Face vein treatment can be done in a number of ways, although we tend to prefer to use the Xeo Cool Glide laser.
At Springdale we have two lasers that can be used for treating face veins – the Dual Yellow (copper bromide) laser and the Cutera Xeo Cool Glide laser.
Lasers work by absorbing into a specific target for an appropriate amount of time that allows very selective effects to be achieved.
In the case of blood vessels the target is the red pigment in red blood cells – haemoglobin. As the light energy in the laser beam absorbs into the pigment it creates heat. This heat energy breaks down the lining of the blood vessel which then heals as in sclerotherapy, with the opposing surfaces fusing together.
A great benefit of laser treatment is that it is very localised.
History Of Laser Treatment
Historically pulsed dye lasers were the first commonly employed and still are in a number of situations and certain clinics. They can treat a defined square area at a time, meaning a rapid pattern can be laid down. Several treatments on different occasions are required to treat an area.
The ones available up until recently created a large bruised appearance which tended to last for two or three weeks, which can be a problem for some people.
The latest generation of these has a pulsed cooling device that seems to reduce this side effect. They remain the treatment of choice for early port wine stains. Other newer lasers do work well in this situation too.
Dual Yellow Laser
The Dual Yellow laser can produce two light colours, a yellow 578nm and a green 511nm light.
For blood vessels the yellow colour is used. This can be applied with a non-contact tip or with a specially tapered clear contact tip that tends to make the treatment more comfortable.
The treatment light is about 0.6mm in diameter with quite rapid repeated shots being utilised. This allows for very fine and accurate treatment.
But it limits the size of vessels which can be treated. And due to the relatively low power it generates, it is not as effective at treating higher flow vessels such as those about the nose. See more>
Cutera Xeo Cool Glide Laser
Our main laser employed in face vein treatment is the Cutera Xeo Cool Glide. This infra red 1064nm light has been used for many years in medical applications in general surgery and gynaecology.
With the high-powered platform which runs it, even though the haemoglobin pigment absorbs less light at this wavelength, effective treatments are achieved.
It can also be used even in dark and tanned skins (which were a problem with previous lasers).
The larger blue reticular veins can be closed as well as high flow vessels including those about the nose.
With the cooling foot of the laser (a gold plated, copper metal one that is water cooled down to 2oC) the treatment is very comfortable and the skin pigment is preserved.
Using a 3mm beam penetration is limited.
A 5mm one is usually employed for the larger, deeper blue reticular veins.
Usually a couple of sessions gives the best effect as more vessels can be closed at the second treatment.
An added benefit from the Xeo Cool Glide is the Genesis programme which employs a low energy, very short but rapidly repeating pulse. This is useful in other applications for improving general skin condition and collagen synthesis. But with vessels it can close down some finer network ones that give skin a fine background blush. See more>
Polarised Light Viewing
In using either laser we employ visualisation with a Syris light that gives a magnified view with polarised halogen light. By removing the skin reflection vessels that are usually difficult to see become obvious.
Laser treatment can be costly due in large part to the high cost of the machines.
Post Laser Treatment Effects
Some redness and swelling will be evident afterwards.
The amount of this and the time it lasts depends on the number of shots employed. Usually the effects are present for a couple of hours. But in more extensive treatments this can persist for 48 hours or so.
It can be modified to a degree by applying 1% hydrocortisone cream during this period.
Another not uncommon effect is for the odd vessel to have a little altered blood in it. This appears a deepish purple in colour and will be spontaneously cleared by the body usually by around seven days.
Tissue damage is uncommon but can occasionally occur and will heal usually very well.
Preparation For Treatment
Makeup and all moisturisers and other topical applications with sun-block are removed as these can absorb laser energy and create unexpected tissue heating effects.
Also it is recommended that sun-tanning within two to three days before a treatment is avoided (the skin may feel more sensitive).
And artificial tan should not be applied for at least four days (and ideally about a week) before.
This is the modality we previously used at Springdale.
Treatment was by instilling a sclerosant solution into the veins with a fine needle.
We used a detergent-based solution, sodium tetradecyl sulphate (STS).
There are other types, with the other most commonly used being concentrated salt solution. This is often combined with some local anaesthetic as it stings on instillation. It can damage the surrounding tissue, too, if it is extruded.
In treating children, we tend to use some local anaesthetic cream applied under plastic film occlusion to the area for an hour before. Or, these days, there are more potent topical applications which usually exert their effect within fifteen minutes.
Post Sclerotherapy Effects
Some slight skin puffiness and redness (extent depends on extent of veins) lasting about two days and can be controlled with some hydrocortisone cream.
Sometimes a little blood gets trapped in a few vessels giving a darker purple line to them that last about a week. These can be masked with makeup.
When Should Treatment be Undertaken
For most conditions when the problem is bothering the patient.
This could be either through their own personal concern, or, for children, at such time as others may be bothering them about it.
Port wine stains are best treated at as young an age as possible, to achieve the best result.
Covering up the involved areas with makeup does help. The green based foundations are excellent for this.
Ones Used Elsewhere
Using electric current or radiofrequency to burn the vessels to close them.
The former type is commonly used by beauty therapists utilising their electrolysis machines. It is important to not create long-term scars. This is a risk in using heat that is non-specific and could affect local tissue as well.
Face vein treatment is relatively simple and straightforward these days with the technology available.