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Patient Information Sheet

The following information will help you to understand how the Pulse Dye Vascular Laser is used to clear your vascular lesions or other skin conditions, including some red scars. The Pulse Dye Laser can also be used for facial wrinkle reduction, also known as NAR (Non Ablative Resurfacing).

Please take the time to read this information. If you have any questions, please call the office (303) 443-2277, or IV Seasons Skin Care (303) 938-1666.

How does the Pulse Dye Vascular Laser work?
The Pulse Dye Vascular Laser produces an intense but gentle burst of light that selectively destroys the blood vessels of your spider veins, and some other skin conditions or lesions, without damaging the surrounding tissue. After laser treatment, the skin overlying the treated area remains intact and healing occurs with new collagen formation in the deep layer of the skin. The blood vessels clot due to the effect of the laser light energy. They gradually diminish in visibility over several months.

The Pulse Dye Vascular Laser, at a wavelength of 595 nanometers, targets the red to brown color spectrum. It is reliable, safe and comfortable due to its built in cooling device which sends a burst of cool air prior to the burst of light. The operator can control the delivery of laser energy very precisely, therefore controlling purpura (bruising). Downtime post treatment is significantly reduced over other treatment modalities for similar skin conditions.

For vascular lesions, 3-5 treatment sessions 4-6 weeks apart is needed to achieve maximum improvement, and for facial wrinkle reduction 4 treatment sessions 4-6 weeks apart is recommended. The final result is not expected, and cannot be judged, for 3-4 months following the last treatment. This time line is dictated by the gradual healing of the skin due to the new collagen formation, and the obliteration of small blood vessels in the treated areas. More aggressive treatment of blood vessels, skin lesions, or skin wrinkles can cause bruising for up to 14 days. Although the more aggressive treatment may reduce the number of treatment sessions, the downtime is much more significant.

Applications for Pulse Dye Vascular Laser treatment include blood vessels, rosacea, certain types of acne lesions, sebaceous adenomas of the face, poikiloderma (the red-brown pigment in the skin of the neck), facial wrinkle reduction, stretch marks, and some red scars. For wrinkle reduction, as with other treatment parameters, the mechanism for improvement is tissue healing due to the stimulation of collagen production in the skin by fibroblasts. Wrinkles can be reduced by as much as 1/3 in many cases. The results however can be less, and are not always predictable. New collagen synthesis is maximized at 3-4 months post treatment.

Are there other ways to treat my vascular lesion?
Heredity, skin characteristics, activity (sedentary vs. ambulatory), pregnancy, and physiologic fluctuations in hormonal levels all contribute to the visibility, prominence and recurrence of the small vessels pre and post treatment. The primary treatment for lower extremity spider veins consists of injection with a sclerosing agent, which irritates the vessels and causes blood to clot within them. Injection therapy is to some degree self limited, in that residual vessels become smaller and smaller in diameter and are unable to be cannulated with even the smallest hypodermic needle. These types of vessels are best treated with vascular laser therapy. Some types of leg telangiectasias are best treated by vascular laser initially. Blue vessels respond poorly to laser. Facial telangiectasias are best treated with vascular laser therapy versus injection sclerotherapy, as injections into facial vessels are dangerous. Injection therapy and vascular laser treatment for lower extremity spider veins are complementary procedures whose application must be individualized to clinical circumstances and desires.

For other types of vascular lesions, such as port wine stain birthmarks, stretch marks, scars, facial spider veins or warts, some patients have tried surgery, electrocautery, cryotherapy (freezing the area) or tattooing. These procedures may result in scarring or may leave an unsatisfactory result.

Other lasers such as the Ruby Laser, Argon Laser and CO2 Laser have also been used to treat vascular lesions. These lasers are not as specific to the destruction of the blood vessels in vascular lesions and have resulted in scarring in many individuals. Because of the chance of scarring, the use of these lasers in infants and young children is not recommended.

If you have been treated by other modalities, which resulted in scarring or loss of pigment, the lesion may not respond as well with the Pulse Dye Vascular Laser therapy. The scarring or loss of pigment may become more evident after treatment with the laser.

Are there any reasons that would not make me a candidate for Pulse Dye Vascular Laser therapy?
The Pulse Dye Vascular Laser is not recommended for patients who are darkly pigmented. Because of the increase in skin pigment, the laser will be less effective in damaging the blood vessels of the spider veins, vascular lesions, or for wrinkle reduction. It is also not recommended for tanned skin.

The depth of penetration of the Pulse Dye Vascular Laser is limited to vessels about 1.5mm in depth. Therefore, vessels deeper than this may not respond to the therapy. Additionally, blue vessels may not respond as well as red ones. Mature scars, those that are white rather than red, will also not respond to treatment.

What should I expect from this laser treatment?
Treatment with the Pulse Dye Vascular Laser will consist of multiple (3-5) treatments for best results. These treatments occur on an average of every 4 to 6 weeks. Individual situations may vary and it is best to discuss yours with Dr. Kuisle, or your IV Seasons Skin Care aesthetician.

The type of vascular lesion to be treated will determine the number of treatments needed. Red veins respond better than blue veins and the smaller, matting vessels will respond sooner than the vessels up to 1.5mm in size. Port wine stain lesions have more vessels to be treated and require multiple treatments, but the number of treatments is unknown in advance.

Are there any adverse effects?
With any laser therapy there is a possibility for adverse effects. The following are adverse effects that may occur with the Pulse Dye Vascular Laser:

1. The treated area may hyperpigment, or appear darker after the bruising/red discoloration heals. Normal skin color usually returns within 6 months after laser therapy.

2. Scarring is a risk with the use of any laser. The Pulse Dye Vascular Laser has had no reported incidence of scarring. If the post treatment skin care instructions are not followed, this can increase the chance of scarring.

3. The treated areas may show a slight depression after the laser treatments. This depression usually resolves within a few months.

Will the laser treatment hurt?
For some areas, a topical cream anesthetic or local injection can be used if requested. The cooling device included with Pulse Dye Vascular Laser treatment automatically cools and numbs the skin prior to the laser light burst. The feeling of a laser pulse has been described as that of being snapped by a rubber band or a slight stinging sensation. Following laser treatment, the area may continue to sting slightly or feel warm like a sunburn for a few hours or days.

If a larger area is to be treated, anesthesia may be used. A small test area can be performed before the entire area is treated to evaluate your pain tolerance. Most patients tolerate this procedure without any need for anesthesia. Applying ice packs to treated areas can alleviate any discomfort experienced following the procedure.

How long will the laser treatment last?
The duration of your laser treatment depends on the size of the area you will have treated or the time allotted by Dr. Kuisle or his designated operator to perform your treatment. The usual treatment session lasts 15-20 minutes, and may be repeated at a minimum of 4 weeks intervals.

Preoperative Pulse Dye Vascular Laser Instructions

Post Treatment Pulse Dye Vascular Laser Instructions

Patient Informed Consent Pulse Dye Vascular Laser

Pusle Dye Vascular Laser Procedure Movie

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