Anyone have any experience with facial telangectasia increasing after fotofacials? And any advice on best treatment to fix it?

In some instances, treatments can cause matting of the vessels making them worse. Personally, I don't treat cases like this for fear that it will continue to get worse - though you may want to try Yag or Vbeam at purpuric levels.

Annie,

I treat a lot of facial redness and telangectasias with a BBL for the fine veins and a 1064 for the larger veins and have never had the problem. Ironically, I will use my BBL on vascular netting/matting following the use of 1064 or sclero on the legs.

What system are you using? what filter and settings are you using? My assumption is that you are using a onesize fits all photofacial (filter) and using too long a pulse width with high energy and causing too much trauma to the area but I could be wrong. You really should not see much of the netting/matting on the face if correctly treated as the face is much lower pressure.

LH, what pulse duration do you use when you treat vascular with your BBL. I have been using 10 ms and the 560 filter. I started to use the shortest pulse duration because the Pulse Dye Laser sometimes treats at 0.4 ms. What are your thoughts?

Jee,

I use the 560 filter at 10msec and 20 to 25 degrees cooling at 14 to 20 joules and I have never had anyone get the matting seen with some lasers. Remember most of my patients are fitz 1 to 3.

I also use a Syris 600 polarized light system so that I can watch for a reaction. I am either looking for blanching of the vessels or darkening. You can also watch after you have done a full pass and the veins look blurred. Witht the polarized light the vessels will not be as well defined. I also will occasionally make multiple passes.

I thought fotofacials were supposed to treat redness, telangiectasia, pigmented spots or sun damage, as well as over all rejuvenation?

Yes ann967. But it depends on the machine and the operator. Not all IPL machines are created equal.

We have Aurora (IPL + RF) of Syneron in our clinic and it gives our patients excellent results.

We've been offering laser photo facials. We use the revlite q switch YAG combined with microdermabrasion and omnilux recommended once per week for six weeks then to maintain once every three months. Luckily, we haven't seen any complications like what Annie claims.

The best available wavelength to treat superficial red blood vessels on the face /body is the 577 nm laser, followed by 532 nm,

IPL remains a staple in many skin clinics and aesthetic practices. The trend is to combine IPL with other treatments which enhances results for patients and raise the average treatment fee for the clinic.

Annie,

Two possibilities. Depending on your filter it might be absorbing more in the melanin, which sits on top of the vascularity, and essentially taking the cover away. If you had a piece of smoked glass and put your hand underneath it you wouldn't see your hand. Strip away the color in the glass and you will see your hand. Same thing with removing pigment and the appearance of more vascularity.

The other thought is that because you are using Syneron you have to be in contact so you don't get arcing. The pressure you are applying might be blanching the vessels during your treatment. If it blanches them they won't won't be there to absorb.

The combination of the two above might be your problem.

Has anyone tried 810nm for telangiectasia? Personally I like the 532nm laser for red blood vessels on the face, but since the longer 810 nm wavelength penetrates deeper into the skin than shorter wavelength, it may be a good choice for badly effected telangiectasia with increased melanin.

The best treatment is PDL. I use the VBeam 595nm by Candela. There are 2 main options to treat those patients. The first is using an aggressive treatment of very short pulse ( .45-1.5 msec) which will create a purpuric treatment. I use this treatment a lot. The purpura will disappear in 5-7 days. One or two treatments will be enough. The non purpiric , with longer pulse duration , will need 4-5 treatments.

It depends on the depth of the redness and vessels. IPL for superficial 532 range. However for deeper vessels ND:YAG is better. One must make a diagnosis of depth and flow.

595 nm...

I own a Sciton system with a BBL (broad band light) platform and love it. I used to be a Vbeam user and have come to the IPL world as well. Yes there still is swelling with a good treatment but the nasty purpura is no longer an issue.

1064 and sometimes I have great luck with IPL (560). Both got me where I needed to be with results but Im always open to others that I haven't used depending on who is the manufacturer.

The maximum absorption of the hemoglobin is about at 420 nm and less at 520 and 590 nm and less at 930 nm.
For patients with skin type 1 to 3, the best choice is the laser with the wavelength around 550 and for the patient with skin type 4 and 5, the ND-YAG with the 1064 wavelength is the best choice.

I use BBL 560 nm for those clients who are types 1-3 and 1064 for those IV and over. Fortunately most of the requests for redness and vessels are usually people with fair skin. Once skin is a true IV there may be the need to chase a vessel but they rarely are complaining about overall redness because the pigment hides it.

The best choice for me too is 560nm. That's why I am using BBL 560nm for patients with skin type 1-3 but I liked the combination with 1064 after the BBL,which reduces the number of the sessions and produces excellent results.

There are 2 types of redness: 1. background or flushing 2. telangiectasia: deep + superficial. Combination laser wavelength are often used by me. Cutera's 520 nm and 1064 Nd:YAG covers all the problems. Cutera has a rapid firing Nd:YAG wavelength that calms the flushing and decreases the background redness