How efficient is laser therapy for telangiectasias, spider veins, and cherry angiomas?—A study using dynamic optical coherence tomography

Abstract

AbstractObjectivesA clinical study to investigate the effectiveness of pulsed dye laser (PDL) versus Nd:YAG laser in the treatment of telangiectasias, spider veins and cherry angiomas. Dynamic optical coherence tomography (D‐OCT) was introduced as an innovative follow‐up tool for evaluation of blood flow within superficial vessels and to allow visualization of morphological changes of the vasculature in vivo. The final aim of this study was to demonstrate a possible treatment benefit comparing both laser types.Materials and MethodsVessel structures of 102 skin lesions were documented photographically and dermoscopically. Subsequently, lesions were imaged using optical coherence tomography before laser therapy (a), directly after the treatment (p) and after a follow‐up 4–6 weeks after laser treatment. All lesions were treated using either a 595 nm PDL or a 1064 nm Nd:YAG laser. Two main vessel parameters, namely density and diameter, and their possible changes during follow‐up were observed in 150/300/500 µm penetration depth using D‐OCT and were subsequently compared between both treatment groups. Other analyzed vessel parameters were depth of the plexus, mean diameter, mean density, top edge of the vessel, columns, and spikes.ResultsBoth laser types are suitable options for the treatment of vascular skin lesions, with the most significant effect on cherry angiomas. PDL shows better results treating smaller vessels in upper skin regions, in comparison to Nd:YAG laser, achieving better results on deeper vessels, like spider veins. Using the applied laser settings, there was no statistically significant effect on telangiectasias.ConclusionD‐OCT represents a new, noninvasive imaging method to evaluate blood flow and vessel morphology in the follow‐up of telangiectasias, spider veins, and cherry angiomas, which underwent laser therapy.