Dr. Smith discusses Laser Vein Removal

Laser Vein Removal

CoolGlide® Laser Removal of Unwanted, Unsightly Blood Vessels on the Face, Legs and Other Part of the Body.

Cutera CoolGlide® laser treatment is a safe, fast, gentle and effective method for removal of unwanted blood vessels. In just a few treatment sessions (in some cases only a single treatment session) using the gentle power of lasers, you can greatly improve the appearance of skin which is disfigured by unwanted blood vessels and broken capillaries.

1. How does Cutera CoolGlide® laser removal of unwanted blood vessels work?
2. How does the Cutera CoolGlide® differ from older laser systems?
3. How does Cutera CoolGlide® blood vessel treatment differ from laser hair removal?
4. What areas of the body can be treated?
5. What are the benefits of laser removal of unwanted blood vessels compared to alternative treatments?
6. What are the advantages over sclerotherapy?
7. How much does it cost?
8. Prices for the most commonly treated body areas.
9. Is laser removal of blood vessels covered by insurance or OHIP?
10. Is the cost of laser removal of blood vessels a tax deductible medical expense?
11. What are the risks of laser removal of blood vessels?
12. Is laser removal of blood vessels "permanent"?
13. Should I expect to be "free of unsightly blood vessels" in the treated area after the series of treatments?
14. How many blood vessels will grow back, and how fast will they grow back?
15. How many treatments are needed?
16. Previous sclerotherapy or laser treatment? No problem!
17. Am I a good candidate for laser removal of unwanted, unsightly blood vessels? Am I being vain?
18. Which types of vessels respond best to treatment?
19. Questions to ask yourself when considering laser blood vessel removal.
20. What causes unwanted blood vessels?
21. What is a "test area", and why is it sometimes performed?
22. Moles, freckles and tattoos in the area to be treated?
23. What will happen on the treatment day?
24. Does it hurt?
25. What will happen after treatment?
26. Why do the blood vessels sometimes look more obvious for 1-3 weeks post treatment?
27. Are there any restrictions on my activity after treatment?
28. Pre-treatment instructions.
29. Post-treatment instructions

How does Cutera CoolGlide® laser removal of unwanted blood vessels work?

The Cutera CoolGlide® laser is a noninvasive light therapy device specifically designed to eliminate undesired blood vessels from all parts of the body. The Cutera CoolGlide® laser generates a pulse of intense, concentrated light which is directed through a small, cooled hand piece which is gently applied to the treatment site.

This laser energy passes through the skin to the blood vessels which you wish to have eliminated, where the energy is absorbed by pigment in the blood, causing selective damage to the lining of the target blood vessel without damaging the surrounding tissues and skin. The deeply penetrating long wavelength of the Cutera CoolGlide® allows us to target blood vessels which other, shorter wavelength lasers cannot safely reach. The laser is pulsed, or "turned on", for only a fraction of a second. The duration of the pulses is carefully determined so that laser energy will be absorbed by the blood vessels without transferring excessive heat to the surrounding skin.

The blood vessels which have been destroyed are reabsorbed by the body, and the flow of blood is directed back down into the deeper vessels, where it belongs.

The surface of the skin is protected by cooling gel pads applied immediately before and after treatment, and by a gold plated cooling head which glides over the skin (CoolGlide® ) half a second before the laser beam. This selectivity helps to protect the skin, while effectively treating the unwanted vessels.

The Cutera CoolGlide® laser can be used just about anywhere on the body, and usually requires no anesthesia or other treatment. Even sensitive areas such as the nose and cheeks can be treated easily and with minimal discomfort.

The system's unique design allows us to customize treatment, according to the size and color of your unwanted blood vessels, your skin colour, and location on the body.

Cutera CoolGlide® laser treatment is a safe, fast, gentle and effective method for removal of unwanted blood vessels. In just a few treatment sessions (in some cases only a single treatment session) using the gentle power of lasers, you can greatly improve the appearance of skin which is disfigured by unwanted blood vessels and broken capillaries.

Physicians and their staff have travelled from the United States and from various parts of Canada to learn from Dr. Smith and his staff how to successfully use the Cutera CoolGlide® laser system to remove unwanted hair and blood vessels from their patients.

