Randomized controlled trial: Comparative efficacy for the treatment of facial telangiectasias with 532 nm versus 940 nm diode laser.

BACKGROUND While the 532 nm wavelength has been demonstrated to be effective for facial telangiectasias, 940 nm is a novel wavelength which has only been reported in case reports. While both the 532 and 940 nm wavelengths are effective for facial telangiectasias, we lack evidence to support whether one wavelength is superior. STUDY DESIGN Randomized, blinded split-faced trial for the 532 and 940 nm diode laser wavelengths. Side effects of erythema, crusting, swelling, and blistering (0-5 scale, 0 = not present, 1 = trace, 5 = severe) were assessed. Prior to treatment and at 2 months after a series of two treatments, telangiectasias were assessed (1-10 scale, 1 = focal telangiectasias, 10 = diffuse telangiectasias). Assessment of the degree of improvement in facial telangiectasias was performed by two blinded non-treating physician evaluators from patient photographs. RESULTS A total of 24 facial anatomic sites were treated with the 532 and 940 nm wavelengths. Presence and severity of side effects of erythema, crusting, swelling, blistering (0-5 scale, 0 = not present, 1 = trace, 5 = severe) were assessed. Pain associated with the laser treatment was rated as significantly less for the 940 nm wavelength relative to the 532 nm wavelength. Erythema post-treatment was significantly less with 940 nm relative to 532 nm. Significant crusting and swelling were only reported with the 532 nm wavelength. The mean percentage improvement with the 940 nm wavelength (63.0%) was greater than that achieved with the 532 nm wavelength (47.8%) (P<0.05). On photographic evaluation, 940 nm was significantly more efficacious for larger caliber vessels than 532 nm. Both wavelengths were equally efficacious for smaller caliber vessels. CONCLUSIONS While both 532 and 940 nm diode laser produced significant improvement in facial telangiectasias, greater efficacy was found with 940 nm as well as a significantly more tolerable side effect profile. Lasers Surg. Med. 41:555-562, 2009. (c) 2009 Wiley-Liss, Inc.