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Pulsed dye laser (PDL) photocoagulation is generally thought to be highly effective for treating spider angiomas. In this prospective study from England, all 201 patients presenting with spider angiomas to an outpatient laser center underwent treatments with a PDL (585-nm wavelength, 0.45-ms pulse duration) every 2 months until complete lesion resolution. The patients were randomized to one of two treatment protocols: a single 3-mm pulse at 12 J/cm2 or one 3-mm pulse at 8 J/cm2 followed by one 5-mm pulse at 6.4 J/cm2. All 191 patients who had complete resolution of the spider angiomas were contacted by a mail survey regarding recurrence.
Total lesion clearance occurred in 95% of patients regardless of anatomic site, presence or absence of fl…