VEINS & SPIDER VEINS

LASER VEIN TREATMENTS
Kansas City

Often, one treatment with the laser can accomplish what four or five sclerotherapy sessions could accomplish. You should also know that many patients that have sclerotherapy often will have an increase in finer veins and matting of veins about 1 to 3 years after sclerotherapy, so they can be made worse by the sclerotherapy!

1. How does laser/pulsed light removal of unwanted blood vessels work?
Laser/pulsed light systems are a non-invasive light therapy devices specifically designed to eliminate undesired blood vessels from all parts of the body. The laser generates a pulse of intense, concentrated light which is directed through a handpiece which is gently applied to the treatment site.

This laser energy passes through the skin to the blood vessels which you wish to have eliminated, where the energy is absorbed by pigment in the blood, causing selective damage to the lining of the target blood vessel without damaging the surrounding tissues and skin. The deeply penetrating wavelength of the laser/pulsed light allows us to target blood vessels which other, shorter wavelength lasers cannot safely reach. The laser is pulsed, or "turned on", for only a fraction of a second. The duration of the pulses is carefully determined so that laser energy will be absorbed by the blood vessels without transferring excessive heat to the surrounding skin.

The blood vessels which have been destroyed are reabsorbed by the body, and the flow of blood is directed back down into the deeper vessels, where it belongs.

The surface of the skin is protected by cooling devices applied immediately before and after treatment, and sometimes by other cooling gels, sprays or rollers. This selectivity helps to protect the skin, while effectively treating the unwanted vessels.

The laser can be used just about anywhere on the body, and usually requires no anesthesia or other treatment. Even sensitive areas such as the nose and cheeks can be treated easily and with minimal discomfort.

The laser/pulsed light system's unique design allows us to customize treatment, according to the size and color of your unwanted blood vessels, your skin color, and location on the body.

Laser treatment is a safe, fast, gentle and effective method for removal of unwanted blood vessels. In just a few treatment sessions (in some cases only a single treatment session) using the gentle power of lasers/pulsed light, you can greatly improve the appearance of skin which is disfigured by unwanted blood vessels and “broken capillaries”.

2. How do newer laser/pulsed light systems differ from older laser systems?
Other laser systems include:
First Generation: Tunable Dye Lasers 575 - 605 nanometers and other short-wavelength lasers like the KPT and Diolite can be useful for unwanted vessels which are very close to the surface of the skin, but frequently cause extensive bruising when used at powers sufficient to eliminate undesired blood vessels.
Second Generation: Alexandrite 745-765 nanometer -- can be useful, but are also limited by their short wavelength.
Third Generation: Diode 800-810 nanometer are not as selective and not as useful on all skin types.

By contrast, the newer lasers, such as, the longer deeper penetrating 1064 nanometer wavelength, reaches even the unsightly blue vessels that can be several mm below the skin surface. Pulsed light systems are useful for spider veins, telangectasia, and matting of vessels, and other generalized redness or rosacea.

The longer wavelength makes it possible to safely and effectively treat all people -- including those with tanned, very dark or even black skin.

Like all lasers, it works more efficiently on light colored skin -- so to minimize the number of treatments you need, try not to have a fresh suntan when you come in for treatment.

The cooling head on many lasers provides an extra margin of safety and comfort, allows the operator a clear view of the area to be treated, and does not require pressure on your skin.

In addition, we are one of the few clinics to use the Syris Light illumination system. This cross-polarized, magnified, halogen illuminated device allows us to clearly visualize even your finest blood vessels, including those that cause unsightly redness but which individually are often invisible to the naked eye.

Laser/pulsed light systems also allows us to precisely adjust the power and the duration of the pulse of laser energy to best suit the diameter and color of the unwanted blood vessels on different parts of your body. Some older laser systems lack this degree of fine control.

3. How do laser/pulsed light blood vessel treatments differ from laser hair removal?
When it is used for laser hair removal, the laser selectively targets the pigment in the hair shafts. This heats up the hair follicle, which dies and is reabsorbed by the body.

