Results of the treatment of cutaneous vascular lesions by method of selective laser coagulation with Yachroma-Med copper vapor laser

Results of the treatment of cutaneous vascular lesions by method of selective laser coagulation with Yachroma-Med copper vapor laser
Igor Danischuk M.D. Head of Medical Cosmetology Department of the Central Scientific Research Institute of dermatology and Venerology, Moscow Russia, Head of the Laser Aesthetic Surgery and Cosmetology Center Ideal-Lik
P.N.Lebedev Physical Institute of the Russian Academy of Science

Results of the treatment of cutaneous vascular lesions by method of selective laser coagulation with Yachroma-Med copper vapor laser
Among the patients desiring to remove their skin vascular lesions 60% have telangiectasias of face and neck, about 20% have telangiectasias of legs and from 8 to 10 % of they suffer of Ïport wine stains" and others are with hemangiomas.

Picture 1. Distribution of diagnosis among the patients desiring to remove their skin vascular lesions

Patients with facial telangiectasies

Patients with legÌs telangiectasies

Port wine stains

Hemangiomas

Before the treatment the patients skin in the treatment area must be not insolated because melanin absorbs the laser radiance and prevents the laser light penetration into the skin to target abnormal vessels. Two weeks after treatment the patients must avoid a sun exposure or use sun protective cream with factor of protection 15 or greater.
The coagulation is performed by the method Ïfrom point to pointÓ. The distance between the treatment points is from 0.5 to 1 mm. When lesion on the face is treated we use laser power from 0.8 to 1.2 Watt and exposition time from 0.1 to 0.2 seconds, which correspond to 10 - 15 J/cm2.

The treatment area of port wine stain treated during one session is no more than 20 cm2. Due to this area restriction the healing time is shorter and swelling is smaller.

When leg telangiectasia is treated we use laser power 1,2 - 1,7 Watt and exposition time 0,2 - 0,4 seconds, which correspond to 15 - 30 J/cm2. Two or three sessions usually need for the treatment of facial telangiectasia and up to five sessions for the treatment of leg one. The time between sessions is 2 - 3 months. When children are treated we use laser power 0.2 - 0.3 Watts less than for adults.

For the treatment of port wine stain it can be needs from two to eight sessions.

To assess the result of the treatment of skin vascular lesions the next criteria are used:

Complete removing the pathology;
Notable removing the pathology;
More than 50% disappearance of abnormal vessels;
Without changes.
Effectiveness of the treatment of facial telangiectasies
Diagram 1. Facial telangiectasia

Complete removing the pathology;

Notable removing the pathology;

More than 50% improvement

Negligible improvement

Now let see a diagram. 92% of the patients with facial telangiectasia showed complete and notable removing the pathologies. Only 3% of the patients ware resistant to the treatment. Resistant patients had telangiectasia of nasal alae. Note that 45% of the patients with facial telangiectasias have lesion on the nose.

Diagram 2. Nasal telangiectasia

This diagram represents the results of the treatment of nasal telangiectasias. Complete and notable removing the pathologies achieved in 93% lesions.

The next diagram 3 show effectiveness of a nasal alae telangiectasia treatment.

Diagram 3. telangiectasia of nasal alae

Almost all the patients with facial telangiectasia satisfied of the treatment results.

Effectiveness of the treatment of low extremity telangiectasies
Diagram 4.

Complete removing the pathology;

Notable removing the pathology;

More than 50% improvement

Negligible improvement

4 diagram represents the effectiveness of the treatment of leg telangiectasias. Patients with venous telangiectasias which diameter is less than 0.6 mm are revealed complete disappearance of the pathology. Notable removing the pathology is achieved in 27 % occurrences. 4% of the patients show more than 50% disappearance of abnormal vessels and 4% show results assessed as without changes. Laser coagulation is less effective in case of leg telangiectasias which diameter is more than 0.6 mm. Sclerotherapy is applied to these patients.

Effectiveness of the treatment of port wine stains and hemangiomas

Photo represents port wine stain after one treatment with the copper vapour laser Yachroma-Med Ò cheek have been treated. The scheme of the treatment when treated areas are not overlapping is well seen. You see fare spots on the skin after the treatment. During one session only about 20 cm2 area is treated.

On the 3d day after the port wine stain treatment the treated skin is covered by scrubs and healing continue under the scrubs. In 2 - 3 months the skin color become normal which attributed to normal patients skin. At the moment the treatment of the patients showed on photo is continued. The treatment of adult patients with port wine stain may continue two years.

Diagram 5.

Complete removing the pathology;

Notable removing the pathology;

More than 50% improvement

Negligible improvement

Now let see a diagram representing the effectiveness of the treatment of port wine stains and hemangiomas. 78% of the patients achieved notable disappearance of the pathology. However 6% of the patients are resistant to the therapy. These data are in accordance with statistical data being represented in articles in international periodical publications.

After materials of the report about Yachroma-Med CVL treatment of cutaneous vescular lesions by Igor Danischuk.