Both ohmic thermolysis and 940 nm laser cause damage to the squamous epithelium and papillary reticular dermis that is transient, according to a recent study that compared different heat modalities for the treatment of telangiectasia. It was also found that ohmic thermolysis provides vessel clearance of >90% in telangiectasias <0.5 mm, while 940 nm laser effectiveness is <70% for vessel clearance, but improves to >90% when sclerotherapy is performed at time of treatment. 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. Researchers found:
- 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 were no long‐term skin sequelae after treatment when each device is used at recommended settings and on appropriate vessel size.
Bush R, Bush P. Histological findings correlated with clinical outcomes in telangiectasia treated with ohmic thermolysis and 940 nm laser. [Published online ahead of print September 17, 2018]. J Cosmet Dermatol. doi:10.1111/jocd.12761.
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Must Reads in Aesthetic Dermatology
Telangiectases Location and Distribution in Youth, J Am Acad Dermatol; ePub 2019 Feb 25; Gonzalez, et al
Heat Modalities Compared in Telangiectasia Treatment, J Cosmet Dermatol; ePub 2018 Sep 17; Bush, Bush