Introduction
Laser vein removal is performed using a 1064 wavelength laser, which is safe for all skin tones and is able to hit deeper spider veins and reticular veins. It is referred to as an Nd YAG. 1064 is the wavelength of the laser. As the wavelength number goes up- the deeper it will penetrate and the less energy it has in each energy packet or "photon." The Fluence or energy level per surface area is turned up to get the desired energy level (in this less powerful packet) to attain the desired results. The treatment uses a cooling device on the skin and the laser shoots through this to hit the vessel and heat it up. We use short bursts of laser shots to carefully overlap and coagulate the blood in the vessel. We balance heating the vessel with keeping the epidermis undamaged. This is an artform. The blood vessel will look darker after treatment. Initially when struck by the laser the vessel seems to disappear. The color comes back to the vessel and it is coagulated shut. Patients refrain from areobic exercise, spicey food, hot tubs and alcohol for a few days. These all tend to vasodilate and open the vessels. Treatments are performed and we recheck your progress in about 4 to 6 weeks. Our device uses contact cooling, meaning a water-cooled crystal is placed on the skin and the laser shoots through this. The cooling helps to protect the outermost layer of skin, the epidermis, from burns or pigmentation changes. We have, for the last two years, been integrating IPL with out laser treatments. The IPL is able to get the very smallest blood vesssels that the laser is unable to heat up. Any laser or light treatment should hit a target with the wavelegth which it is able to see. Small objects cool down as fast as they heat up due to having more surface area than volume. As objects get larger, there is less surface area to conduct heat away from the larger volume. This means larger objects are easier to treat than small ones (most of the time.). The very large ugly "road map" vessels are easy for the laser, but the smallest little faint vessels can't be heated as easily. This is where our combination care really shines. Utilizing IPL (non-laser) and 1064 laser has given us more control over the vessels you want to be free of.
Discussion
Long wavelength lasers, such as the 1064 have become the gold standard for treatment of unwanted veins. The longer wavelength allows the beam to reach deeper into the dermis to hit the blood vessels. Some veins are too deep to be reached by other lasers or IPL. The long wavelength also makes it safer for darker skin-types. If you do not have green or blue eyes, you are a person of color from a laser treatment perspective. Melanin gives the skin its color tone and can absorb energy from any laser used for vein treatments. This can lead to burns and pigmentation problems. In general, hyperpigmentation or darkening of skin patches and is the result of inflammation and is temporary. Hypopigmentation or lightening of patches of the skin may be permanent due to actual destruction of the melanin producing cells. No laser is without its potential problems. Even the safest lasers can be dangerous in untrained hands. We are very conservative in our trreatments. I would rather you need an extra treatment, than cause a problem. Our device is also able to cool the epidermis during the treatment. We set the temperature to a specific setting for your skin type. This improves safety even further and makes the treatment more comfortable. Keep in mind, there is discomfort associated with these treatments.
FAQ
I had laser vein treatments before but it did not work, why was that?
If the treatment looked like a flash of light you had an IPL treatment and not a laser procedure. IPL is limited in its ability to treat deeper and larger veins due to the risk of heat induced skin damage and therefore low energy is often used. the IPL is like a shotgun of light, shooting out many wavelengths of light. This is great with for photorejuvenation, but not larger vein treatments. Our laser goes deeper, and puts more energy down without risk of complication because it has a specific wavelength to hit just blood vessels. IPL does work wonderfully well on tiny telangiectasia on the face or legs.
I had a treatment and I had blisters afterward. What happened?
Treatment for veins targets hemoglobin. Melanin, the pigment in the skin, which gives us our skin tone, follows a very similar absorption curve and short wave length lasers can hit both. When too much energy hits the surface of the skin, the epidermis can be damaged. In order to effectively treat a vein and prevent skin damage, the energy to the dermis must be greater than the energy on the epidermis. The way to increase the amount of energy going into the dermis is 1) use a long wavelength, 2) cool the epidermis, 3) decrease the distance to the dermis and 4) extending with width of the pulse. All of these conditions can be met with our long wavelength 1064 laser with contact cooling.
I had injections a while ago and now I have dark stains.
Sclerotherapy uses injections to destroy veins. The laser uses heat to coagulate the blood and shut down the vessel. In the early days of sclerotherapy, saline was used, but it tended to be very uncomfortable. The newest sclerotherapy agents are detergents, which desolve the inner lipid layers and destroy the vessel. Both treatments work and both require multiple treatments, we just like laser at this time. If the blood veessel is severly damaged, blood can leak out and leave an iron compund, hemosiderin, which stains the skin. This can happen with both sclero and laser treatments. We find the laser very fine tuned for vessels. We are very "measured" with our treatments as to avoid injuring blood vessels. We just want to heat them . ///////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////