When it is used for laser removal of blood vessels, the laser/light energy target the blood in the vessels which you want to get rid of. The blood heats the blood vessel, which dies off and is reabsorbed by the body. The flow of blood is re-directed away from the surface of the skin, back down beneath the skin where it should have been in the first place.

When blood vessels are treated, the laser has a special handpiece which allows a choice of spot sizes or head sizes.

4. What areas of the body can be treated?

ALL parts of the body CAN be treated (and ARE treated) with the laser/pulsed light. In women, the most common areas for treatment are blood vessels on the thighs, lower legs and ankles. In men and women, unwanted red blood vessels on the nose and face, including those associated with acne rosacea and with sun damage, are successfully treated. Cherry hemangiomas (red dots on the trunk, arms and legs), and “spider vessels and angiomas” on the face, upper chest and other parts of the body are other commonly treated lesions.

5. What are the benefits of laser removal of unwanted blood vessels compared to alternative treatments?
The primary benefits of laser removal of unwanted blood vessels are:
o Larger areas may be treated with less discomfort than with sclerotherapy or vein stripping.
o Lasers combines speed, comfort and long lasting results.
o The laser works on any area of the body where you wish to have blood vessels removed.
o Small blood vessels which are difficult or impossible to treat with sclerotherapy respond very well to vascular lasers.
o Because only a beam of pure laser light is used when the laser/pulsed light treats an unwanted vessel, there is less risk of bruising compared with injection sclerotherapy which breaks the skin and the wall of the blood vessel, then places an irritating solution in the bloodstream of the unwanted vessel.
o Because the skin is not broken, there is no need for bandages, tape or support stockings after laser treatment of blood vessels (though support stockings may be useful for combined treatments with larger vessels).

Laser/pulsed light removal of unwanted blood vessels offers long lasting results with minimal discomfort and little or no “downtime” after the treatment.

6. What are the advantages over sclerotherapy?
It has been said that:
"Removing blood vessels by sclerotherapy is like mowing grass -- one blade at a time!"

With injection sclerotherapy, the operator inserts a needle into the blood vessel and tries to inject an irritating solution into the unwanted vessel. The body detects that the vessel has been damaged, and reabsorbs the unwanted vessel.

Injection sclerotherapy can be an excellent technique for the removal of large vessels on the legs, and injection sclerotherapy is superior to any kind of laser treatment for the removal of blood vessels which are thicker than 4 mm in diameter.

Our doctor can combine lasers and injection sclerotherapy, depending on the needs and wishes of the patient. For example, injection sclerotherapy can be useful for large, deep blood vessels, which are easier to inject than to treat with laser. Some people who have a mixture of small and large vessels will have laser treatment to remove as many of the smaller superficial vessels as possible, and have injection sclerotherapy to remove large deep vessels.

Some people just don’t like needles and bandages, and prefer to be treated with laser/pulsed light only.

(Very large varicose veins may need the attention of a general surgeon for vein strippings or ligation).

7. Many people want laser removal of unwanted blood vessels, but everyone wonders: "How much does it cost?"
You will find that the fees listed below for laser removal of unwanted blood vessels using the efficient, effective, laser/pulsed light systems are surprisingly affordable.

Fees are per treatment session, and must be paid at the time of treatment with Visa, MasterCard, check or cash.
Treatment in our office is for age 12 and up.

Physician laser consultation is available by calling our office for an appointment, no referral is necessary.

8. Prices for Laser Vein Treatment

(We can give you a better estimate with your physician consultation, based on the clinical exam of your vein/vessel problems). In most cases, we can commit to an exact fee after the laser consultation. Averages $150 per 15 minutes of laser treatment time, with a minimum of $100 per leg (so $200 is minimum if both legs worked on). Two or three sessions (many clinics do five or six sessions) may be necessary for best results, but even one treatment gives nice improvement.

9. Is laser removal of blood vessels covered by insurance?

Any consultation fee for the laser blood vessel removal will be credited toward the cost of your first treatment if you elect to proceed with treatment.

Private insurance companies do not offer reimbursement for "cosmetic" procedures like laser vein and vascular treatments.

We do not file or accept any paper work for insurance filing on any "cosmetic procedures", laser service, or peels, or acne.

