Treatment with a Nd:YAG (Neodynium-doped Yellow Aluminum Garnet) laser can be extremely effective for treating superficial venous malformations or it can be used to treat the superficial component of a deep lesion. It is essential that this treatment be done by a physician who has extensive experience in this because there is a very narrow therapeutic range. This means that the power settings necessary to obtain the desired effect fall within a very narrow range and will vary from patient to patient. If the physician wanders out of this very narrow range, scarring will result. It is important to note that a power setting effective for one patient, can cause scarring on another. It is thus critical that the treating physician be experienced in this form of treatment.
The Nd:YAG laser is capable of effectively reducing the bluish discoloration of skin (Fig. 2) and mucosa (the lining of the lip and mouth)( Fig 1.). By using a cooling device together with the laser, the skin is spared and it is possible to treat through intact skin. Using an Nd: YAG laser with cooling, we have been able to successfully treat the superficial discoloration associated with these lesions. This is a recent innovation. Laser treatment is thus often combined with surgery and sclerotherapy to successfully treat compound venous malformations.