Thick linear
telangiectasia on the ala nasi and nasolabial crease can be resistant to treatment with the
potassium-titanyl-phosphate (
KTP) laser and the traditional round spot on a
pulsed dye laser (PDL). We evaluated the efficacy of a 3 mm x 10 mm elliptical spot using the ultra-long pulse width on a Candela Vbeam(R) PDL for treatment of PDL- and
KTP laser-resistant nasal
telangiectasia. Nasal
telangiectasia resistant to PDL (12 patients) and
KTP laser (12 patients) in 18 patients were treated with a 3 mm x 10 mm elliptical spot on the ultra-long pulse
pulsed dye laser (ULPDL) utilising long pulse width [595 nm, 40 ms, double pulse, 30:20 dynamic cooling device (
DCD)]. Six patients had previously received treatment with both PDL and
KTP laser prior to ULPDL (40 treatments, range1-4, mean 2.2). Complete clearance was seen in ten patients, and eight patients displayed more than 80% improvement after ULPDL treatment. Self-limiting
purpura occurred with round spot PDL and
erythema with
KTP laser and ULPDL. Subtle linear furrows along the treatment sites were seen in three patients treated with the
KTP laser. ULPDL treatment delivered using a 3 mm x 10 mm elliptical spot was non-purpuric and highly effective in the treatment of nasal
telangiectasia resistant to
KTP laser and PDL.