10. Is the cost of laser removal of blood vessels a tax deductible medical expense?

Check with your tax advisor.

11. What are the risks of laser removal of blood vessels?

Short-term side effects may include a reddening of the skin over the treated vessels or local swelling which typically lasts less than a day, although it may infrequently last a few days. New laser/pulsed light systems with longer wavelengths are less likely than older lasers to cause prolonged irritation, pigment changes, or blistering.

Occasionally there can be increased or decreased pigment change in the treated area. This is seldom a major cosmetic problem, and generally resolves after several months. Even a single blister (rather like a tiny sunburn) is unusual, and generally will resolve within a week or two with some Polysporin or Aloe Vera.

Bruising can occur occasionally when treating vessels on the legs which are 2-4 mm in diameter. This is more of a nuisance than a major problem, and usually resolves within a few weeks without needing any treatment.

Even though risks of side effects are low, even with the best of care, adverse reactions can happen, because of individual sensitivities to laser and pulsed light that cannot be determined prior to treatment, and can include redness, blistering, bruising, hyper and hypo pigmentation, dried blood and superficial clots in destroyed vessels as they are absorbing away, and in very rare instances scarring.

Laser/pulsed light does not cause skin cancer.

12. Is laser removal of blood vessels "permanent"?

"Permanent removal" means: "ALL the blood vessels are gone, FOREVER!"-No clinic can or should claim this!

There are NO treatments for blood vessels (including laser) which can guarantee anybody "permanent blood vessel removal" forever.

The most realistic description of the results after laser treatment is: "long term blood vessel REDUCTION". This means: "After one or two treatments on the face, or one to four treatments on the legs the total number of unsightly blood vessels are greatly reduced -- generally by 70% to 90%." Most people are very pleased with this degree of improvement, as long as they know that this is what to expect before they have laser removal of blood vessels. The cosmetic improvement in appearance is usually excellent.

Because lasers have been used on a large scale for blood vessel removal for only about the last 10 years, we can't know if the results will continue to be felt in 15 or 20 years. However, we do know that stable, long-term blood vessel reduction commonly lasts for at least two years, and some patients who had their last treatment many years ago are still enjoying a high degree of blood vessel reduction.

13. Should I expect to be "free of unsightly blood vessels" in the treated area after the series of treatments?

No, most patients experience a 70-90% reduction in the number of blood vessels in a given area, but you should not expect to be "completely free of unwanted blood vessels". No clinic can guarantee complete and permanent removal, and you should avoid these clinics if you are told this, because they are misleading you.

All our treatments are performed by a physician! Please be aware that many "laser shops" use technicians and many lack sufficient clinical knowledge about skin disorders and dermatological conditions.

14. How many blood vessels will grow back, and how fast will they grow back?

The regrowth of blood vessels after treatment by laser or by sclerotherapy is highly individual, and depends both on your genetic background and also on medical conditions like acne rosacea, medications you may be taking (like prednisone, or estrogens, for example) and on external factors like sun exposure (which can speed up the appearance of new vessels on the face and legs -- so this gives you one MORE good reason to protect yourself from the sun!) Further, many clinical conditions can cause aggravation of the venous system with venous incompetence (in the lower extremities especially). Large varicose veins may require the attention of a general surgeon for vein stripping or ligation.

If you take care to control medical conditions like acne rosacea, and protect yourself from sun damage, you can stop or at least slow down the rate at which new unwanted vessels appear on your skin of the face, neck, or upper chest.

Support stockings are useful to retard the growth of large, deep vessels and varicose veins which are treated by sclerotherapy, but support stockings are unfortunately not useful to prevent the unsightly 1-3 mm superficial vessels and spider veins on the legs which are treated with laser or pulsed light systems. This is what makes the laser/pulsed light system so useful to improve ones image and confidence to wear shorts, swim suits, or any other revealing options you might elect.

