Pulsed Dye Laser for Blood Vessels, Port Wine Stains and Scars

Pre Treatment Instructions
TANNED SKIN CANNOT BE TREATED!
1) You may not have a tan (real or chemical) at the time of the treatment. This may lead to abnormally high absorption of the laser beam that can result in scarring or permanent pigment change. We suggest waiting 6 weeks after a real tan and 1 week after complete fading of a chemical tan.
2) If you naturally tan easily, tan before you burn, or if your skin wounds tend to pigment, you are at risk for permanent pigment changes, especially increased pigment (hyperpigmentation). We prefer to treat you with a "skin-bleaching" agent for 1 month prior to the procedure and restart the bleaching agent 10 days after the procedure. This means you may be on the cream up to and including your next laser procedure. We also recommend continuing the bleaching agent for 4 months after the last laser procedure.
3) If you are subject to cold sores around your lips, the laser beam can activate the virus that causes these sores. If we are treating near your lips, we prefer to treat you with an anti-viral agent like acyclovir starting the day before the treatment and continuing for a total of 7 days.

During the Treatment
PLEASE DO NOT WEAR MAKE-UP FOR YOUR TREATMENT.
Your eyes will be protected with protective glasses or shields.
For the Candela V-Beam Laser, you may or may not choose to have a topical anesthetic. During the procedure you can expect to feel a very cold spray followed by a snap (like a rubber band) every time the laser fires. It should be very tolerable, but some areas (e.g. lower nose, just below the nose, and eyelids) are more sensitive that others. About 2/3 of our patients have their treatments without topical anesthetic. Very few patients require injected anesthetic (most commonly young children). For the Candela IPL machine, a cool gel (called an optical coupler) is applied to the skin to improve the penetration of the beam and decrease pain. Generally, no topical anesthetic is needed.
Either procedure generally takes less than 6-8 minutes. You will have redness and swelling after the procedure and ice will be applied immediately after the procedure. You should continue ice packs for 20 minutes every two hours while awake for the next 48 hours. As a general rule, the darker the blood vessels, the more the absorption of the light waves and the more swelling you can expect. Also, with larger or darker blood vessels there is a better chance of some purple discoloration (purpura). If both cheeks are heavy in deep colored blood vessels and are treated, you can even expect some swelling of your upper and lower eyelids. The more you apply the ice, the quicker the swelling will subside. Redness usually resolves in 48 hours with conscientious application of ice. If it occurs, purple discoloration (purpura) can persist 10-14 days and can be covered with make up at 24 hours. Most patients have little or no purpura. You should not have any blisters or scabs. If you do, you should call us.

Re-Treatment

Many patients will require more than one treatment. It takes about 4-12 weeks to see the full effect of the laser/IPL. With the laser, we usually do follow up treatments at 8-12 week intervals. With the IPL, the interval is 4-6 weeks. How many treatments you have is up to you and your aesthetic goals. No laser/IPL can clear every blood vessel. The objective is to get to a point with which you are happy. After that, especially in conditions like Rosacea, you may want a touch up procedure in 18-24 months. The treated vessels will not return, but new vessels may form.

Post Treatment Instructions

1. You can expect the lasered site to be red, swollen and sometimes purple (purpura). Apply ice to the lasered areas for 20 minutes each hour until bedtime the day of the procedure. You may wear make-up the day after the treatment. Tylenol is generally sufficient for any discomfort.
2. Call us if you have any blistering. You may apply Bacitracin ointment three times a day until weeping and crusting is gone. You may get the area wet. Gently pat it dry.
3. If you were treated with a higher dose (purpuric dose) to minimize the number of procedures, you may expect a purplish discoloration that should fade gradually over in 5-10 days on the face.
4. Sun may cause the site to become more pigmented than desired You may not tan (naturally or chemically) for 6 months after your last procedure. We strongly recommend a titanium based sunscreen of SPF 40 or higher on all treated areas when you are out in direct sun for 1 year after the last procedure. If you are in tropical sun, please use zinc oxide.