The V-beam Pulsed Dye Laser is the most advanced laser for the treatment of redness of the skin, whether it is rosacea, acne rosacea, broken capillaries, spider veins, telangiectasias, hemangiomas, or port wine stains. Some types of redness can be completely resolved using a Pulsed Dye Laser, and some types of redness can only be temporarily improved. In addition, there are some red lesions of the skin that do not respond to Pulsed Dye Laser treatments, such as actinic keratosis. Therefore, a consultation prior to the Pulsed Dye Laser treatment is necessary to determine how your facial redness will respond to the procedure.
What is The Pulsed Dye Laser?
The Pulsed Dye Laser emits a very intense light that passes through the skin and is absorbed by the blood within a blood vessel. The blood within the blood vessel absorbs the light energy and the light energy is then converted into heat energy. It is the heat energy that injures the blood vessel, and the injury makes the facial redness improve.
The Pulsed Dye Laser has two primary settings. In the first setting, the laser heats up the blood very quickly, which causes the blood vessel to rupture. When this happens, it results in a bruise that lasts about 10 days. In the second setting, the laser heats up the blood slowly so that it injures the blood vessel without rupturing it. If the blood vessel does not rupture, there is no bruising and the skin is just red and swollen for a day. The Pulsed Dye Laser setting that causes the bruise will improve facial redness with fewer treatments than the setting that causes only some mild redness and swelling. During your consultation, the appropriate setting for your facial redness will be determined.
How many treatments will I need?
Everyone’s skin is different, and there is no way to predict how many treatments will be necessary to clear or improve areas of facial redness. Some people have skin that is very sensitive, and their skin redness needs to be treated with lower settings over a longer period of time. Some people have skin that is very tough, and their skin can be treated more aggressively. People with darker skin will be treated less aggressively to avoid pigmentation issues.
What is the procedure like?
The Pulsed Dye Laser treatment is done in the office and you can drive yourself to and from the appointment. There is no need for sedation or medications for discomfort. Topical numbing cream can’t be used prior to a Pulsed Dye Laser treatment because it causes contraction of the blood vessels, resulting in less of a target to absorb the light energy. The Pulsed Dye Laser treatment takes about 10 to 30 minutes depending on how large of an area needs to be addressed.
During the laser treatment, you wear metal eye shields (like the ones you would see in a tanning booth) over your eyes. You will first feel a burst of cold air. This cold air chills the skin prior to the light pulse, and makes the laser much more comfortable. Even with your eyes closed under the metal eye shields, you will see a bright flash of light. The pulse of light will feel like a hot rubber band snapping you for a second. After the procedure, there is no discomfort. Children also tolerate this procedure well, without any sedation or anesthesia.
What are the results?
At the end of the treatment your skin will be slightly swollen and it will be either red or bruised, depending on the setting that was chosen. The redness and bruise only develop at the treated area and they do not spread or enlarge. You should ice the area for the day, and you should limit the amount of bending over that you do that day. It is also recommended to sleep with your head slightly above the level of your heart the night after the treatment. You may start wearing makeup immediately after the treatment and wash your face with a gentle facial cleanser at any time.
It is very important that you protect your skin from the sun and do not get a sun tan for at least one month after your treatment. If you are not good about wearing sunblock and/or a protective hat, the areas that were treated will become hyperpigmented (become darker). This darker skin will fade by itself over time, but it can also be treated with prescription skin-lightening creams if necessary. Because of the risk of temporarily darker skin, it is recommended that Pulsed Dye Laser treatments not be performed in the summer when it is harder to be compliant in protecting the skin from the sun.
Patients usually follow up one month after the Pulsed Dye Laser treatment for evaluation and possible re-treatment. If the lesion is not completely resolved, it is best to treat the lesion again at that time. If the treatment is delayed for several months or longer, a partially treated lesion runs the risk of returning to its pre-treatment state. This is because a blood vessel that is only partially closed down will re-dilate over time due to the continued flow of blood through the vessel. Therefore, it is always best to continue the Pulsed Dye Laser treatments monthly until the redness is completely resolved or improved to a satisfactory state.