| TREATMENT GUIDE
vessels seem to disappear after treatment. It is theorised that the energy from the laser creates a small steam bubble that expands along the axis of the vessel, clearing the lumen by pushing a column of hot blood along the vessel. As the vessel cools during its thermal relaxation time (TRT), the vapour bubble condenses, collapsing the vessel wall. Thermal coagulation of the blood, which is ejected beyond the actual exposure site, creates an intravascular ‘plug’, leaving an empty, thermally damaged lumen at the site of the laser exposure 1
. As the walls do not
rupture, no purpura is produced, which is a great advantage of this wavelength. I generally deliver double laser shots
every few millimetres along the vessel during treatment. It is important to find the lowest power setting that ablates the vessel without burning the skin. A more selective photothermolysis can be achieved by using a pulse duration that is close or equal to the TRT of the targeted vessel 1,2
. The 532 nm laser has a pulse
duration of 60–100 ms, which closely matches the TRT of facial telangiectasias of 10–60 ms. While the range of pulse duration for the pulsed dye laser, which is 450 µs to 50 ms, is significantly shorter than the TRT of facial telangiectasias 3
. A
longer pulse duration is required to target deeper, larger vessels, making the 532 nm wavelength less effective for those regions.
Changing techniques Although the 532 nm laser was my first option for vascular patients. After purchasing the Iridex Varilite dual wavelength laser, my technique has changed. The new laser offers the 940 nm wavelength in addition to the 532 nm. The 940 nm wavelength has truly changed my practice and I now rarely use the 532 nm option. The 940 nm is a near infrared
wavelength representing the latest technology and was originally intended to treat larger (over 1 mm), deeper, more resistant, and bluer vessels 2
. The 940 nm
wavelength is emitted directly from a customised indium gallium arsenide diode laser and is used for larger and deeper vessels because it is exactly at the peak of the secondary absorption band of oxyhaemoglobin in the near infrared
Turn the page for more vascular and pigmented lesion products ☞
Ellipse I2PL+, Ellipse
MultiFlex+ Ellipse A/S
Description Ellipse has set a new gold standard in treatment of vascular lesions. A wide choice of I2PL applicators allows treatment of epidermal pigmented lesions and of vascular conditions ranging from diffuse redness, port wine stains, and telangiectasias, while removing the wavelengths that mainly heat up water in the skin. Leg vessels, venous lakes and resistant port wine stains can be treated with the Nd:YAG applicator available on the Ellipse MultiFlex+.
Indications Vascular and pigmented lesions, acne, PDT, hair removal, photo- rejuvenation
Availability Worldwide. Contact
www.ellipse.org
Excel V Laser Cutera, Inc
Description With a powerful 532 nm KTP laser and two 1064 nm Nd:YAG laser modes, the Cutera Excel V system offers the ability to treat a wide-range of vascular and benign pigmented conditions in a single system. Cutera designed the Excel V laser from the ground up based on physician input, with a focus on the laser capabilities, the handpiece, and a modern, efficient design. An ergonomic handpiece provides an unobstructed view of the treatment area and contact cooling.
This cutting- edge laser gives you more treatment options with quick start-up, no consumables or dye kits, and a cool and quiet operation.
Indications Port wine stains, rosacea, leg veins, facial telangiectasia, cherry angiomas
Availability US, Canada, CE Countries, Australia, and Korea
Contact
www.excelv.com
Palomar Icon™ Aesthetic System Palomar Medical Technologies®, Inc.
Description The Palomar® Icon™ Aesthetic System — featuring Skintel™ an integrated melanin reader — is the next generation of aesthetic platform technology. With high-peak powers, state-of-the-art cooling, built-in calibration, and an intuitive user interface, the Palomar Icon system provides fast treatments with excellent outcomes. Offering an unparalleled variety of aesthetic treatments. The Palomar Icon system provides exceptional versatility and comfort for remarkable results.
Indications Fractional non-ablative and ablative skin resurfacing, hair removal, photo rejuvenation for pigmented and vascular lesions, leg vein treatment
Availability Worldwide Contact
www.palomarmedical.com/icon
prime-journal.com | May/June 2013 ❚ 65 TRI-
BEAM Jeisys
Description Tri-Beam is a cutting edge Q-switched Nd:YAG laser that sets a new standard for the treatment of melasma with an innovative fractional hand piece. High peak energy, a true flat-top beam profile and a long pulse mode make Tri-Beam a versatile laser for the treatment of acne, tattoo removal, and vascular and pigmented lesions.
Indications Acne, melasma , pore reduction, skin rejuvenation, skin texture, skin tone, tattoo removal, vascular lesions and wrinkles
Availability Worldwide US exclusively by Eclipse Aesthetics
Contact
www.jeisys.com
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