How does the Cutera CoolGlide® differ from older laser systems

Other laser and intense pulsed light systems include:

• First Generation: Tunable Dye Lasers 575 - 605 nanometers (V-Star™, V Beam™, ScleroPlus™) and other short-wavelength lasers like the KPT and Diolite™ can be useful for unwanted vessels which are very close to the surface of the skin, but frequently cause extensive bruising when used at powers sufficient to eliminate undesired blood vessels.
• Second Generation: Alexandrite 745-765 nanometre -- can be useful, but are also limited by their short wavelength.
• Third Generation: Diode 800-810 nanometre (LightSheer, Apex)

By contrast, the Fourth Generation Cutera CoolGlide® laser uses the longest available, deeper penetrating 1064 nanometre wavelength. Cutera CoolGlide® reaches even the unsightly blue vessels can be several mm below the skin surface.

The long 1064 nanometre wavelength of the Cutera CoolGlide® makes it possible to safely and effectively treat all people -- including those with tanned, very dark or even black skin.

Like all lasers, the CoolGlide® works more efficiently on light colored skin -- so to minimize the number of treatments you need, try not to have a fresh suntan when you come in for treatment.

The gold plated ClearView™ cooling head on the CoolGlide® laser provides an extra margin of safety and comfort, allows the operator a clear view of the area to be treated, and does not require pressure on your skin. While using the Cutera CoolGlide® our operators wear clear UVEX CLT™ 1064 goggles, for better, safer and more effective visualization of your skin than is possible with the dark glasses commonly worn by operators of older, shorter wavelength lasers.

In addition, we are one of the few clinics in Canada to use the Syris Light illumination system. This cross-polarized, magnified, halogen illuminated device allows us to clearly visualize even your finest blood vessels, including those that cause unsightly redness but which individually are invisible to the naked eye.

CoolGlide® also allows us to precisely adjust the power and the duration of the pulse of laser energy to best suit the diameter and colour of the unwanted blood vessels on different parts of your body. Some older laser systems lack this degree of fine control.

Our CoolGlide® lasers are also very effective for removing unwanted hair from the face, legs, and other parts of the body. Please ask for a brochure, or visit www.smithlaser.com for more information.

How does Cutera CoolGlide® blood vessel treatment differ from laser hair removal?

When it is used for laser hair removal,the Cutera CoolGlide® selectively targets the pigment in the hair shafts. This heats up the hair follicle, which dies and is reabsorbed by the body.

When it is used for laser removal of blood vessels, the Cutera CoolGlide® target the blood in the vessels which you want to get rid of. The blood heats the blood vessel, which dies off and is reabsorbed by the body. The flow of blood is re-directed away from the surface of the skin, back down beneath the skin where it should have been in the first place.

When blood vessels are treated, the CoolGlide® Excel™ has a special handpiece which allows us to choose 4 different spot sizes ranging from 3 mm to 10 mm. The 3 mm beam is used for tiny superficial vessels, the 5 mm beam for slightly larger vessels, and the 7 mm beam is used for the largest vessels and sometimes for areas where there are many vessels. These delicate small-diameter beams allow us to use higher energies on the unwanted vessels which are close to the surface of your skin. The 10 mm beam is only used for hair removal.

The 10 mm laser beam penetrates deeply enough to reach the roots hair anywhere on the body. The 3, 5 and 7 mm beams do not penetrate the skin as deeply, so they are unlikely to cause much unwanted hair loss (for example, from a man’s beard). The 5 mm and 7 mm beams may occasionally be used for the removal of small amounts of hair between the eyebrows and in other difficult areas.

What areas of the body can be treated?

ALL parts of the body CAN be treated (and ARE treated) with the Cutera CoolGlide® laser. In women, the most common areas for treatment are blood vessels on the thighs, lower legs and ankles. In men and women unwanted red blood vessels on the nose and face, including those associated with acne rosacea and with sun damage, are successfully treated. Cherry hemangiomas (sometimes called Campbell de Morgan spots", which are little red dots on the trunk, arms and legs), and spider hemangiomas (sometimes called "broken capillaries" or "broken blood vessels") on the face , upper chest and other parts of the body are other commonly treated lesions.

