Combined Pulsed Dye and ND:YAG Laser Treatment (Cynergy Laser) of Cherry Angiomas

Cherry angiomas are benign, commonly acquired red colored growths that typically occur in our third decade of life. These microvascular malformations can be up to several millimeters in size and increase with age. Cherry angiomas can appear anywhere on the body but are typically found on the trunk and proximal extremeties. They are asymptomatic, but can bleed with trauma. Cherry angiomas are indeed the most common vascular malformation and patients can present with several hundreds on the trunk. Often, patients during pregnancy can demonstrate new growths that may involute post pregnancy. But when the angioma is present in areas that cause cosmetic concern such as the face, what can be done? Previously, scissor dissection and electrocautery was utilized. The lesions could be removed effectively with these methods, however sometimes, slight scarring could occur. With the advent of laser technology, the pulsed dye laser, which targets hemoglobin was utilized. Histologically, after laser treatment, the lesion was filled with cords of agglutinated red blood cells and coagulated endothelium that was molded to the shape of the original lesion (Aghassi et al, J Am Academy of Dermatology).

The way I approach cherry angiomas is with the Cynergy laser which has a combination of pulsed dye laser and Nd:YAG so that the full depth of the lesion is treated. The treatment consists of pulses to the area which is felt as transient heat. The lesion then turns a bluish color (coagulated blood) and over the next several weeks regresses. Typically only one treatment is needed, however, if the lesion is large, a second treatment may be performed 6 weeks later. I have patients sun protect the area. No further post treatment regimen is necessary.

Raminder Saluja, MD

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