Cardiovascular

Comparative evaluation of long-pulsed Nd: YAG and pulsed dye lasers in the treatment of venous lake lesions: a prospective clinical study.

Behrouzeh A, Heidari N, et al. • Lasers in medical science • 2026

PubMed 42734837 DOI 10.1007/s10103-026-05035-8
TL;DR

Nd:YAG laser was associated with greater improvement than PDL in treating venous lake lesions, particularly in lesion color, with complete clearance observed only in the Nd:YAG group.

Key Findings

Results

Overall lesion size decreased significantly following laser treatment across both groups combined.

  • Mean lesion size decreased from 1.14 ± 0.71 cm to 0.53 ± 0.72 cm (P < 0.001)
  • This corresponded to a mean relative reduction of 58.3%
  • Mean color improvement across all patients was 65.2%
  • Total of 23 patients were treated with mean 3.17 ± 1.02 treatment sessions at 6-week intervals
  • Mean participant age was 48.8 ± 12.3 years
Results

Nd:YAG laser achieved ≥75% reduction in lesion size more frequently than PDL.

  • 53.3% of Nd:YAG-treated patients achieved ≥75% reduction in lesion size versus 12.5% of PDL-treated patients
  • Overall, 39.1% of all patients achieved ≥75% lesion size reduction
  • The difference in lesion size reduction between groups was not statistically significant
  • Nd:YAG group: n = 15; PDL group: n = 8
Results

Nd:YAG laser achieved significantly greater improvement in lesion color compared to PDL.

  • ≥75% improvement in lesion color occurred in 60.0% of Nd:YAG patients versus 0% of PDL patients (P = 0.007)
  • Mean color improvement score was significantly greater with Nd:YAG than PDL (0.75 ± 0.27 vs. 0.46 ± 0.19; P = 0.007)
  • Color improvement was evaluated by two experienced dermatologists comparing pre- and post-treatment images
Results

Complete clearance of venous lake lesions was observed only in patients treated with Nd:YAG laser.

  • Complete clearance was observed in 17.4% of all patients
  • All patients achieving complete clearance were in the Nd:YAG treatment group
  • No patients in the PDL group achieved complete clearance
Results

Mean absolute lesion size reduction was numerically greater with Nd:YAG than PDL, though not statistically significant.

  • Mean absolute lesion size reduction was 0.68 ± 0.34 cm with Nd:YAG versus 0.40 ± 0.30 cm with PDL
  • The difference in absolute lesion size reduction between the two groups did not reach statistical significance
  • Nd:YAG group: n = 15; PDL group: n = 8
Results

Laser treatment for venous lakes was generally well tolerated with minimal adverse events.

  • One case of post-treatment scarring was reported across all 23 patients
  • Treatment was described as 'generally well tolerated'
  • No other specific adverse events were enumerated in the abstract

What This Means

This research suggests that both long-pulsed Nd:YAG and pulsed dye lasers (PDL) can effectively treat venous lakes — benign, bluish-purple spots that typically appear on the lips and face of older adults. In a study of 23 patients treated over multiple sessions spaced six weeks apart, the average lesion shrank by about 58% and color improved by about 65% across both treatments combined. The treatments were generally well tolerated, with only one case of scarring reported. The study found that the Nd:YAG laser outperformed PDL, particularly in improving lesion color. Sixty percent of Nd:YAG patients saw at least a 75% color improvement compared to none in the PDL group, and this difference was statistically significant. Complete clearance of lesions was seen in roughly 17% of all patients, and every one of those cases occurred in the Nd:YAG group. While Nd:YAG also reduced lesion size more than PDL on average, that size difference did not reach statistical significance, likely due to the small sample sizes. This research suggests that Nd:YAG laser may be the more effective option for treating venous lakes, especially for improving their discoloration. However, the study was small and non-randomized, with only 23 patients split unevenly between the two treatments. The authors acknowledge that larger, randomized controlled trials are needed before firm conclusions can be drawn about which laser is definitively superior.

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Citation

Behrouzeh A, Heidari N, Heidari A, Daneshpazhooh M, Nasimi M, Mahmoudi H. (2026). Comparative evaluation of long-pulsed Nd: YAG and pulsed dye lasers in the treatment of venous lake lesions: a prospective clinical study.. Lasers in medical science. https://doi.org/10.1007/s10103-026-05035-8