Telangiectasia treatment with the copper vapor laser
Yachroma-Med
The term telangiectasia originated from three Latin words: tel,
angio, ectasia which denote tip, vessel, enlargement respectively.
Telangiectasias can be classified into three large groups:
"spider" or "star", linear and arborizing
telangiectasias.
A"spider" telangiectasia develops in children and
teenagers. It rear occurs in adults. A "spider"
telangiectasia is looked as a large main vessel with smaller
"legs" around it.
On the photos you can see the linear and the arborizing
telangiectasia, which looked as a tree. This forms consist of
the vessels of similarly diameters. Leaner and arborizing
telangiectasia usually develops in adults.
Telangiectasias localize as a rule on face and legs.
Diameters of the ectatic vessels are from 0.1 to 1 mm on the
face and from 0.1 to 3 mm on the legs.
The most patients, who come to clinics of dermatology and
aesthetic surgery, are patients with telangiectasias.
Telangiectasia is term for ectatic vessels of skin, which are
located on face and neck or on legs, in about of 60% and 20% of
cases respectively.
About 30 % of fare skin population suffer from the
telangiectasias.The most common factor in occurrence of facial
telangiectasia is weakness of the vessel walls due to chronic
sun exposure. Genetic predisposition, liver disease, surgical
trauma, radiation therapy, chronic steroid use, deep chemical
peeling of the face may also play a role.
Methods of removing telangiectasias may be
selective and non selective. Some years ago a common method was
electrocautery. Electrode may equally destroy ectatic vessel and
adjacent normal tissue. Thus scars, hipo- and hiper-
pigmentation may occur after electrocautery.Most physicians
consider that non-selective methods are not suitable for the
vascular and pigmented skin lesions removing in case of facial
location.
Selective laser coagulation is based on the concepts of
selective photothermolysis. Abnormal vessels selectively absorb
laser light and warmed. The vessel temperature increases to 60
- 70 Grad C causing the abnormal vessels destruction. Adjacent
tissue far less absorbs light of "vascular" laser and
don't injuring. Thus light of "vascular" laser may
selectively destroy of abnormal tissue. The treatment is
accurate as in microsurgery. Radiance of "vascular" laser
must have the characteristics to provide the selective
destruction of telangiectasias.
Effectiveness of the treatment depends of the laser radiation
parameters. Such parameters are
-
Wavelength -
 -
Laser power - P,
-
Laser light spot size: diameter d and
square - S,
-
Exposition time - T,
-
Fluence F = P*T/S .
One of the best "vascular" laser is a copper vapor laser
which can provide the optimal combination of treatment
parameters. For the copper vapor laser "Yahroma-Med"
(manufactured by P.N. Lebedev Physics Institute, Moscow, Russia)
great investigation work have been fulfilled to determine the
parameters, mode and schemes of the treatment of vascular
lesions and telangiectasias in particular. Articles and The
Methodology (Edited by Russian State Medical University) became
the results of this work.
To appreciate the results of telangiectasia removing two
criteria are used:
-
Effectiveness,
-
Lack of complications.
Main features of using the copper vapor laser
"Yahroma-Med" for the successive treatment of
telangiectasias are
-
shot exposure time provided by mechanical shutter,
-
laser light spot, which according to size of vessels,
-
steady light spot on the patient skin
-
some untreated area around every treatment point.
Adult patients tolerate the treatment of telangiectasias with
the copper vapor laser "Yahroma-Med" without anesthesia.
Local anesthesia can be required for the most sensible patient.
The treatment with other "vascular" laser available on the
market is more painful. The patients suffer no pain after the
procedure.
Middle erythema can occur during two hours after the
treatment. After the copper vapor laser treatment scabs can be
noted along treatment vessels can be noted. They spontaneously
resolve during 3 to 7 days. However many physicians using
Yahroma-Med choose such laser parameter that scabs can't be
noted at all. On photos 1 and 2 you can see the patients before
and a day after one treatment session with Yahroma-Med.
Complete or almost complete clearance achieved in 90% of
patients. Telangiectasias on cheeks are usually easy to treat.
Telangiectasias of nasal alae are more complicated for treatment
and required particular caution. Some patients with
telangiectasias of nasal alae may be resistant to the treatment
(about 4%).
Abnormal vessels disappear during the treatment. Most
abnormal vessels disappeared after one treatment but not all
vessels. Appearance of the patients notably improved (photo 1
and 2). Many patients satisfied by the results of one treatment.
However two or tree treatments may be require for removing all
ectatic vessels.
New ectatic vessels can began to appear in some years if the
patient predisposed to telangiectasia. In the beginning they may
be easy removed by laser. If the patient avoid the factor, which
play a role in occurrence of telangiectasias, ectatic vessels
may not appear at all. |