15. How many treatments are needed?
The number of treatments will depend on:
o the desired degree of blood vessel reduction/and present clinical status of vessels
o hormonal status
o area being treated
o medication (for example medicines like prednisone, estrogens, can increase superficial blood vessel growth)

Typically, one or two treatments are needed for facial vessels; and three or four treatments may be needed on the legs. On average, treatment can be done every 6 weeks on the face, and every 3 months on the legs. Cherry hemangiomas (red dots on the body) usually only require one or two treatments.

Some people start with the area which troubles them the most, then when they can see the results they often return to have other areas treated.

Our office frequently uses a combination of modalities, to include lasers and pulsed light for the larger vessels, all based on the clinical judgment of the physician to give you the best treatment options.

Additional "touchup" treatments on small troublesome areas can be arranged at relatively low cost. There is no safety limit on the number of treatments a person can have. People who have been partially treated with other types of blood vessel removing laser and/or injection sclerotherapy might in some cases need a smaller number of laser treatments.

16. Previous sclerotherapy or laser treatment? No problem!

Laser/pulsed light has been successfully used on many people who were not able to tolerate -- or did not obtain satisfactory results with -- older short wavelength laser systems, including dye laser, ruby laser, alexandrite laser, and 800 nm diode lasers. Newer laser/pulsed light has also been beneficial for people who are having injection sclerotherapy for larger, deeper vessels and for people who have had injection sclerotherapy in the past.

17. Am I a good candidate for laser removal of unwanted, unsightly blood vessels?

The unique design of the newer laser/pulsed light systems in our office, and their longer wavelengths, allows treatment of people with all skin colors. A smaller number of treatments is needed when the skin is light colored -- so to get maximum effect from each session avoid coming in with a fresh suntan or sunburn at the time of treatment, but even people who have black skin can be successfully treated with the newer laser/pulsed light systems in our office. Our office can treat all skin types I through VI.

Children can be treated, for example if they have a congenital hemangioma or have some “spider nevi” on the face or other parts of the body, but the child must be old enough (for example, 12 years old) to understand and cooperate with treatment. Tiny lesions, such as “spider hemangiomas” sometimes only require 2-3 pulses of the laser. Our office restricts laser treatments to age 12 and up.

Lasers and pulsed light systems are excellent for the treatment of vascular redness and rosacea of the nose, face, neck and chest area that can cause tremendous psychological impact to a patient.

Reasonable people who have realistic expectations tend to be excellent candidates for laser/pulsed light removal of unwanted blood vessels.

Am I being “vain”?

Many people at some time before laser treatment for unwanted vessels, hair removal, acne, or before photo facials or skin rejuvenation for wrinkles have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have laser hair removal, blood vessel treatments, skin rejuvenation and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after our appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have laser hair removal, and other laser treatments if it is for you. It is a big mistake to do these things if it is just for somebody else. You need to want it for yourself, not just to try and please others.

As another esteemed doctor has noted: the same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and well dressed, and often careful in their diet, exercise, and other aspects of health maintenance leads our patients to seek help for their wrinkles and the aging process. The same holds for laser hair removal, vein treatments, newer light treatments for acne, treatment of age spots and pigment disorders with laser/pulsed light, or skin rejuvenation with laser/pulsed light treatments.

These individuals are normal healthy people, and the same degree of self interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of cosmetic laser procedures. Our patients simply want to look their best and they should, "go for it", you have earned it!

18. Which types of vessels respond best to treatment?

Blood vessels you can see with the naked eye tend to respond best to laser treatment. Vessels so small that they can only be seen with magnification are difficult but not impossible to treat. Vessels larger than 3-4 mm in diameter, and vessels which are considerably elevated above the surface of the skin, respond better to injection sclerotherapy and even larger ones to surgical removal.

The color of the vessels can range from light pink to dark purple.

19. Questions to ask yourself when considering laser blood vessel removal.

How much are you bothered by your unwanted blood vessels?

How much are you bothered by the time you spend concealing your unwanted blood vessels?

How uncomfortable do your facial, neck, chest, thigh, leg or other unwanted blood vessels make you feel when you are dealing with other people?

Does the appearance of your unwanted blood vessels inhibit you in exchanges of affection with your partner (for example, are you uncomfortable if your partner sees your legs?)

