Treatment of spider veins of the lower extremity with a novel 532 nm KTP laser

BACKGROUND AND OBJECTIVES:
This study investigated a novel, high-power, 532 nm frequency-doubled Nd:YAG, KTP laser with contact cooling for the treatment of spider veins of the lower extremities.


STUDY:
Twenty female subjects with Fitzpatrick skin types I-III, were treated to 79 sites using the 532 nm wavelength of a dual-wavelength 532/1,064 nm laser (Excel V, Cutera, Brisbane, CA) with a 5 mm-diameter spot, fluences ranging from 13 to 15 J/cm(2) , and a pulse-duration of 40 milliseconds. Two treatments were performed 12 weeks apart. Photographs were taken at baseline and 12 weeks following the final treatment. Improvement was assessed by two independent physicians reviewing photographs in a blinded fashion using a 5-point improvement scale.

RESULTS:
All subjects demonstrated improvement resulting in a median improvement of 2.5 (one-sample Wilcoxon signed rank test, 95% CI: 1.9-2.9, P = 0.000). The reviewers were highly consistent (kappa of 0.85), and highly accurate (kappa of 0.85) in identification of "after photograph" and they were highly consistent in grading improvement. Subjects and the treating physician reported "significant" to "very significant" (∼51 to 100%) improvement in 75% and 69% of subjects, respectively. Post-inflammatory hyper-pigmentation was seen in 2% of sites (1/64). No serious adverse effects reported. All subjects tolerated the treatments well (mean pain score of 2.9/10).


CONCLUSION:
Treatment of spider veins of the leg with a novel 532 nm KTP laser was found to be safe and effective, with minimal discomfort and adverse effects in Fitzpatrick skin types I-III.

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