Vascular Lesions

Vascular skin lesions are lesions in the skin that contain blood. Some examples of vascular lesions include red facial thread veins, often referred to as ‘broken veins’; port wine stains (a type of birthmark); spider naevi; haemangiomas and the broken facial veins of rosacea (telangiectasias). These conditions may be treated with various lasers, particularly the KTP laser and the Pulsed Dye Laser systems. Treatment works by matching the laser light to the colour of the lesion. This way, the laser only interacts with the unwanted red area, bypassing normal vein free skin. The laser generates heat and makes the blood vessel wall stick together. As no blood can flow through the sealed vessels, the lesion will lose its colour, become paler and can completely disappear. This process is referred to technically as selective photothermolysis. Each laser pulse is extremely brief, so that there is no build up of heat in the skin.

Solar Lentigos (‘Sun Spots’ / ‘Liver Spots’)

These are well defined, light to dark brown, flat spots caused by exposure to ultraviolet light. They may be single or multiple. Whilst themselves benign, they indicate excessive ultraviolet exposure, which is a risk factor for the development of skin cancer. They are more common in those who burn easily and tan poorly, and also in older individuals. Lentigos may be treated with cryotherapy, although this often results in an area of indentation and paler skin (hypopigmentation). Bleaching creams are also sometimes used but may not work. Laser treatment results in heat destruction of the pigment in the lesion. The lesion will lose its colour, become paler and can completely disappear. This process is referred to technically as selective photothermolysis. Each laser pulse is extremely brief, so that there is no build up of heat in the surrounding skin.

What to expect during treatment

  • Usually, no anaesthetic is required, but if you desire, a topical anaesthetic cream or gel may be applied to the affected area before treatment
  • Safety eyewear will be used to protect your eyes
  • A handpiece will be used by the doctor to deliver the laser energy to the skin. Immediately before each laser pulse, a light spray of coolant will be fired onto the skin. Cooling the skin helps to minimise side-effects
  • You may experience a brief stinging sensation when the laser is fired onto your skin
  • You will experience some redness and swelling of the treated area. This will settle within 24 – 48 hours. Swelling is more common when treatment is carried out around the eye area
  • Depending on the laser system used, you may experience temporary bruising. This is much more common with the Pulsed Dye Laser than with the KTP laser. Like a normal bruise, this will settle within 10 – 14 days
  • Make-up may interfere with treatment and should be removed beforehand
  • Laser treatment cannot be carried out if you have a suntan as the tan will block penetration of the laser beam
  • It is also important to avoid tanning after laser treatment, to reduce the risk of pigment changes
  • Depending on the diagnosis, sometimes a test area, or small area of skin, is treated initially. This allows the doctor to gauge your response and tailor further treatment accordingly

Possible side-effects

  • With any laser treatment, there is a possibility of side-effects
  • The treated area may form a scab or become scaly. Do not disturb any scabs or scale. These should be managed by simply applying Vaseline Petroleum Jelly or Aloe Vera Gel to the affected area and they will resolve within 10 – 14 days
  • Pigment changes may also occasionally occur after the treatment. The treated area may either appear darker (hyperpigment) or lighter (hypopigment). Normal skin colour usually returns, but may take 6 to 12 months to do so. This side-effect is more common in darker skins and in those who tan easily. You must avoid tanning after laser treatment, as discussed above
  • Rarely, you may experience a slight indentation at the treated site. This tends to resolve within a few months
  • Scarring is a potential complication following the use of any laser. The risk is around 1% for the Pulsed Dye and KTP lasers. Aftercare instructions should be followed to minimise the risk of this happening

Sometimes, the blood vessels may be difficult to seal and / or they may open up again. This depends on how much blood is flowing through them and the pressure of the blood flow. New vessels may also develop. Therefore, more than one treatment may be required to achieve a satisfactory response. Treatment can be carried out at 6 weekly intervals. Thereafter, ‘top-up’ treatments may also be required, at 4 – 6 monthly intervals (although this may vary), to maintain the effects of treatment.

Different skin types and colours will also react differently to laser treatment and variations in treatment response may occur.
We therefore cannot make any guarantees that all marks and blemishes will disappear.