Recurrence of spider naevi following treatment with 585nm pulsed dye laser

During a 2-year period 201 patients underwent treatment for spider naevi with a 585nm pulsed dye laser at Canniesburn Hospital Laser Suite. Patients were treated with a either single or double pulse technique. Of these patients 191 (95%) had a successful result, with clearance in a mean of 1.8 treatments (range, 1–7). There was no significant difference between the two treatment protocols in terms of probability of clearing the lesion or number of treatments required. These 191 patients were contacted by postal survey to determine their long-term results. The mean duration of follow-up was 37.9 months (range, 27–51 months).

Response rate to the survey was 73%, 139 patients. Fifty patients (36%) had suffered recurrence of their spider naevi in the same site. There was no correlation found between the risk of recurrence and the site, number of treatments received, size and characteristics of the spider naevus, or treatment protocol used. The risk of recurrence increased with increasing age and was higher for peripheral facial lesions.

The most common time of recurrence was between 6 and 18 months with 48% of recurrences occurring during this period. Existing published series, which have demonstrated low recurrence rates, have either had low numbers of patients or short follow-up periods of less than 6 months.