: EF
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000368:Aged; D004487:Edema / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D053685:Laser Therapy; D035002:Lower Extremity; D008875:Middle Aged; D017060:Patient Satisfaction; D010781:Photography; D011693:Purpura / Q000209:etiology; D012867:Skin / Q000528:radiation effects; D013684:Telangiectasis / Q000628:therapy*