فهرست نشریات علمی دسترسی آزاد ایران

Facial telangiectasia, commonly known as spider veins, are dilated superficial dermal blood vessels that represent a frequent cosmetic concern. Conventional therapies such as sclerotherapy, electrocautery, and intense pulsed light have limitations, while vascular lasers, particularly long- pulsed Nd:YAG, offer deeper penetration and reduced risk of pigmentary changes, making them suitable for treatment in darker skin types. This study aims to evaluate the efficacy, safety, and tolerability of long-pulsed 1,064-nm Nd:YAG laser in the treatment of facial telangiectasia. This prospective interventional-based study was conducted at Erbil Dermatology Teaching Center, Iraq. Thirty-four patients with facial telangiectasia were enrolled. Demographic and clinical data were recorded, and baseline assessments included telangiectasia quantification using a novel Telangiectasia Area Involvement Score (TAIS) (range 0–7). All patients underwent up to four treatment sessions of the affected areas with a long-pulsed 1,064-nm Nd:YAG laser (spot size 2 mm, fluence 140 J/cm², handpiece 2 mm, frequency 2 Hz, and pulse duration 20 ms with dynamic cold air cooling) at two-week intervals. Clinical outcomes were evaluated by changes in TAIS scores, and adverse events were documented after each session and at follow-ups. The treatment endpoint was defined as a change in vessel coloration, disappearance, or inability to refill. The study population (n=34; mean age 42.8 ± 9.9 years; 73.5% female) demonstrated high treatment tolerance, with no cases of poor tolerance or serious adverse effects. Immediate reactions at ≤ 1 hour were limited to erythema in all of the patients, which resolved spontaneously with cold air cooling. Post-treatment adverse reactions at 1 hour to 14 days were minimal and were limited to transient erythema only (76.5%), burning/stinging (8.8%), or erythema and burning (14.7%), all of which resolved within 48 hours with symptomatic care. These reactions steadily decreased across the treatment sessions. Complete clearance of telangiectasia was achieved in 58.8% of patients, while 41.2% showed partial reduction after treatment. There was a statistically significant progressive reduction in mean telangiectasia grades, from 0.991 ± 0.099 at baseline to 0.124 ± 0.024 after the fourth session (p < 0.001). Long-pulsed 1,064-nm Nd:YAG laser is a safe and effective modality for facial telangiectasia, achieving high clearance rates with minimal, transient side effects.