I am still in the learning phase utilizing the YAG in vein treatments. Recently,in treating a patient for leg veins, came upon with what looks like a collection of hemosiderin staining(approximately the size of a quarter) in 2 separate areas of the lowwer leg. She related that these lesions just sort of 'showed up' after having kids. They have no distinct vessel markings, are circular collections, and vary in color from darker red to dark blue. She wanted me to try and laser them. Does anyone have any experience with this sort of lesion and its response to 1064 treatment?

As far as I understand about 1064 in vein treatment, you don't use it for any size of > 3mm in diameter.

I think the laser treatments work well

do not treat this area , staining will resolve in time

I would like to know the settings for using a 1064 Nd:Yag laser on nasal veins. Regarding the initial authors question. I would use an IPL is the hemosiderin like pigment is swallow enough. It will turn slightly brown and will eventually exfoliate off. You can facilitate it's removal by doing a microderm of the area after two weeks of the IPL.

Hemosiderin staining is not red or blue. It is brown or carmel colored.

IPL does not work well on hemosiderin.

KTP laser works best on them IF it is going to work. Most of the time it does not.

If she saw them after pregnancy it is most likely originating from a vein sub-surface and she may need an ultrasound study to find it.

Don't treat this patient with long pulse 1064 ND-Yag, you may make it worse.