Pulsed dye (PDL) 595- and 1,064-nm Nd:YAG lasers are used for the treatment of vascular lesions. PDL-heated blood exhibits increased absorption of radiation at 1,064 nm, suggesting that the use of combined sequential dual wavelengths may offer benefits over single-wavelength treatments. This study compares the treatment efficacy of combined sequential dual-wavelength versus single delivery of 595-nm PDL or 1,064-nm Nd:YAG wavelengths in facial telangiectasia in a split face study design using subpurpuric parameters. Twenty patients were studied using the sequential delivery of PDL and Nd:YAG wavelengths on one side of the nose. The other side received either PDL or Nd:YAG treatment. Vessels (<0.6 mm in diameter) were treated with a 7-mm spot size at 10 J/cm(2), 10 ms with the PDL, followed by the Nd:YAG at 70 J/cm(2), 15 ms with a multiplex interpulse delay of 100 ms. Subjects received a single treatment, and results were evaluated after 4-week follow-up. Improvement was determined by blinded assessment of photographs taken before and after final evaluation. The efficacy of the dual-wavelength laser treatment when compared to Nd:YAG or PDL laser alone was significantly more evident than either single-wavelength treatment (p<.05). There was no statistically significant difference in efficacy between the single-wavelength treatment groups. The sequential delivery of 595- and 1,064-nm-wavelength radiation with an interpulse delay suggests that the synergistic approach to laser therapy for facial telangiectasia is a superior method compared to standard single wavelength therapy.