For Face Veins, Rosacea and other Vascular Lesions

The V-Beam laser is a pulsed dye laser that can successfully treat:

• Face veins (telangiectasias)
• Facial, neck and chest redness
• Rosacea
• Hemangiomas (large and small red bumps or growths)
• Red birthmarks (port wine stains)
• Other vascular lesions, including venous lakes (blue spots, usually found on lips)
• Scars

The V-Beam produces an intense but gentle burst of light that selectively destroys the blood vessels within the treated area, without damaging the surrounding tissue. Red veins respond better than blue veins and smaller vessels respond sooner than larger ones. While one treatment will produce some improvement, two to four treatments will probably be needed to achieve the best results. Treatments are usually performed four weeks apart.

Do not apply any anesthetic (numbing) gels. Treatments are well tolerated without them. The feeling has been described as being snapped by a rubber band or as a slight stinging sensation. Following treatment the area may feel warm or sting slightly like a sunburn.

Improvement can usually be seen immediately. Immediately following the treatment however the area may appear red or bruised and possibly slightly swollen. Swelling usually resolves within 1 – 5 days while bruising or redness may last 7-14 days. Crusting can rarely develop when port wine stains (red birthmarks) are treated. As with many lasers, color changes (darkening or lightening of skin color) can occasionally occur in darker skin types as can scarring (in less than 1% of cases.)
For important social events, treatment should not be done within 14 days before the event.

What types of lesions can be treated with laser? 
The V-Beam laser is the most advanced type of pulsed dye laser.  It is the most effective instrument for removing spider veins (small dilated vessels usually on the face), and cherry angiomas (small red spots on the face and body). These lesions often clear with only one or two treatments. The Pulsed Dye Laser can also help fade, over the course of multiple treatments, red or raised scars, “port wine stain” birthmarks, and red discoloration of the face from rosacea. Although leg veins respond better to sclerotherapy, laser can be used to treat vessels that are too small for sclerotherapy. Unfortunately, all of these conditions, with the possible exception of some facial birthmarks, are considered cosmetic and are not covered by insurance. 

2. How does the laser work? 
The V-Beam Laser emits a burst of light tuned precisely to target the red pigment in blood and blood vessels without harming other parts of the skin. Therefore, this laser can remove dilated blood vessels while leaving the surrounding skin intact. A brief pulse of a cold spray precedes the pulse of light, further protecting the skin from injury. 

3. Does treatment hurt? 
Each pulse of light feels like the snapping of a small rubber band, while the cool spray of the laser minimizes this brief discomfort. A topical numbing cream called LMX may further decrease discomfort. A 30 gram tube may be ordered from your pharmacy without a prescription. Apply a generous amount of LMX 1 hour before your appointment and rub into the skin. Repeat this application 15 minutes before the appointment. 

4. What does the skin look like after treatment? 
The intensity of the treatment can be adjusted to each patient's needs.  Each pulse of light treats approximately the size of a pencil eraser.  If done more conservatively, you may experience only redness and slight swelling.  If the treatment is more aggressive, spots can sometimes turn a purple bruised color that can last for a week. You may want to schedule the treatment at a time when no major work or social events are planned so that we can most effectively treat the problem area.

5. What are the risks? 
Complications of treatment with the pulsed dye laser are uncommon. Dark discoloration (hyperpigmentation) of the treated area is unlikely to occur and would fade over months; however, it is important to avoid sun exposure after treatment to minimize this risk. Light discoloration (hypopigmentation) and scarring are extremely rare, unless you have recently taken a medication called Accutane for acne. Swelling is common when large areas of the cheeks are treated, but generally resolves in a few days.  Laser light cannot penetrate deeper than the skin and will not harm internal organs, but goggles must be worn to protect the eyes. Some lesions may not be completely cleared by the treatment, requiring more treatments at additional cost. 

Patient Instructions for Laser Vessel Treatment 

Pre-Treatment Instructions 
1. Avoid sun exposure or tanning for one month prior to treatment. Tanned skin can shade blood vessels from the laser light, making treatment less effective and increasing the chance of discoloration and other side effects. 

2. Do not take aspirin, ibuprofen (Motrin, Advil or related products) or Vitamin E capsules for 10 days prior to the procedure, and avoid alcoholic beverages for 3 days prior. You may take Tylenol, which will not affect your laser results. 

3. Do not scrub or traumatize the skin to be treated.

4. If desired, LMX cream (4 or 5%) can be ordered in advance from your pharmacy without a prescription.  Apply generously to the area to be treated 30 minutes to 1 hour prior to your appointment to decrease any discomfort.

Post-Treatment Instructions 
1. The treated area may be slightly red, with mild soreness like a sunburn for a few hours to a few days. Small areas of bruising may be visible.  These symptoms, if they occur, can be improving using soft ice packs and Tylenol. If a large facial area has been treated, you may experience swelling. If this occurs, keep your head elevated, and prop it up on several pillows at night. 

2. For a week or two after the treatment, the treated area may have a few red to dark purple spots. If there is no crusting, blistering or swelling of the area, make-up may be applied very gently starting 1-2 days after treatment. Makeup with a green or yellow tint can be especially helpful in neutralizing the discoloration. 

3. Cleanse the treated area gently, and apply Vaseline jelly or Aquaphor ointment once or twice a day until the skin returns to its normal color. Take lukewarm, not hot, showers, and avoid strenuous exercise for two days. 

4. Do not, under any circumstances, pick any crusts or scabs that may form. Scratching and picking of the skin is the leading cause of scarring after laser treatment. 

5. Avoid taking aspirin or ibuprofen (Motrin, Advil) and avoid alcoholic beverages for 7 days after the procedure. You may take Tylenol, which will not affect your laser results. 

6. Strictly avoid sun exposure for at least a month after treatment to minimize the risk of discoloration in the treated skin. Use sunscreen of spf 30 or higher, preferably containing zinc oxide or titanium dioxide, and a hat or sunprotective clothing.