How uncomfortable do your unwanted blood vessels make you feel when you meet new people?

Do you fear that the appearance of red vessels on your nose and face makes people think that you might be a heavy drinker?

Do they make you appear much older than you could look?

How uncomfortable do your unwanted blood vessels make you feel when you go to social gatherings, dine out in a public restaurant, go to a beach, pool or gymnasium, or other public place?

Do your unwanted blood vessels (for example, on you legs) inhibit your choice of clothing or limit the activities that you engage in (for example, swimming, wearing shorts, or wearing shorter skirts)?

How uncomfortable do your unwanted blood vessels make you feel when you go to work or school?

**Laser/pulsed light therapy for blood vessel treatment, hair removal, skin rejuvenation, light therapy of acne, treatment of age spots and pigmentation problems, and other cosmetic treatments, add significantly to an individuals self-esteem, self-image, and overall physical and psychological well-being. Patients that have had cosmetic procedures often feel it was some of the best money they ever spent. Most of you spend all your time helping others, this is something you can do for yourself. Go for it!**

                                     Normal valves in vein moving upward,
                       and abnormal varicose vein valves leaking a backflow

20. What causes unwanted blood vessels?

o Unwanted vessels on the surface of the skin of the legs are to some extent an inherited tendency, and become more common with increasing age. They can also be made worse by sun exposure, and sometimes become more prominent after pregnancy. They can in some cases be made worse by or be associated with varicose veins.

o Unwanted blood vessels on the face (sometimes referred to as: “broken capillaries”) are more common in people who have a tendency toward acne rosacea; and are often made worse by sun exposure. As with unwanted vessels on the legs, there is sometimes a family history of other people with a similar problem.

o Spider hemangiomas on the face and other parts of the body are a common nuisance, and can be quite disfiguring. Most children and adults who have a few spider hemangiomas are perfectly normal and healthy. Rarely, numerous spider hemangiomas are found to be associated with serious liver disease or other disorders. People who are otherwise healthy and have just a few spider hemangiomas do not need any blood tests or other investigations.

o Telangectasia on the face and other parts of the body can sometimes be associated with medications like prednisone and other corticosteroids, and with certain skin diseases like lupus.

o Sometimes children will be born with “port wine stains” or other types of hemangiomas, or these may become apparent as the years go on. Some of these hemangiomas can be improved or even eliminated by vascular lasers.

21. What is a "test area", and why is it sometimes performed?

"Test areas" are small areas of skin that are treated at various laser energy levels, with various spot sizes and at various laser pulse durations prior to treatment of large surface areas, for example, if there is an unusual hemangioma or port wine stain. This may be done at the same time as your consultation, and a small fee is sometimes required for this test. The fee for the "test area" will be deducted from the cost of your first treatment if you elect to proceed with treatments. "Test areas" are not necessary in most cases and would usually be performed if some unusual sensitivity could be suspected.

22. Moles, freckles and tattoos in the area to be treated?

Small moles and freckles do not usually require any special precautions. Large, dark moles and freckles which are in areas to be treated may require a reduction in the intensity of the laser light, the same way that the intensity would be reduced when treating a dark-skinned or tanned person. Tattoos might require a "test area" to make sure that they will not absorb an excessive amount of laser energy, which could cause fading of the tattoo, discomfort or even a burn. We generally prefer not to treat over tattoos. Be sure to tell the doctor if you have permanent lip liner or permanent eyebrow liner, because these are tattoos and special precautions may be needed in these areas.

23. What will happen on the treatment day?

Other than your regular skin care routine, there is no standard "prep" for this procedure. There are no restrictions on what you may eat or drink prior to your appointment. Many people like to take 2 or 3 plain Tylenol to prevent or reduce any potential discomfort.

Please shave or clip the areas to be treated before you come in for treatment. Freshly shaved skin is more sensitive, and there is less discomfort if you wait at least an hour between shaving and having laser treatment. Excess dark hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the undesired blood vessels, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin. If there is just a bit of “peach fuzz” on your skin, this will not be a problem, because “peach fuzz” is very fine and fair and so does not absorb laser energy. It would be best to shave about 24 hours before a laser procedure.

