Pulsed dye lasers are used for the treatment of hemangiomas, cherry spots, spider vessels of the face, body and leg veins. This laser has also been found to be useful in the treatment of warts, scars, and stretch marks. This particular laser was designed in such a way that, in most cases, the top layer of skin (epidermis) is not injured as the underlying vessel is destroyed. This is possible because the characteristics of the laser are specific for the destruction of vascular lesions. The wavelength of light that it emits (595 nanometers) corresponds to the absorption of the abnormal blood vessel. The laser light is delivered so quickly that there is almost no chance for destruction or scarring of the surrounding skin. Cooling sprays have been incorporated into some of the lasers to reduce discomfort and further protect the skin surface from the laser energy. The V-BEAM Perfecta laser, which is a derivative of the original pulsed dye laser, is the laser that is primarily used in our office for the treatment of vascular lesions.
The skin may look entirely normal after therapy or it may immediately turn gray to purple in color. The appearance of the skin immediately after treatment depends on the type of condition being treated. Any color that develops will usually disappear over the next two to four weeks. Makeup can be applied two days after the procedure. Most patients need no special care other than daily washing of the area with soap and water.
Telangectasias are enlarged blood vessels that can occur anywhere on the body. They can be a result of trauma, hormones, sun damage or other underlying medical conditions. Their occurrence runs in families. In most cases, the actual cause is unknown. Telangectasias and cherry spots usually require one to five treatments. An eight week period between treatments is usually recommended.
Most of our patients will not require anesthesia for a laser treatment. There is a slight stinging or burning experienced during the procedure. Some patients, particularly children, will find it more comfortable to apply a topical anesthetic to the area one hour before the office treatment. Elamax cream is available over the counter for this purpose, and EMLA Cream is available by prescription. After the treatment, an ice pack may be applied for fifteen minutes.
The risk of scarring is quite small. The most common side effect is a transient discoloration of the skin, which is a result of laser irritation of pigment cells at the treated area. This stain may be lighter or darker after treatment. Color changes usually return to normal within three to six months after laser treatment. Discoloration is not common. The top of the hands and the lower legs are more subject to discoloration than other areas. Response to treatment will be improved by using a #30 or higher sun block (containing titanium dioxide or zinc oxide) over the treated area once discoloration from the laser has disappeared.