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The
laser treatment of various vascular lesions utilizes the principle
of selective thermolysis. The energy of the lasers is targeted
at the vessels or at times more specifically at the contents
of the vessels that comprise the lesion. Thus, in a non-invasive
manner, selective destruction of the lesions is accomplished,
while minimizing collateral damage to the surrounding skin.
There are two main types of lesions that we
These are small diameter,
linear blood vessels that occur on the surface of the skin.
Some people may refer to them as "broken blood vessels". Common
areas where these lesions occur are the face and cheeks, particularly
on the sides of the nasal ala and around the nostrils. Telangiectasias
are common in people with sun-damaged skin and also in people
with rosacea. Nasal vessels tend to be more resistant to treatment
and may require multiple treatments. Pulsed-dye lasers and
pulsed green lasers have been used effectively for the treatment
of telangiectasias.
These are components of rosacea
that can be treated with a pulsed-dye laser. Multiple treatments
are usually required. The newer vascular lasers can be modified
so that the pulse of light is on for longer which results
in reduced bruising after the treatment. Experience shows
particularly with the pulsed dye laser that those who are
treated more aggressively and bruise may indeed respond better.
Rhinophyma describes the growth of the nose in some patients
with rosacea. It is an uncommon complication and if it occurs
it is almost always a man. The distal part of the nose thickens
up. In time it develops a knobby appearance and the pores
may be significantly enlarged. Large superficial blood vessels
sometimes develop. Treatment requires physical destruction
of the excessive growth of sebaceous and fibrous tissue. Topical
and oral medications do not help other than reducing inflammation.
The vascular laser used for flushing and blood vessels may
reduce the redness but not the size of the nose. A variety
of techniques have been used including dermabrasion, hot knife
surgery, electrosurgery as well as laser removal of tissue.
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