Laser cryo-sclerotherapy versus conventional sclerotherapy for reticular veins and telangiectasias: A randomized controlled trial.
Marcos Maraskin Fonseca, Lara R Poltronieri, Rodrigo Argenta et al.
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In 30 seconds
This single-center, prospective randomized controlled trial compared laser cryo-sclerotherapy (LCS) with conventional sclerotherapy (CS) for lower-limb reticular veins and telangiectasias in 56 women with CEAP C1 disease; 54 completed 90-day follow-up and were analyzed. Blinded physicians rated aesthetic change using the Global Aesthetic Improvement Scale (GAIS). LCS performed better in all four comparisons, although the Day 1-to-Day 90 comparison without augmented reality did not remain significant after correction for multiple comparisons. Improvement continued from Day 30 to Day 90 in 80.0% with LCS versus 29.1% with CS.
Key findings
- After Bonferroni correction, three of four GAIS comparisons favored LCS; the Day 1-to-Day 90 comparison without augmented reality was no longer significant.
- From Day 30 to Day 90, 80.0% of LCS participants continued improving, compared with 29.1% receiving CS; 70.8% of the CS group had no change.
- Median ecchymosis duration was 5.0 days with LCS versus 10.0 days with CS (P = .012).
- Severe pigmentation at Day 90 occurred in 8.3% with CS and 0% with LCS; the authors identify this as exploratory.
Why it matters
For cosmetic CEAP C1 disease, the trial suggests that LCS may yield greater aesthetic improvement, particularly later in follow-up, and shorter-lasting ecchymosis than CS. The findings also show that assessment timing and augmented-reality imaging can affect measured aesthetic outcomes. These potential benefits should be considered alongside the authors’ note that LCS is more costly and complex.
What to keep in mind
The trial was single-center, included only women with Fitzpatrick phototypes I–III, and had 90-day follow-up. The severe-pigmentation finding was exploratory and had low reported power.