The treatment of telangiectasias of the face represents a modern and effective solution for those seeking to relieve and improve the appearance of veins on the face.
These small vascular dilations, although commonly harmless, can be a source of aesthetic discomfort for many people.
At Unilaser Médica, we understand the importance of specialized and personalized treatment for each case, whether due to couperose, rosacea or simply the presence of visible veins or red dots on the facial skin and throughout the body.
Couperose, a condition characterized by the appearance of small red or blue veins on the face, can be especially problematic. Often confused with rosacea, couperose requires a specific treatment approach.
Our team of experts uses the latest technologies and techniques to provide effective couperose treatment, minimizing the visibility of these veins and improving the health and appearance of the skin.
Rosacea, on the other hand, is a chronic condition that can cause redness, veins on the face, and sometimes red bumps.
Although rosacea can be more complex to treat due to its persistent nature, at Unilaser Médica we offer advanced treatment options that not only address the visible veins but also the underlying symptoms of rosacea.
Our approach to the treatment of facial telangiectasias focuses on personalization. Each patient is unique, and therefore, each treatment plan is adapted to their specific needs.
We use a combination of laser therapies and other non-invasive treatments to reduce the visibility of veins on the face, improve skin texture and provide long-lasting results.
The following text may be very technical. We will later create other more direct pages related to individual cases.
The main purpose is to announce the arrival of new equipment that we have already used and known its results.
Factors to Consider in the Treatment of telangiectasias of the face
- Vessel Density : Facial telangiectasias vary in density. In cases of high density, such as photodamage or rosacea, multiple sessions are required to treat the abundance of very varied types of thickness.
- Vessel Thickness : Vessel thickness may require different types of laser or power and pulse length parameters.
- Depth of Vessels : The depth of the vessels affects the choice of laser. Lasers such as Nd-YAG are effective for deeper vessels. Also sometimes it may be necessary to choose a shortcut with radio frequency.
Types of Lasers and Their Application
- Primelase Nd-YAG Laser :® Ideal for treating violet and red vessels. This laser penetrates deeply to coagulate the affected vessels.
- Milesman® 445 Laser : Used for thinner and more superficial vessels. It offers high selectivity, although its penetration is lower compared to Nd-YAG.
- Viridex ®: Ultramodulated radiofrequency equipment. It works by direct contact with the glass.
Important Considerations
- Multiple Sessions : Most cases require multiple sessions to achieve full results. The number of sessions varies depending on the density, thickness and depth of the telangiectasias.
- Post-Treatment Follow-up : Regular follow-up is essential to evaluate the effectiveness of the treatment and make adjustments if necessary.
- Risks and Safety : It is important to discuss possible risks and post-treatment care.
Vessel Density: A Key Factor in Laser Treatment of Facial Venous Dilations
Treatment of facial telangiectasias with laser
The presence of numerous telangiectasias on the face implies a detailed approach to treating a variety of vessels, from the thinnest to the thickest, located at different depths.
There is no laser capable of selecting each and every one of the vessels using a scanner so that they can be eliminated in the same way.
In high-density cases, such as photodamage, rosacea, and inherited vascular disorders, we face the challenge of treating a large number of thin vessels, which often results in less noticeable changes after a single session.
Comprehensive treatment, in collaboration with dermatology, is crucial to achieve long-lasting results, especially in chronic inflammatory conditions.
In your treatment strategy, it is important to avoid two extremes: A too gentle approach can be as disappointing as an overly aggressive session.
Therefore, it is essential to plan multiple effective sessions, performed sequentially, to adequately treat all vessels.
Furthermore, it is common for many vessels to reappear rapidly, underscoring the importance of continuous monitoring as part of treatment.
Salmon Patch Type Vascular Dilations
An example of high density of small vessels is the common “salmon patch,” also known as “stork bites” or “angel’s kiss,” frequently visible on the face and neck of newborns. They are genetically defined areas to house the type of vessels they contain: Multiple and very small.
Although unsightly for some, they are easily camouflage.
These lesions are not challenging, it is simply not possible to treat them since a replacement technique will cause scars more noticeable than the mole itself.
In the future, there will surely be some equipment capable of reversing the genetic material of this type of tissue. Mechanically, it is impossible to achieve this.
Port Wine Stain Type Vascular Dilations
The stains on port wine are darker because the vessels are thicker than those of the salmon patch.
The indication here appears due to the difficulty in camouflaging them.
Some cases are resistant to laser treatment.
There are also cases that recur after initially successful treatments.
Hemangiomas
More segmented and smaller dilations, such as Ruby nevi, are easier to treat due to their greater circumscription and small size.
However, actively growing or partially treated lesions may have paradoxical behavior.
Regarding cherry hemangiomas, it has been shown that they are not lesions with afferent vessels. The density of these lesions can be high, especially in the anterior trunk, arms and thighs.
Sampling with polarized light equipment often reveals a large number of these lesions, which explains the impression of their reappearance. Although traces of lesions are also observed after treatment, they are generally inconspicuous.
For this type of injury, lasers such as the Milesman 445 and Primelase with its vascular piece are ideal, being drier and less painful than other types of laser.
