Comparative Assessment of 532/1064-nm KTP/Nd: YAG and 595-nm Pulsed Dye Laser for Cutaneous Vascular Lesions: A Prospective Split-Site Study.

OBJECTIVES: This exploratory pilot study aims to characterize effective laser settings and evaluate the clinical outcomes and tolerability of a dual-wavelength 532/1064-nm KTP/Nd: YAG laser system compared to a 595-nm pulsed dye laser with cryogen spray cooling, across multiple vascular indications, including port-wine capillary malformations (PWCM), erythematous scars, rosacea, venous lakes, and vascular lesions associated with hereditary hemorrhagic telangiectasia. STUDY DESIGN AND METHODS: Adults with cutaneous vascular conditions were treated with 532/1064-nm KTP/Nd: YAG and 595-nm PDL on one to four test spots. Optimal parameters were chosen by the study team. Subjects assessed pain/discomfort (Scale 0-10), edema (Scale 0-4), redness (Scale 0-4), purpura (Scale 0-4), and overall improvement (Scale 0-4) post treatment. Blinded physician assessments were collected at the completion of the study. RESULTS: Twenty-five subjects completed study procedures. The average pulse duration was 10 ms for 532-nm and 1.8 ms for 595-nm laser. Among subjects treated with both lasers and at selected settings, subject-reported outcomes indicated significantly higher pain scores, redness, and purpura following PDL treatment (p < 0.05). No significant differences were observed for swelling or perceived improvement. In subjects with PWCM, physician-blinded evaluations judged both laser clinical outcomes as equivalent in 60.3% of cases, with KTP/Nd: YAG favored in 25.4% and PDL in 14.3%. CONCLUSION: Our findings demonstrate that both 532/1064-nm KTP/Nd: YAG and 595-nm PDL are effective in the treatment of cutaneous vascular lesions. At selected settings, subjects reported significantly less pain, redness, and purpura following KTP/Nd: YAG treatment compared to PDL.