What are the benefits of laser removal of unwanted blood vessels compared to alternative treatments?

The primary benefits of laser removal of unwanted blood vessels are:

• Larger areas may be treated with less discomfort than with sclerotherapy or vein stripping.
• The CoolGlide® combines speed, comfort and long lasting results.
• The CoolGlide® works on any area of the body where you wish to have blood vessels removed.
• Small blood vessels which are difficult or impossible to treat with sclerotherapy respond very well to Cutera CoolGlide® vascular laser.
• Because only a beam of pure laser light is used when the CoolGlide® treats an unwanted vessel, there is less risk of bruising compared with injection sclerotherapy which breaks the skin and the wall of the blood vessel, then places an irritating solution in the bloodstream of the unwanted vessel.
• Because the skin is not broken, there is no need for bandages, tape or support stockings after Cutera CoolGlide® laser treatment of blood vessels.

Cutera CoolGlide® laser removal of unwanted blood vessels offers long lasting results with minimal discomfort and little or no downtime after the treatment.

What are the advantages over sclerotherapy?

It has been said that:
"Removing blood vessels by sclerotherapy is like mowing grass -- one blade at a time!"

With injection sclerotherapy, the operator inserts a needle into the blood vessel and tries to inject an irritating solution into the unwanted vessel. The body detects that the vessel has been damaged, and reabsorbs the unwanted vessel.

Injection sclerotherapy can be an excellent technique for the removal of large vessels on the legs, and injection sclerotherapy is superior to any kind of laser treatment for the removal of blood vessels which are thicker than 3 mm in diameter (about 1/8 of an inch).

I sometimes refer patients for injection sclerotherapy, and injection sclerotherapy operators sometimes refer patients to me, depending on the needs and wishes of the patient. For example, injection sclerotherapy can be useful for large, deep blood vessels, which are easier to inject than to treat with laser. Some people who have a mixture of small and large vessels will have laser treatment to remove as many of the smaller superficial vessels as possible, and have injection sclerotherapy to remove large deep vessels.

Some people just don’t like needles and bandages, and prefer to be treated only with Cutera CoolGlide® .

Many people want laser removal of unwanted blood vessels, but everyone wonders: "How much does it cost?"

You will find that the fees listed below for laser removal of unwanted blood vessels using the efficient, effective, fourth-generation Cutera CoolGlide® laser are surprisingly affordable.

Fees are per treatment session, plus GST, and can be paid at the time of treatment with Interac, Visa, MasterCard, or cash. No cheques please.

Fees paid for laser removal of blood vessels may be tax deductible medical expenses, like other payments to doctors and dentists.

Professional services provided by appointment only.
Prices subject to change without notice.

There is no fee for pre-laser consultation. Consultations about laser can usually be arranged within a week or two. Treatment may be scheduled for the same day as the consultation if there is a time slot which is convenient for you, or may be scheduled for a later date.

Consultations about laser can usually be arranged within a week or two simply by calling our special LaserLine at Toll Free 866 707 3222where our staff, some of whom have had Cutera CoolGlide® laser removal of unwanted blood vessels, can take the time to discuss your wishes and options, and answer your questions. No referral is required.

Prices for the most commonly treated areas include (typical prices per treatment):

Please feel free to enquire about other areas not listed.

Is laser removal of blood vessels covered by insurance or OHIP?

OHIP will not pay for Cutera CoolGlide® laser removal of blood vessels, or for laser consultations. The $80 fee for the laser blood vessel removal consultation with Dr. Smith will be credited toward the cost of your first treatment.

Most private insurance companies do not offer reimbursement for "cosmetic" procedures like laser removal of blood vessels; however, consult your insurance carrier for more information.

The removal of unwanted blood vessels for the management of congenital, disease-related or drug-related telangiectasia may be covered by some private insurance plans. There will be an additional charge for any paperwork we have to do if you are trying to get reimbursed by your private insurance plan.

Is the cost of laser removal of blood vessels a tax deductible medical expense?