Additional considerations regarding density in the treatment of facial telangiectasias with laser
- Vessel Thickness: The smallest vessels visible on the face, red in color, with a caliber between 0.4 and 0.5 mm, can collapse with different types of lasers, as long as an appropriate handpiece is used. to the diameter of the glass.
- Vessel Depth: Superficial violet and red vessels require different types of lasers for effective coagulation. In the case of salmon patches and port wine stains, we are dealing with smaller and deeper vessels than red telangiectasias. Larger hemangiomas, meanwhile, often require a surgical approach, especially if they are deep.
Vessel thickness as a factor in the treatment of facial telangiectasias with laser
The smaller vessels visible on the face are red in color, and could have a caliber between 0.4 and 0.5 mm when they can be seen individually. When this does not occur and a pink appearance is seen, the skin has a diameter close to 0.2 mm and, as a rule, they are numerous.
Vessels identify smaller and collapse more easily with the Milesman 445 ® laser.
The violet vessels exceed diameters of 0.5 mm and can reach 1 millimeter in diameter. The Nd-YAG laser can reach them.
Another factor to take into account is the parameters used in relation to power and pulse duration.
Power is the amount of energy that is brought to the vessel, as well as how it affects it, it could destroy the host tissue if it is high. If the power is low, nothing happens, the glass does not collapse.
The final point for many lasers is to show the effect of vessel collapse. Once this is observed, the best advice is to reduce it rather than increase it.
Why so? Well, because a greater thermal effect would most likely lead to destroying the portion of skin overlying the glass. And using a lower but effective power can improve pain tolerance and decrease the possibility of dermal damage in a reshot.
In general, with superficial vessels, the collapse effect can be better observed. The vessel can reappear, but many times it is smaller and will only return to its original size as the years go by.
Telangiectasias behave a little differently than hemagiomas in terms of their progressive reduction and the rarely seen phenomenon of mat revacularization that occurs after sclerotherapy.
For slightly deeper vessels, a coagulatory effect could be sufficient in thicker vessels. It is the safest and will always have a second chance.
Another factor to take into account is pulse width.
Pulse widths in vascular lasers range from one millisecond to several tens of milliseconds.
Wider vessels will need to increase the power to the extent that it is being observed that it is sufficient in short pulses for thinner vessels and that, when selecting vessels with a larger diameter, maintaining the same power will decrease the energy density sufficient to obtain a collapse of it.
It works something like wanting to obtain higher water pressure by closing the diameter of the hose or pouring it with lower pressure.
And there are more details, far from the didactic intention of this article, considering the most important being the diameter of the handpiece and also the frequency in shots per second that is being used. (Hertz).
Depth as a factor in the treatment of facial telangiectasias with laser
The purple glasses are a little deeper. They cannot be treated with a superficial laser like the Milesman®. The laser choice will be the Nd-YAG 1064 laser.
The red ones are more superficial.
Some vascular formations may have a deeper origin and in these cases Polaris LV® has proven to be useful.
In some cases the depth may be within reach of a special radiofrequency needle accessed by the Viridex® radiofrequency equipment.
Why can laser treatment of facial telangiectasias be dangerous?
Dermal injuries are not uncommon in vascular skin treatments.
The dermis is the structure that surrounds the vessels and can be injured by overexposure, especially in those cases in which the vessel does not collapse after the first laser shot.
The usual attitude is to reshot, but this is when unexpectedly destruction of the dermis can occur.
In these cases it is preferable to make a new appointment to perform a new session or to observe changes that could be interpreted as resolution of the vessel.
Also, when lasers with wide impact diameters are used, the skin pigment will preferentially capture the laser in darker skin.
What are the easiest vascular lesions to remove?
Ruby nevi (red dots or balls) are small, superficial and very well circumscribed. Their removal is better tolerated with the laser because they are not usually generated by tributary vessels, but rather a contained growth of exuberant and very small vessels.
Treatment with the Milenium 450 laser is especially beneficial when we have a high amount in the body.
More specific injuries can be treated without using anesthesia and in much larger quantities.
Higher lesions are best removed with local anesthesia.
Also the treatment of venous lakes can be very efficient, especially these lesions are very circumscribed and are quite difficult to treat with other methods.
The initial response of the vessel is observed with a change in its diffuse appearance to a more circumscribed one without loss of the mucosa due to heating and with complete resolution in the control after the procedure.
How is spider veins treated?
Unlike laser treatment of other vascular dilations, it is preferred not to reshoot the tributary vessel to avoid injuring the skin with highly penetrating lasers. In many cases, it is the persistence of the central vessel that causes the lesion to persist.
What's new in the treatment of facial telangiectasias in Colombia?
The arrival of a new blue wavelength device, the Milenium 450 device, has been especially beneficial for the treatment of smaller vessels on the face.
The Milesman® equipment is a diode that, at low power, has so much energy density that it allows very small diameter vessels to be impacted with little pain and trauma after the session.
We were surprised by the duration of the effect, very temporary with the previous lasers we had used. Recovery is also very quick.
The new Primelase® handpiece in ND-YAG wavelength is effective in treating violet vessels on the back of the nose and in the middle of the cheek.
