Which laser to get rid of Telangiectases under nose? (photo)

Question

I'm 41 years old and have had Telangiectases under my nose since I was a teenager. I've had several consultations about my Telangiectases and all are pushing the laser that is in there office and all these offices have different lasers. How do I know which laser will get rid of my Telangiectases? How do I find out how experienced someone is in lasers?

Kristin M. Baird, MD · Answer

The most effective treatment for perinasal telangiectasia is a vascular laser. The most effective vascular lasers are the Excel V 532nm KTP laser and the pulsed dye 595nm laser. The vessels around the nose can be more resistant to treatment and tend to recur so numerous treatments are usually required. Once the vessels are treated maintenance treatments are needed to address recurrences. Bruising and mild swelling may occur at the time of treatment. Please consult a board certified dermatologist or plastic surgeon experienced in vascular lasers. Best wishes.

Richard Ort, MD · Answer

The red veins under the nose can be treated with a number of lasers, including pulsed dye laser (585-595 nm), KTP laser (532 nm), infrared laser (940 or 1064 nm), or IPL.  There is a fairly high risk of recurrence with these types of veins no matter what laser is used.  Treatment can usually be repeated if needed.  The success and safety of laser treatment is largely determined by the doctor who does the treatment.  In my hands I would likely start with the 940 nm laser with small spot size (0.7 or 1 mm) to trace out the veins.  If the veins proved resistant, I would use the pulsed dye laser which is still the gold standard for vascular lesions.  The downside to pulsed dye laser is that it causes bruising or purpura for a few days but this always goes away.  Make sure to see a laser specialist and not just someone who dabbles in laser.Regards,Dr. Ort

Matthew Elias, DO, FAAD · Answer

Thank you for your question.  The Excel V is the current gold standard laser for treating vascular issues like telangiectasias.  In the past the Pulsed Dye laser was the gold standard, however it has been surpassed by the Excel V in efficacy, safety, tolerability, and time to treat.  The Excel V is a 532 KTP which has a high vascularity for hemoglobin leading to its impressive desired effect.  Regards, Dr. Matt Elias

Which laser to get rid of Telangiectases under nose? (photo)

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