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.
This Week's Must Reads
TNF inhibitor prices rose despite increased drug class competition, San-Juan-Rodriguez A et al. JAMA Intern Med. 2019 Feb 18. doi: 10.1001/jamainternmed.2018.7656
List of medications linked to drug-induced lupus expands, Arnaud L et al. Ann Rheum Dis. 2019 Feb 4. doi: 10.1136/annrheumdis-2018-214598
HLA Antigen Mismatch Linked with Skin Cancer Risk, JAMA Dermatology; ePub 2019 Jan 23; Gao, Twigg, et al
Poor Prognosis for Thin Ulcerated Melanomas Found, J Am Acad Dermatol; ePub 2019 Jan 14; Hawkins, et al
Association Between AD and Mental Health Disorders, Dermatitis; ePub 2018 Dec 18; Hsu, Smith, et al
Must Reads in Aesthetic Dermatology
Heat Modalities Compared in Telangiectasia Treatment, J Cosmet Dermatol; ePub 2018 Sep 17; Bush, Bush
Chemical Peels Show Excellent Clinical Efficacy, J Clin Aesthet Dermatol; 2018 Aug 1; Soleymani, et al
Patient Motivations for Seeking Cosmetic Procedures, JAMA Dermatology; ePub 2018 Aug 15; Maisel, et al
Microneedling Treatment Improves Skin Aging, J Clin Aesthet Dermatol; 2018 Aug 1; Ablon
Rejuvenation Procedure Proves Safe and Effective , Lasers Surg Med; ePub 2018 Aug 8; Knight, Kautz