Treating facial veins with Nd: YAG laser

Treating facial veins with Nd: YAG laser
Apr 1, 2006
By:Karen Nash
Advanstar Communications, Inc

National report Û Facelifts may give a person a renewed youthful appearance, but they can also have an unpleasant side effect Û the development of noticeable, large, blue veins. Temple veins, especially, tend to become more prominent after facelift procedures.

A number of therapies are used to reduce the evidence of the veins Û sclerotherapy and surgical methods. Arielle N.B. Kauvar, M.D., specializing in cosmetic dermatology and Mohs micrographic surgery, and a clinical associate professor at New York University, says the treatment of the veins with the Nd:YAG laser (FriendlyLight) does an excellent job of destroying the veins in a painless and safe way Û offering several advantages over other options.

"Sclerotherapy injections carry certain risks," she tells Dermatology Times. "Sclerotherapy carries a risk of causing skin ulcerations when the sclerosant diffuses into the skin. When detergent solutions are used at high volumes or concentrations, backflow into the ophthalmic artery carries a risk of retinal changes and blindness. The surgical method of direct cautery and transection can cause scars and the veins have a high recurrence rate."

Dr. Kauvar says the YAG laser can be used safely as long as it is not used within 1 cm of the orbital rim where there would be a risk of light being transmitted to the eye.

She says the procedure is virtually painless and causes no patient down-time.

At the American Society for Dermatologic Surgery meeting in Atlanta, Dr. Kauvar outlined the method she uses for removing the veins.

"We treated veins measuring 1 mm to 3 mm on the temporal region, forehead, nasal dorsum and cheek. No anesthetic was required. We used the Nd:YAG laser (Laserscope Gemini) with a sapphire-chilled tip. The parameters we use are a 3 mm spot size, a 50 ms pulse duration, and a fluence of 150-250 J/cm, depending on the size of the vein. The way we perform the treatment is to apply laser pulses along the length of the vessel with about 1 mm to 3 mm of space between each laser pulse."

Contiguous, non-overlapping pulses must be applied to prevent excessive tissue heating, which can occur with a long pulsed Nd:YAG laser, and a risk of vesiculation and ulceration. The endpoint of treatment is complete vessel blanching.

If any portions of the vein are visible ...