Background: Telangiectases of the lower extremities have been refractory to permanent ablation by photothermal coagulation. In addition, adverse effects often occur because of nonselective absorption of the light by the overlying skin. Objective: This study was performed to determine the effectiveness and the incidence of adverse effects associated with the PhotodermVL in the treatment of telangiectases, less than 0.4 mm in diameter, of the lower extremities. Methods: Seventy-two patients were treated, each at one treatment site, by means of a treatment protocol designed by ESC Medical Systems, Ltd., the developer and manufacturer of the PhotodermVL. Results: Complete, or almost complete, clearance of telangiectases was observed in 10% of patients. No improvement occurred in 56% of treated telangiectases, and 25% had partial clearing. Adverse effects were common, including scarring in 21% of patients. Conclusion: The PhotodermVL provided a low rate of success in the treatment of telangi-ectases on the lower extremities. Treatment was associated with a high rate of adverse effects. (J Am Acad Dermatol 1998;38:61-8.)