Riding the wave: Newer, innovative laser technologies treat vascular lesions

Key Points

Paris - Laser and light technology has been used for over two decades in the treatment of vascular and pigmented lesions.

"The 595 nm and 1,064 nm wavelengths have proven themselves to be very effective in the treatment of vascular lesions.

Cynergy laser

Cynergy laser from Cynosure is a top-of-the-line laser that can emit both of these wavelengths in close tandem, effectively treating all types of vascular lesions.

Dr. Goldberg says that both the 595 nm and 1,064 nm wavelengths are differently absorbed by hemoglobin.

The 595 nm wavelength is fired into a vascular lesion, transforming the hemoglobin to met-hemoglobin. The 1,064 nm wavelength, which is immediately fired in tandem following the 595 nm, is not only absorbed by the hemoglobin but also by met-hemoglobin.

This combined synergistic effect of the Cynergy laser leads to a better, more effective treatment of some difficult-to-treat vascular lesions.

Historically speaking

Dr. Goldberg says that newer wavelengths between 940 nm and 980 nm have also been pioneered for the treatment of vascular lesions and seem to be very effective in the treatment of facial telangiectasias.

The KTP laser (532 nm) has been used historically, achieving good cosmetic results. The problem with the KTP laser is that it does not penetrate very deeply.

Several years ago, the advent of the 1,064 Nd:YAG laser appeared to help in treating some of these more difficult facial vessels.

However, this laser proved to be somewhat less forgiving for the less-experienced physician, as one could easily penetrate too deep and create pits in the target area.

"There has been a move now in the last few years to create something in between - with the effectiveness of 1,064 nm of the Nd:YAG laser and the safety of the 532 nm KTP laser.

"The compromise was found in the 940 nm and 980 nm wavelengths," Dr. Goldberg tells Dermatology Times.

V-Raser, VariLite

HOYA ConBio came up with the V-Raser, which features a 980 nm wavelength, and Iridex produced the VariLite laser, which combines 532 nm and 940 nm wavelengths.

Both devices have proven very effective for both red and blue vascular lesions around the nose and cheek area.

According to Dr. Goldberg, both of these lasers combine the safety of the 532 nm KTP laser with some of the greater depth that is achieved with the 1,064 nm lasers, also providing greater safety.

Veinwave

Another new development is the Veinwave - a technology that treats vascular lesions with microwaves, not light.

This treatment works on the principle of thermo-coagulation, in which the microwaves heat the vascular lesion without affecting the skin itself.

Dr. Goldberg says this novel treatment is also very effective for facial telangiectasias.