Like fees paid to physicians for other medical services, fees for laser removal of blood vessels, laser hair removal, BOTOX® injections and Restylane®/Perlane® treatments may be tax deductible medical expenses (similar to dental, orthodontic and cosmetic surgery bills), so save your receipts!

What are the risks of laser removal of blood vessels?

Short-term side effects may include a reddening of the skin over the treated vessels or local swelling which typically lasts less than a day, although it may infrequently last a few days. Fourth generation, long wavelength 1064 lasers like CoolGlide® are less likely than older lasers to cause prolonged irritation, pigment changes or blistering.

Occasionally there can be increased or decreased pigment in the treated area. This is seldom a major cosmetic problem, and generally resolves after several months. Even a single blister (rather like a tiny sunburn) is unusual, and generally will resolve within a week or two with some Polysporin or Aloe Vera.

Bruising can occur occasionally when treating vessels on the legs which are 2-3 mm in diameter. This is more of a nuisance than an major problem, and usually resolves within a few weeks without needing any treatment.

The light from the Cutera CoolGlide® Laser does not cause skin cancer.

Is laser removal of blood vessels "permanent"?

"Permanent removal" means: "ALL the blood vessels are gone, FOREVER!"

There is NO treatment for blood vessels (including laser) which can guarantee anybody "permanent blood vessel REMOVAL".

The most realistic description of the results after laser treatment is: "long term blood vessel REDUCTION". This means: "After one or two treatments on the face, or one to four treatments on the legs the total number of unsightly blood vessels is greatly reduced -- generally by 70% to 90%." Most people are very pleased with this degree of improvement, as long as they know that this is what to expect before they have laser removal of blood vessels.

Because lasers have been used on a large scale for blood vessel removal for only about last 10 years, we can't know if the results will continue to be felt in 15 or 20 years. However, we do know that stable, long-term blood vessel reduction commonly lasts for at least two years, and some patients who had their last treatment many years ago are still enjoying a high degree of blood vessel reduction.

Should I expect to be "free of unsightly blood vessels" in the treated area after the series of treatments?

No, most patients experience a 70-90% reduction in the number of blood vessels in a given area, but you should not expect to be "completely free of unwanted blood vessels".

How many blood vessels will grow back, and how fast will they grow back?

The regrowth of blood vessels after treatment by laser or by sclerotherapy is highly individual, and depends both on your genetic background and also on medical conditions like acne rosacea, medications you may be taking (like prednisone, for example) and on external factors like sun exposure (which can speed up the appearance of new vessels on the face and legs -- so this gives you one MORE good reason to protect yourself from the sun!)

If you take care to control medical conditions like acne rosacea, and protect yourself from sun damage, you can stop or at least slow down the rate at which new unwanted vessels appear on your skin.

Support stockings are useful to retard the growth of large, deep vessels and varicose veins which are treated by sclerotherapy, but support stockings are unfortunately not useful to prevent the unsightly 1-3 mm superficial vessels on the legs which are treated with Cutera CoolGlide® .

How many treatments are needed?

The number of treatments will depend on:

• the desired degree of blood vessel reduction
• hormonal status
• area being treated
• medication (for example medicines like prednisone can increase superficial blood vessel growth)

Typically, one or two treatments are needed for facial vessels; and three or four treatments may be needed on the legs. Treatment can be done every 6 weeks on the face, and every 3 months on the legs. Cherry hemangiomas (red dots on the body) usually only require one or two treatments.

Some people start with the area which troubles them the most, then when they can see the results they often return to have other areas treated.

Additional "touchup" treatments on small troublesome areas can be arranged at relatively low cost. There is no safety limit on the number of treatments a person can have. People who have been partially treated with other types of blood vessel removing laser and/or injection sclerotherapy might in some cases need a smaller number of CoolGlide® laser treatments.

Previous sclerotherapy or laser treatment? No problem!

CoolGlide® has been successfully used on many people who were not able to tolerate -- or did not obtain satisfactory results with -- older short wavelength laser systems, including dye laser, ruby laser, alexandrite laser, and 800 nm diode lasers. CoolGlide® laser is also been beneficial for people who are having injection sclerotherapy for larger, deeper vessels and for people who have had injection sclerotherapy in the past.

