What are Vascular & Pigmented Lesions and how are they caused?
Vascular Lesions are the result of abnormal clustering of blood vessels directly under the skin that become enlarged and visible due to weakened valves, causing blood to pool rather than flow to the heart. Vascular Lesions often cause a cosmetic concern because they are visible underneath the skin. Common Vascular Lesions include broken capillaries, spider veins, varicose veins, rosacea, port-wine stains, hemangiomas and cherry angiomas). Unfortunately, these lesions will not go away without treatment. However, they do respond quite well to laser and light-based therapy. Many common Vascular Lesions are quite easy to treat and results can be seen quickly.
Pigmented Lesions are dark spots on the skin as a result of a higher concentration of melanin that have clustered in one area beneath the skin, such as sun spots, freckles and melasma. While some Pigmented Lesions are present at birth, most are usually caused by sun exposure or by aging. Pigmented Lesions can be flat or raised. Some lesions may fade, others become more pronounced over time. In most cases, Pigmented Lesions are merely a cosmetic concern, but in some cases, they can be an early sign of skin cancer. Common benign Pigmented Lesions are typically easy to treat and results are seen quickly.
Technology & Treatment Options for Vascular & Pigmented Lesions
At ARC we utilize four different light-based and laser technologies and Sclerotherapy (Saline Injection therapy) to treat Vascular and Pigmented Lesions, depending on the concern:
Advanced Fluorescence Technology (AFT™) – AFT™ takes unused short-wavelength UV light and converts it into the optimum usable spectrum through a special filtering system, delivering Equally Distributed Fluence. AFT’s pulsed light energy is precisely absorbed by the target areas, without damaging the surrounding healthy tissue.
In the treatment of Vascular Lesions, the pulsed light energy selectively heat and close blood vessels to reduce the lesions or make them disappear. With Pigmented Lesions, the light energy heats the melanin in the lesion and causes it to fragment. The melanin fragments are then absorbed by the body and eliminated. At ARC we commonly use this technology (along with IPL) to treat skin pigmentation concerns.
Intense Pulsed Light (IPL) – Unlike lasers, which use one continuous light wavelength, IPL therapy uses a variety of wavelengths. This allows for variations in the settings so specific tissue can be targeted for treatment. Treatment is delivered by a high output flash lamp that releases broad wavelengths of light pulses onto the surface of the skin.
Intense Pulsed Light systems treat Pigmented Lesions in the superficial layers of the skin by releasing short pulses of filtered light that is readily absorbed by the high concentration of melanin found within freckles, sun spots or liver spots. The rapid absorption of light energy heats the melanin and causes the destruction of the melanin-rich cells. We also use IPL for pigmented veins.
Dye-VL – Based on Advanced Fluorescence Technology (AFT™), Dye-VL harnesses light energy from a very precise narrowband spectrum, specifically targeted for the treatment of Vascular Lesions. The Dye-VL utilizes a narrowband 500-600nm wavelength, allowing for the precision required to target only the melanin in the lesion or blood vessel. At ARC we commonly use this to treat Rosacea.
Long Pulse Nd:YAG Laser – is a non-ablative laser designed to target superficial and natural pigment cells. Its long pulse duration allows for deep penetration into the skin, hailing it a gold standard for deep Pigmented Lesions such as melasma as it selectively targets deep lying veins. The energy from the laser beam heats up the blood inside the vein coagulating the vessel and its lining. This process restricts the blood flow in the vessel, which subsequently destroys the vein. At ARC we use this for Vascular Lesions around the nose (Telangiectasia).
Saline Injection (Sclerotherapy) – Sclerotherapy involves an injection of a salt solution directly into the vein for the treatment of spider veins (Angiomas). The solution irritates the lining of the vein, causing it to collapse and stick together and the blood to clot. The blood flow is then re-routed through healthier veins. Over time, the vein then turns into scar tissue that may eventually fade from view.
How many treatments are required?
This all depends on the condition and the area being treated and will be decided at the time of your consultation. For treatment of Pigmented Lesions, generally 4-5 treatments at 4-6 weekly intervals are required for optimum results.
Vascular Lesions concerns may require 3 to10 treatments to be successful. These can be spaced 4-6 weeks apart. Please note that some capillaries are very stubborn and won’t always respond to pulsed light systems.
What can I expect after my treatment?
Immediately after light-based and laser treatments, there may be a stinging or mild sunburn-like sensation and this can be relieved with cold compresses or ice packs if required.
Your skin may be pink for between 1–12 hours. Any pigmented areas or lesions will temporarily turn darker then either lighten or completely flake off. This can be expected to take between 5 –10 days following treatment. Please keep skin well moisturised during this time.
Vascular lesions may disappear immediately or fade over time.
Protect the treated skin from the sun by wearing sunscreen with SPF 30+.
With Sclerotherapy (Saline Injection therapy), occasionally the skin over the injection site may become more pigmented (darkened). This is only temporary and will disappear over a three to six month period. Very occasionally a small ulcer may form at the injection site. Again this is normal and nothing of concern and will heal in about ten days.
Over time, the spider veins become scar tissue and may gradually disappear over a period of two or three months. Please note that Saline Injection treatment is for existing spider veins / broken capillaries and does not act as a preventive measure. The formation of new spider veins near the treated area is possible in some patients, but these new vessels also typically disappear within 6 months.