Blood Vessels, Port Wine Stains and Scars Treatment
Candela V-Beam® Dye Laser, 595 nm works best for:
- Facial and neck telangiectasias (often called “broken blood vessels”)
- Spider veins of the face
- Port Wine stains
- Facial hemangiomas (including facial spider hemangiomas)
- Venous lakes (dark purple spots) of the lip
Dr. Bentkover most commonly uses the Candela V-Beam® pulsed dye laser for these conditions. The V-Beam® laser can also be used promote new collagen formation in the dermis for scar modification. There is usually minimal downtime with some redness and swelling that generally resolves in 24 to 48 hours. Ice is your friend after this treatment. With higher dose treatments or very dark vessels there is more swelling and sometimes even some purple discoloration (purpura) that may persist for 10-14 days.
This is an office procedure usually requiring no anesthetic all.
Pre Treatment Instructions
TANNED SKIN CANNOT BE TREATED!
- 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.
- 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.
- 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 MAKEUP 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.
Most patients will require more than one treatment to achieve significant improvement.. It takes about 12 weeks to see the full effect of the laser. With the laser, we usually do follow up treatments at 8-12 week intervals. No laser 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
- 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.
- 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.
- 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.
- 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.
No. Dr. Bentkover can usually significantly decrease the density, size and number of superficial blood vessels in your face. However, he cannot stop the Rosacea. There is no cure for Rosacea. He often reduces the number of superficial blood vessels to the point that most are cleared and patients return for a touch up treatment every 18-24 months.
Usually swelling and significant redness are gone in 24-36 hours. With a higher power treatment on most of the surface area of your face some degree of swelling and purpura (purple discoloration) may persist for 10 days or so.
We have been very successful over the years in clearing these completely or almost completely in many patients. The amount of a Port Wine Stain that can be removed, however, often depends on your age. As you age, so does your Port Wine Stain. Unfortunately, they often get thicker and become darker as they age. This makes them harder to clear. While the greatest success is with children and young adults, we have been very successful in significantly improving Port Wine Stains that have thickened and darkened over the years. Take a look at the Port Wine Stain of the chest in our photo gallery.
Absolutely. You would not think that such a non-invasive laser would do much for scars, but it often does. We use it to take the redness out of post-operative scars and traumatic scars. At the same time it often flattens and blends the scar. Check out the photos of the young lady in our photo gallery with traumatic scars of her forehead.
Not especially well. It can actually cause some hyperpigmentation in patients with very dark skin. We have better ways to treat brown spots and hyperpigmentation, depending on the degree of the pigment change and its cause. These range from our ZO Skin Care line to Portrait Plasma Skin rejuvenation.