Histological findings correlated with clinical outcomes in telangiectasia treated with ohmic thermolysis and 940 nm laser

• Published in: Journal of cosmetic dermatology Vol. 17; no. 5; pp. 779 - 782
• Main Authors: Bush, Ronald, Bush, Peggy
• Format: Journal Article
• Language: English
• Published: England 01.10.2018
• Subjects: Electrocoagulation - methods; Humans; Laser Coagulation - methods; Radiofrequency Therapy - methods; Sclerotherapy; Skin - pathology; Telangiectasis - pathology; Telangiectasis - therapy
• ISSN: 1473-2130; 1473-2165
• DOI: 10.1111/jocd.12761

Summary Background Heat modalities are commonly used as either primary or adjunctive treatment for telangiectasia. Minimal information is available as to the nature of injury to the vessel and surrounding tissue. Method A total of 135 patients were treated over a 2‐year period using ohmic thermolysis (45), 940 nm laser (50), and 940 nm laser with sclerotherapy (40). After treatment, 1 mm biopsies were done in selected patients in each group. Clinical correlation was studied in each group by observing vessel response at 4‐6 weeks postprocedure. Results Ohmic thermolysis produces electrodessication of the squamous epithelium, reticular dermis, and fusion of the target vessel. 940 nm laser results include squamous epithelial damage, subcutaneous water blister, collagen denaturation, and vessel endothelial cell loss with thrombus at point of maximal impact. The addition of sclerotherapy at time of laser potentiates vessel damage. There was no long‐term skin sequelae after treatment when each device is used at recommended settings and on appropriate vessel size. Conclusion Each device causes damage to the squamous epithelium and papillary reticular dermis that is transient. Ohmic thermolysis provides vessel clearance of >90% in telangiectasias <0.5 mm. 940 nm laser effectiveness is <70% for vessel clearance, but improves to >90% when sclerotherapy is performed at time of treatment.