In fact, depending on how many vessels are left, people who have been partially treated with other lasers or with injection sclerotherapy may need only one or two treatments with the Cutera CoolGlide® to "finish the job".

Am I a good candidate for laser removal of unwanted, unsightly blood vessels?

The unique design of the CoolGlide® laser, and the long wavelength, allows treatment of people with all skin colors. A smaller number of treatment is needed when the skin is light colored -- so to get maximum effect from each session avoid coming in with a fresh suntan or sunburn, but even people who have black skin can be successfully treated with the Cutera CoolGlide® .

Children can be treated, for example if they have a congenital hemangioma or have some spider nevi on the face or other parts of the body, but the child must be old enough (for example, 10 years old) to understand and cooperate with treatment. Tiny lesions, such as spider hemangiomas sometimes only require 2-3 pulses of the laser, and even very young children are able to co operate with this sometimes.

CoolGlide® laser removal of blood vessels is not just for "cosmetic" problems. Patients with unsightly blood vessels on the face and other parts of the body because of medications (for example, prednisone) can benefit from CoolGlide® laser treatment as can patients who have problems with unwanted blood vessels because of congenital conditions like port wine stains and disorders like lupus and rosacea.

Normal, reasonable people who have realistic expectations tend to be excellent candidates for Cutera CoolGlide® laser removal of unwanted blood vessels.

Am I being vain?
Many people at some time before laser treatment for unwanted vessels or hair, or before BOTOX® injections treatment for wrinkles or excessive sweating have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have BOTOX® injections treatment, laser hair removal, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after our appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have BOTOX® injections treatment, laser hair removal, and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

As Dr. Richard Glogau of San Francisco has noted: the same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and well dressed, and often careful in their diet, exercise, and other aspects of health maintenance leads our patients to seek help for their wrinkles and frown lines.

These individuals are normal healthy people, and the same degree of self interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of BOTOX® injections. Our patients simply want to look their best.

Which types of vessels respond best to treatment?

Blood vessels you can see with the naked eye tend to respond best to Cutera CoolGlide® laser treatment. Vessels so small that they can only be seen with magnification are difficult but not impossible to treat. Vessels larger than 3 mm in diameter, and vessels which are considerably elevated above the surface of the skin, respond better to injection sclerotherapy or surgical removal.

The color of the vessels can range from light pink to dark purple.

Questions to ask yourself when considering laser blood vessel removal.

• How much are you bothered by your unwanted blood vessels?
• How much are you bothered by the time you spend concealing your unwanted blood vessels?
• How uncomfortable do your facial or other unwanted blood vessels make you feel when you are dealing with other people?
• Does the appearance of your unwanted blood vessels inhibit you in exchanges of affection with your partner (for example, are you uncomfortable if your partner sees your legs?)
• How uncomfortable do your unwanted blood vessels make you feel when you meet new people?
• Do you fear that the appearance of red vessels on your nose and face makes people think that you might be a heavy drinker?
• How uncomfortable do your unwanted blood vessels make you feel when you go to social gatherings, dine out in a public restaurant, go to a beach, pool or gymnasium, or other public place?
• Do your unwanted blood vessels (for example, on you legs) inhibit your choice of clothing or limit the activities that you engage in (for example, swimming)?
• How uncomfortable do your unwanted blood vessels make you feel when you go to work or class?

What causes unwanted blood vessels?

• Unwanted vessels on the surface of the skin of the legs are to some extent an inherited tendency, and become more common with increasing age. They can also be made worse by sun exposure, and sometimes become more prominent after pregnancy. They can in some cases be made worse by or be associated with varicose veins
  
  
• Unwanted blood vessels on the face (sometimes referred to as: broken capillaries) are more common in people who have a tendency toward acne rosacea; and are often made worse by sun exposure. As with unwanted vessels on the legs, there is sometimes a family history of other people with a similar problem.
  
  
• Spider hemangiomas on the face and other parts of the body are a common nuisance, and can be quite disfiguring. Most children and adults who have a few spider hemangiomas are perfectly normal and healthy. Rarely, numerous spider hemangiomas are found to be associated with serious liver disease or other disorders. People who are otherwise healthy and have just a few spider hemangiomas do not need any blood tests or other investigations.
  
