Long-pulsed dye laser vs. intense pulsed light for the treatment of facial telangiectasias: a randomized controlled trial

Objective This study aims to compare the efficacy and adverse effects of long-pulsed dye laser (LPDL) and intense pulsed light (IPL) in the treatment of facial telangiectasias. Methods We used intra-individual, randomized, controlled trial with split-face treatments and single-blind outcome evaluations in this study. Forty patients with symmetrically located facial telangiectasias received a series of three LPDL (V-beam, 595 nm, Candela Laser Corp.) and three IPL treatments (Ellipse Flex, PR and VL2 applicators, Danish Dermatologic Development) at 6-week intervals. Patients were evaluated 3 months after the final treatment. Outcome measures were clinical efficacy (five-point ordinal scale), pain (10-point numerical scale), adverse effects, patient satisfaction (10-point numerical scale) and preferred treatment. Results Thirty-nine of 40 patients completed the study. All but 2 patients obtained a reduction in facial telangiectasias from both IPL and LPDL treatments. Both treatments were effective with good or excellent response in 30 of 39 patients. The LPDL was superior in the overall reduction of telangiectasias by blinded photographic evaluations: Excellent clearance (75% to 100% vessel clearance) was found in 18 patients treated with LPDL (46%) and in 11 patients treated with IPL (28%) (P = 0.01). Patients experienced less pain from LPDL [4 (2-6)] than IPL treatments [7 (3-9)] (P < 0.001). No adverse effects (hypo-/hyperpigmentation or scarring) were seen from any of the treatments. Patients were satisfied with both LPDL [8 (2-10)] and IPL treatments [7 (2-10)] (P = 0.05). Twenty-five patients preferred the LPDL (64%), 8 patients preferred IPL (21%) and 6 patients had no preference (15%) (P < 0.001). Conclusion This study was based on two specific types of laser and IPL equipment, which effectively clear telangiectasias; however, the most beneficial outcome was from the LPDL.