Telangiectasias - venulectasias, phlebectasias - are venous, capillary, arterial and arteriovenous dilations of the sub papillary dermal plexus and in the majority of the cases are a peripheral expression of the varicose disease.
Strongly hated by the female sex as the so-called leg capillaries, after an accurate anamnesis and a precise diagnosis with haemodynamic study, they can be treated with different laser methodologies: exclusively transdermal for isolated and superficial vessels or combined to endoluminal photocoagulation on deeper vessels - FLEBOLASER/FTF System – LASEmaR® 800.
The high incidence of relapses (+50%) leads to the continuous research of mini – invasive therapies, efficient, without complications which permit fast recovery, better life standards and permanent results.
The transdermal laser treatment of telangiectasias of the lower limbs - also known as percutaneous, transcutaneous or exodermic treatment - which has required over the last years poorly penetrating and more selective wavelengths of yellow—green color (532, 577, 585 nm) working according to the principle of selective photothermolysis, has changed to close N.IR wavelengths (808,940,1064nm) which are considerably less selective on the hemoglobin optic baits, but more penetrating (3-4mm).
To induce the vessel parietal photocoagulation, these radiations need long pulses (50-100ms) depending on the parietal thickness, with a sufficient thermal damaging time (TDT) associated to a local epicutaneous cooling and more sessions.
The most complete solution suggested by Eufoton® for the vascular transdermal treatments of the limbs includes three solutions:
Green laser LASEmaR® 500 - 532nm for smaller superficial teleangectasias of red colour – matting, for the post-sclerosis superficial hemosiderin pigmentations. This device is extremely useful for all the superficial vascular applications most dermatologically relevant (facial teleangectasias, spider naevus, erythrosis, rosacea, klippel trenaunay syndrome, plan, cherry angiomas).
LASEmaR® 800808nm for the transdermal treatment of venules at higher concentration of deoxyhemoglobin (blue/ purple color). A valid and modern alternative to chemical sclerosis of deeper telangiectases, which can not be transdermally treated, is the endoluminal perivenous photosclerosis through optical fibers of 200μ.
LASEmaR® 940940nm for the exclusively transdermal treatment of violet or blue venulectasias, which contain more deoxyhemoglobin (blue colour).
Laser treatment of hemosiderin pigmentations
After treating reticular and teleangectatic varicose veins with sclerotherapy, the patient can experience an aesthetic complication represented by hemosiderin dermo – epidermic pigmentations.
The pigmentation from sclerosis of bigger trunks is obviously deeper.
The therapy of pigmentations post sclerosing can be chemical or physical.
Chemical exfoliating substances such as trichloroacetic acid, retinoic, phenol, EDTA etc., can cause post-flogistic pigmentations, burns, infections, depigmentations and imperfect scars.
The ideal physical therapy uses Q-Switch laser, however LASEmaR® 500 represents an excellent alternative thanks to the wavelength near to that of the cromophoric spectrum of hemosiderin pigmentations (477 nm) and, when used with fractional scanner Lightscan™ determines a fractional selective phototermolysis, which is very superficial. The instrument simplifies enormously the operator in distributing the energy which vaporizes the pigments on wide surfaces.
Because of its fast execution, absence of bleeding, infections, pain, repetitiveness and poor erythema, it is an efficient treatment for the post inflammatory, sclerotherapic and superficial traumatic pigmentations.
