Optimal Management of Facial Telangiectasia

Research paper by Mitchel P. Goldman

Indexed on: 21 Aug '12Published on: 21 Aug '12Published in: American Journal of Clinical Dermatology


Telangiectasia can be treated with many different modalities. Electrosurgery is effective but dependent on technique. Sclerotherapy can be used on larger blue telangiectasia but may be complicated from inadvertent injection into arterioles. Surgical phlebectomy can be used on reticular veins but is technically difficult. Many different laser wavelengths can be successfully used to minimize and/or eliminate vascular lesions on the face. Each type of laser has advantages unique to its profile of wavelength, pulse duration, spot size and cutaneous cooling. The benefits of using 532–595nm lasers are the multiple applications of these lasers on treating not only telangiectasia, but also pigmentation and even fine wrinkles. Newer methods of cutaneous cooling and lengthening of pulse duration make these lasers less painful with fewer adverse effects (purpura) than previous lasers. The benefit in using a 1064nm laser is that its longer wavelength can penetrate more deeply, allowing effective thermosclerosis of vessels up to 3–4mm in diameter. In addition, the 1064nm wavelength permits treatment of patients of skin types I–VI with or without a tan, since melanin absorption is minimal.