Quality-Switched Nd:YAG 1064 nm Laser for Management of Hyperpigmentation and Atrophic Scars after Long-Pulsed Nd:YAG Laser for Treatment of Leg Telangiectasias-A Case Report

The correction of leg telangiectasias is one of the most frequently performed interventions in the Western world. While sclerotherapy remains the gold standard of treatment, several studies have shown comparable efficacy and, in some situations, an even more favorable use of lasers as an alternative treatment option. The most frequent side effect of both treatment options is hyperpigmentation, which usually clears spontaneously in most cases but can be challenging to treat if it persists. The origin of this hyperpigmentation is not fully understood; small studies point to hemosiderin as the causative pigment, at least in post-sclerotherapy hyperpigmentation. More rare side effects of the treatment include ulcerations and scarring. Quality-switched (QS) Nd:YAG lasers have demonstrated good efficacy in treating hemosiderin depositions in the skin, post-inflammatory hyperpigmentation and atrophic scars. We present a case of post-inflammatory hyperpigmentation and scarring after laser treatment of leg telangiectasia with a long-pulsed Nd:YAG laser that was successfully treated using a QS Nd:YAG 1064 nm laser. This case suggests the QS Nd:YAG laser as a possible treatment option in cases of hyperpigmentation with various origins, including hemosiderin and melanin, and scarring after laser treatment of leg telangiectasias.