When you come for treatment, it is important not to wear any makeup -- or at least wear simple water-based makeup that can be easily removed -- because makeup can sometimes absorb laser energy. This could interfere with treatment, or even cause overheating of the skin surface and burning. Makeup also makes it hard for us to see the vessels you would like to have treated. Makeup can be re-applied immediately after laser treatment, if done gently, if you wish.

Many patients find that they have less discomfort if they shave the area to be treated at least a couple of hours to 24 hours BEFORE coming in for treatment, because freshly shaved skin is often somewhat more sensitive.

After all of your last minute questions have been answered and paperwork handled, the areas you wish to have treated may be cleansed and pre treatment photos may be taken. Everyone in the treatment room must wear protective goggles when the laser is turned on. The laser/pulsed light is a high powered laser system, and can cause eye injury if proper eyewear is not worn while the laser is used.

The length of the procedure itself can range from a few minutes for a few spider hemangiomas to an hour or more for very extensive blood vessels on the thighs and lower legs.

If you decide before coming in that you would like to have additional areas treated, please call ahead so that we can schedule enough time to accommodate your needs.

The process is very simple...

Cooling gels, sprays, pads, or rollers may be applied to the skin for a minute or two before the area is treated. Immediately before the laser is used on an area, the cooling pad is removed and a thin coat of clear gel or spray mist may be lightly smoothed over the skin, then the laser pulses are quickly and evenly applied to the unwanted vessels. A cooling method may be applied to the skin before and after each pulse of the laser/pulsed light system, to further protect your skin and prevent or reduce discomfort.

You can bring a friend or family member if you like -- quite often mothers and daughters will come in together for laser treatment. Generally, because of room size and crowding, and need for laser goggles, we tend to restrict the treatment room to the patient only, special arrangements can be made with our office, it is best not to bring along younger children. We do have an age limit restriction in our office to children age 12 and up for any treatments.

24. Does it hurt?

The laser or pulsed light system emits only light. You may feel a tingling or snapping sensation like a rubber band. There is no bleeding and no open wound is created. Some people find the FIRST laser treatment more uncomfortable than subsequent treatments. Maybe this is because there are more blood vessels which are destroyed during the first treatment, and perhaps also because some people are more apprehensive during the first treatment, because they are not sure of what to expect. We will do our best to allay your fears, generally speaking, the treatments are quite tolerable.

While some areas of the body like the nose are more sensitive than others, many patients report little or no discomfort. If there is unusual discomfort, please let us know so that we can apply more cooling or adjust the settings on the laser or pulsed light system.

People who have had injection sclerotherapy (or treatment with the electric needle, or with other lasers like the KTP laser) usually report that the longer wavelengths cause less discomfort, and sometimes there is almost no discomfort.

Our careful use of cooling devices if needed, contributes greatly to the comfort and safety of our patients. In addition, with our laser/pulsed light systems we have the ability to adjust the frequency of laser pulses, the power level, the pulse duration and the beam width or head size in sensitive areas, to maximize your comfort.

Topical anesthetic cream is occasionally used in very sensitive areas or by those who think they have a very low pain threshold. Topical anesthetic creams can be purchased without a prescription, and a very thick layer should be applied an hour before the procedure. Most people do best with cooling gel packs and Aloe lotions or creams, and do not bother with anesthetic cream.

Most people find it helpful to simply take two or three Tylenol 2 hours before coming in for treatment. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time. You should pamper yourself on laser day: for example, make sure you are not hungry or thirsty when you arrive for your laser appointment, because people who are hungry or thirsty tend to be more sensitive.

25. What will happen after treatment?

Redness often has faded greatly by the next day. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favorite moisturizer or Aloe Vera lotion or cream. Please avoid tanning or sun exposure at least 1-2 weeks before any laser/pulsed light treatments. Our office will not try to peddle or sell other lotions or creams to you like many do, when your own moisturizer or OTC aloe vera lotions will work very well.

