Laser Treatment Of Telangiectasias - Flushed Face
Laser treatments are becoming more sophisticated every year, and are becoming an effective tool in combating facial flushing. Specifically, selective thermolysis is the method of targeting vessels or specific content in the vessels that comprise the lesion, but without damaging its surroundings. Unlike cruder tools of the past, modern lasers have the ability to minimize damage to surrounding cells.
Roughly, there are two types of lesions that occur in rosacea which lasers can treat: Telangiectasia or broken blood vessels, and flushing. Broken blood vessels are common in those with sun damaged skin, and in those with rosacea. They are individual vessels that occur on the cheeks and the sides of the nasal area. Flushing and generalized redness are also common, and may require a longer treatment span.
Is anesthesia required?
Laser treatments can be mildly uncomfortable. A stinging sensation is common, but for most procedures, the discomfort is tolerable without anesthetic. Generally, the larger the legion to be treated, the more likely it is that anesthesia is required.
How many treatments are necessary?
Multiple treatments are necessary to control vascular legions, but an exact number is difficult to predict. Individual broken
blood vessels are easier to treat, particularly if they are small and may only require a single treatment. The nose area is more challenging to treat, however, and will require a 4 to 6 week interval between treatments.
Are there any concerns about complications?
Complications from laser treatment of vascular lesions are rare when performed by qualified physicians. However, some level of pain, swelling, and redness of the treated area for about 48 hours after the operation is common. With pulsed dye lasers, bruising and crusting of the skin may occur, but will subside within a week. Sun sensitivity and mild hyperpigmentation are possible. Scarring and infection are possible, but extremely unlikely.
Who is a candidate for laser treatment for vascular legions?
Lasers are a safe and effective treatment for most cases of broken blood vessels and flushing. A patient using isotretinoin may not be a good candidate due to the risk of atypical scarring.
What areas of the skin can be treated?
Lasers can be used on almost any skin surface. When treating areas close to the eye, goggles or metal eye shields may be used to protect the eyes.
How do I best take care of myself before and after a laser treatment session?
Prior to treatment, all cosmetics should be removed from the skin that is being treated. After the treatment session, the operating physician should take appropriate steps to ensure your comfort. This may include applying cold compresses, or applying creams which may also contain antibiotics. The patient should take care to avoid sun exposure as much as possible in the days following the procedure. Makeup and cosmetic products should also be avoided for some time.
What are the common types of lasers used?
The three most common lasers are:
- Pulsed dye laser (595 nm, yellow): Most commonly used to treat port-wine stains and erythema in rosacea, but can be used to treat various blood vessel problems. Lighter skinned patients tend to respond better as the laser penetrates deeper. These lasers have very little risk of scarring and are most successful treating the neck and head area. Newer models tend to produce less bruising. The most postoperative changes include bruising for about a week, crusting of affected skin, and temporary pigment changes in the skin.
- Pulsed Nd: YAG (532 nm, green): This laser is used mostly to treat superficial vessels, but can also be used to treat cherry angiomas, spider angiomas and venous lakes. The skin is cooled using cooling gels, and bruising is uncommon. It is most effective for treating patients with a lighter skin tone. The most post-operative change is a temporary redness, but this generally subsides in 24 hours.
- Intense Pulsed Light (515-1200nm): Also called IPL, this therapy is used to treat port-wine stains, broken blood vessels and hemangiomas. Multiple wavelengths are delivered simultaneously. Bruising is common, and correlates with treatment response.