VLC acne

A vascular lesion is formed by abnormally large or numerous small vessels located directly under the surface of the skin. These vessels may be visible through the skin (Spider Angiomas) or result in a red appearance of the skin. Vascular lasers target the red blood cells which in turn heat and damage the vessels. At the Vein Laser Center we have combined Pulse Dye Lasers with variable long pulse Nd-Yag laser to treat various vascular lesions with great success.

Hemangiomas
Hemangiomas are an abnormal growth or proliferation of blood vessels. Hemangiomas usually not present at birth, appear and proliferate rabidly at some time after birth. Usually hemangiomas shrink slowly over several years and eventually disappear, or involute.
Hemangiomas occur in about 2-7% of newborns, more commonly in females and multiple births. They present as whitish, flat patches surrounded by dilated blood vessels, but enlarge over the first year of life. Most hemangiomas will begin to regress by age 4, eventually leaving a small, barely visible patch of slightly irregular skin, although incomplete regression is common.

There are two types of hemangiomas:

	Strawberry hemangiomas: Slightly raised and bright red because the abnormal vessels are close to skin surface.
	Canernous hemangiomas: have a blue color because the abnormal vessels are deep under the skin.

In a very few cases, these lesions may enlarge rapidly, become irritated and bleed, and even affect vital structures. Occasionally they may be associated with similar lesions elsewhere in the body, especially the larynx and trachea. Most of these lesions require no treatment-more aggressive growths can be treated with oral or injected cortisone, Interferon and lasers.
Physicians recommend laser treatment in infancy with the Pulsed Dye laser, may limit the growth and encourage early regression of these unsightly lesions. Others reserve treatment for those lesions than have not begun to regress spontaneously after age 3 or 4. In either case multiple treatments are necessary.


Before Treatment	After one Treatment

After Two Treatments with Nd-YAG Laser

Cherry Hemangioma (angioma, senile angiokeratoma)
Cherry angiomas are the most common of all vascular malformations. They are smooth, well circumscribed, red-to-purple lesions. They occur mostly on the trunk in persons over 30. Their exact cause is unknown, but they can be successfully treated with Pulse Dye Lasers (PDL). Occasionally, they may clinically resemble nodular melanoma.


Before Laser	After One Laser (PDL) Treatment

Spider Angiomas
These are small red lesions, has a central nidus surrounded by “legs” / “Telangiectasias”. These lesions respond favorably to laser therapy.

Vascular Malformation, Port Wine Stain (PWS), Nevus Flammeus
These are growths always present at birth that remain unchanged. They can be any size and they grow as the child grows. Unfortunately, they never go away by themselves. They last a lifetime. They are flat, pale pink in color at infancy and gradually darken to a red shade during adulthood. Mostly found on face, neck, arms and legs.

About 5% of these lesions are associated with glaucoma, metal retardation, and or seizures due to involvement of the vessels of the eye and central nervous system (Sturge-Weber Syndrome)

The ideal treatment should begin as early as possible. In infancy, the birthmark is smaller and the blood vessels are less ecstatic. Treatment at this time also spares the patient emotional and psychological trauma. With maturity, the lesion tends to become nodular with larger and deeper blood vessels. Treatment required becomes more extensive. Lesions on extremities respond less dramatically than facial lesions.

Optimal treatment is with the Pulsed Dye Laser (PDL) beginning in infancy. Multiple treatments are necessary, and complete removal of the growth is not possible in every case.

Rosacea
Red facial lesions around the nose and cheeks causing a sunburn look. It is characterized by:

	Flushing followed by diffuse redness
	Adult onset acne
	Facial telangiectasia

Excellent results are seen when treating patients with Pulse Dye Lasers (PDL). Purpura- free treatment is now possible with longer pulse lasers.

Venous Lakes
Venous Lakes are deep purple colored lesions most common on sun-exposed areas in older individuals, especially on the vermilion of the lower lip and on the ears. These smooth, easily compressible lesions are composed of dilated or "varicose" vein. Because of their deep purple, almost black color, they may be mistaken by patients for melanoma. Bleeding following trauma or irritation may occur. Venous lakes are easily and successfully treated by PDL and long pulse Nd-Yag laser lasers at our centers. One or two treatments are required to clear these lesions.


Venous Lake, lower lip	Post ONE treatment (Nd-Yag Laser)

Poikiloderma
Poikiloderma of Civatte refers to redness associated with a mottled pigmentation seen on the sides of the neck, more commonly in women. The term poikiloderma refers to the combination of skin thinning, dilatation of fine blood vessels (telangiectasia), and pigmentary changes (both hypopigmentation and hyperpigmentation).
The causes are unknown, but many factors have been implicated.

	Chronic exposure to ultraviolet light appears to be a primary etiologic factor
	Photosensitizing chemicals in perfumes or cosmetics
	Possibly, hormonal changes related to menopause or low estrogen levels
	Genetic predisposition may exist.

Treatment:
At the Vein Laser Center, Pulsed dye laser (PDL) treatment has been found the best way to reduce the telangiectasia and pigmentation. Two to three treatments are required to clear this condition. In addition, we recommend:

	Sun protection including daily broad spectrum SPF 30+ sunscreen
	Avoid all perfumes on or near the affected area, including those in soap
	Hydroquinone-containing preparations may help fade the pigmentation
	Exfoliants including long term use of alpha hydroxy-acids and/or tretinoin.

PDL laser is not available at this time at Vein Laser Center
Facial Veins

Spider veins of the legs

Benign Cutaneous Lesions Having a Vascular Component

	Warts: Benign skin lesions caused by Human Papilloma Virus (HPV). Treatment every 2 -3 weeks is recommended for optimal results. Multiple treatments are required.
	Hypertrophic Red Scars: Whether these scars are related to trauma, surgery or acne, PDL laser has been used to improve the thickness, height, redness, skin elasticity and texture.

To find out more about our vascular lesion treatments or other cosmetic procedures,
call our center to arange for a consultation.