Hi Tom,
The Versapulse (HELP) and V-beam are excellent lasers. They are both
significant improvements over the 577 and 585 nm pulsed dye lasers.
Both of these new lasers are superb in treating the obvious traceable
telangiectasia. They both have an extended pulse – so they heat up the
inside of the blood vessel very slowly without rupture -- no
bruising. Clearance of the vessels can occur within one to four
treatments.
Regarding the treatment of generalized erythema, I have received mixed
reports from both patients and doctors. The main problem is that most
of these new lasers have built in cooling chips. When the cooling chips
are placed on the top of the skin (to cool the epidermis and dermis),
those hundreds of tiny superficial blood vessels that are still
functionally responsive will constrict. No one can argue with this
point. When this happens, you WILL NOT be able to treat them. This may
be the reason for the varying reports. In fact, in a major 1999 Laser
article on the effectiveness of versapulse in the treatment of blood
vessels, Drs. Massey and Katz, caution that although they have had
excellent success with the treatment of structurally damaged blood
vessels with versapulse, the "cutaneous vascoconstriction caused by the
cooling chip device" could limit the success in the treatment of the
superficially located microvessels.
So, to answer your question about versapulse and V-beam....yes, they
are excellent lasers for telangiectasia – with much less pain than the
pulsed dye lasers. They may also have some affect on the flushing, but
because they cannot target the superficial vessels – due to
constriction, the generalized erythema may not respond as well. But,
this is a good option that we should all keep our eyes on.
BTW, the photoderm has a new extension to it -- Vasculight (1064 YAG)
which is similar to the versapulse. The vasculight can treat blood
vessels in the deepest portions of the skin. Several physicians are now
combining photoderm treatments with the vasculight. It is just a
matter of time before docs find the right 'best' treatment parameters.
I still have not found a laser system that is more selective for blood
vessels than photoderm (in experienced hands). As technology advances,
then we certainly will see even greater improvements in laser
technology. The goal should be "one treatment and done". This would
be nice. But, it is impossible because one cannot target the
microvessels in the upper dermis, the larger vessels in the mid-dermis
and the deep feed vessels in the lower dermis all at once -- you need
different wavelengths (i.e. several treatment sessions) to attack each
vascular plexus.
Please keep us all updated -- everyone needs options.
Regards,
Geoffrey
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Dr.Geoffrey Nase, PhD