The treated blood vessels, in particular on the legs, may appear slightly more obvious or a bit darker for the next week or two, but this is seldom a major cosmetic problem, and generally less obvious than after injection sclerotherapy. Occasionally on the legs and infrequently on the face there can be isolated superficial bruising which generally is a nuisance and resolves within a week or two on the face, or several weeks on the legs without needing any treatment.

It is important to note that even though side effects or adverse reactions are rare, they still can occur, and it is often impossible to predict with the best of care when these will happen, mainly because of increased individual sensitivity to laser or pulsed light and the subsequent reactions that occur. These can include redness, dryness or scaling, bruising, blistering, hyper or hypo pigmentation, rashes, brownish staining of the skin, clots or phlebitis, infection, dried blood or superficial inflammation in destroyed vessels as they are absorbing away, and very rarely scarring to an area.

26. Why do the blood vessels sometimes look more obvious for several weeks after treatment?

After the blood vessels are treated with laser energy, they sometimes swell up slightly, and the body moves in to begin the job of removing and absorbing the treated vessels.

Sometimes portions of the vessels will seal off immediately, and a bit of blood stays behind in the treated vessels, causing temporary red or purple coloration. If this happens, the blood in the vessels is usually reabsorbed along with the vessels themselves by the body over a period of several weeks to a couple of months on the legs, without needing any additional treatment. If a little pocket of old blood persists it can easily be removed if you wish.

27. Are there any restrictions on my activity after treatment?

Since the laser does not burn or cut the skin in any way, no bandages are necessary. You can return to work the same day and resume all your regular activities. To reduce the chance of uneven tanning in the treated area, you should minimize sun exposure and tanning for a week or two after treatment.

28. Pre-treatment instructions:

1. Please try to minimize tanning for a week or two before treatment: a fresh tan can interfere a bit with the effectiveness of the laser/pulsed light treatment, though this is less of a problem with the newer long wavelength lasers, than with older, short wavelength lasers.

2. Please do not wear makeup on the areas to be treated, or at least wear makeup that is easy to remove before treatment so that we can easily see all the vessels you would like to get rid of. If makeup absorbs laser energy, less energy will reach your unwanted blood vessels, and if the makeup heats up it could irritate or burn your skin. Makeup can be re-applied immediately after laser treatment, if you wish.

3. Please shave or clip the areas to be treated the day before treatment or on the morning of treatment. This way, the skin will be less sensitive. Excess hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the unwanted blood vessels where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin.

4. Some people find it helpful to simply take two or three plain Tylenol 2 hours before coming in for treatment. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time. You will be less sensitive if you are well rested, well fed, and not thirsty when you have your treatment. You should pamper yourself on laser days!

During the treatment, remember that: “We want to be doing this FOR you, not doing it TO you.” Unexpected discomfort is Nature’s way of telling us something is wrong, so please tell us and we will go slower, apply more cooling, or adjust the power of the laser for you.

29. Post-treatment instructions:

1. Redness often has faded greatly within a day or two. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favorite moisturizer or aloe vera cream or lotion. The treated blood vessels may appear slightly more obvious for the next week or two, but this is seldom a cosmetic problem, and generally much less obvious than after injection sclerotherapy. Masking or concealer cosmetics may be used as necessary, but do not overly rub or irritate the vessels that have been treated.

2. Try to avoid tanning for a week or two after treatment, because occasionally the tan could be somewhat irregular (lighter and/or darker in the treated areas.) and sunscreens are always smart options to protect your skin.

3. You do not need to purchase expensive support stockings or special creams, and there is no special routine for you to follow, except if larger vessels are also treated by sclerotherapy with combination treatments with lasers, then you may be encouraged to wear support hose for several weeks.

4. Blistering or scaling after laser/pulsed light treatments with longer wavelengths of light for removal of blood vessels is very rare, but usually resolves over a few days or a week with a bit of Polysporin or aloe vera cream several times a day. Please call us if you feel you are having any unusual reactions, or if you have any other problems or questions.

OUR OFFICE WANTS TO CARE FOR YOU, AND HELP YOU TRY TO LOOK YOUR BEST.

PLEASE CALL US AT (913) 962-1869 FOR A CONSULTATION FOR LASER SERVICES.