Treatment of Reticular Veins with a Long-pulsed 1064 nm Nd:YAG Laser: a Pilot Study

Sclerotherapy is the gold-standard treatment for reticular veins. However, this method is invasive and characterized by high incidence of persistent hyperpigmentation. A long-pulsed 1064-nm Nd:YAG laser seems to be more suitable for reticular veins. Objective. To calculate the optimal Nd:YAG laser parameters for reticular vein treatment and check their efficacy and safety. Material and methods. A pilot study included female volunteers aged 30-67 years with C1 reticular veins who were treated with 1064 nm Nd:YAG laser. Disappearance of vessels and side effects were analyzed after 1, 2 and 6 months using a 6-point scale (0 — no change, 5 — no vein). Pain sensation was measured using the Visual Analogue Scale (VAS). Outcome satisfaction was assessed using a 3-point scale (from 0 to 2), skin hyperpigmentation — using skin hyperpigmentation index (SHI). Results. The following laser parameters for reticular veins were established: spot size — 7 mm, pulse length — 50 msec, energy — 140 J/cm2. Seven female volunteers completed 6-month follow-up. The median score of vessel clearing (interquartile range, IQR) was 5 (3—5) after six months, patient satisfaction — 1.5 (1—2) points, pain during the procedure — 5 (2.5—5.75) points. Hyperpigmentation was observed in 6 patients (86%) after one month and in 4 patients (57%) after six months. There was moderate hyperpigmentation after treatment and mild by the end of the follow-up (SHI 1.09 (1.01—1.125)). Telangiectatic matting developed in one patient. There were no other side effects. Conclusions. Reticular veins of the lower extremities can be treated using the Nd:YAG laser with the specific parameters calculated for reticular veins during the study. But hyperpigmentation occurs frequently and persists for six months and more, perhaps the same as after sclerotherapy. A comparative study of the Nd:YAG laser with sclerotherapy alone and a combined treatment of the Nd:YAG laser and sclerotherapy needs to be carried out.