  
• Telangiectasia on the face and other parts of the body can sometimes be associated with medications like prednisone and other corticosteroids, and with certain skin diseases like lupus.
  
  
• Sometimes children will be born with port wine stains or other types of hemangiomas, or these may become apparent as the years go on. Some of these hemangiomas can be improved or even eliminated by Cutera CoolGlide® vascular laser.

What is a "test area", and why is it sometimes performed?

"Test areas" are small areas of skin that are treated at various laser energy levels, with various spot sizes and at various laser pulse durations prior to treatment of large surface areas, for example, if there is an unusual hemangioma or port wine stain. This may be done at the same time as your consultation, and a $50 fee is required for this test. The fee for the "test area" is in addition to from the cost of your first treatment. "Test areas" are not necessary in most cases.

Moles, freckles and tattoos in the area to be treated?

Small moles and freckles do not usually require any special precautions. Large, dark moles and freckles which are in areas to be treated may require a reduction in the intensity of the laser light, the same way that the intensity would be reduced when treating a dark-skinned or tanned person. Tattoos might require a "test area" to make sure that they will not absorb an excessive amount of laser energy, which could cause fading of the tattoo, discomfort or even a burn. We generally prefer not to treat over tattoos. Be sure to tell Dr. Smith and his staff if you have permanent lip liner or permanent eyebrow liner, because these are tattoos and special precautions may be needed in these areas.

What will happen on the treatment day?

Other than your regular skin care routine, there is no standard "prep" for this procedure. There are no restrictions on what you may eat or drink prior to your appointment. Many people like to take 2 or 3 plain Tylenol or Advil (as you might do before having a flu shot or going to the dentist) to prevent or reduce discomfort.

Please shave or clip the areas to be treated before you come in for treatment. Freshly shaved skin is more sensitive, and there is less discomfort if you wait at least an hour between shaving and having laser treatment. Excess dark hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the undesired blood vessels, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin. If there is just a bit of peach fuzz on your skin, this will not be a problem, because peach fuzz is very fine and fair and so does not absorb laser energy.

When you come for treatment, it is important not to wear any makeup -- or at least wear simple water-based makeup that can be easily removed -- because makeup can sometimes absorb laser energy. This could interfere with treatment, or even cause overheating of the skin surface and burning. Makeup also makes it hard for us to see the vessels you would like to have treated. Makeup can be re-applied immediately after Cutera CoolGlide® laser treatment, if you wish.

After all of your last minute questions have been answered and paperwork handled, the areas you wish to have treated will be cleansed and pre treatment photos may be taken. Everyone in the treatment room must wear protective goggles when the laser is turned on. The Cutera CoolGlide® is a high powered laser system, and can cause eye injury if proper eyewear is not worn while the laser is used.

The length of the procedure itself can range from a few minutes for a few spider hemangiomas to an hour or more for very extensive blood vessels on the thighs and lower legs.

If you decide before coming in that you would like to have additional areas treated, please call ahead so that we can schedule enough time to accommodate your needs.

The process is very simple...

Cooling pads are applied to the skin for a minute or two before the area is treated. Immediately before the laser is used on an area, the cooling pad is removed and a thin coat of clear gel is lightly smoothed over the skin, then the laser pulses are quickly and evenly applied to the unwanted vessels. The cooling head of the CoolGlide® Excel may be applied to the skin immediately before and after each pulse of the laser, to further protect your skin and prevent or reduce discomfort.

You can bring a friend or family member if you like -- quite often mothers and daughters will come in together for laser treatment. If you want to let the person with you watch your treatment, that person must wear the special laser goggles to prevent laser light from getting in the eyes.

Does it hurt?

The laser emits only light. You may feel a tingling or snapping sensation like a rubber band. There is no bleeding and no open wound is created. Some people find the FIRST laser treatment more uncomfortable than subsequent treatments. Maybe this is because there are more blood vessels which are destroyed during the first treatment; and perhaps also because some people are more apprehensive during the first treatment, because they are not sure of what to expect.

Many patients find that they have less discomfort if they shave the area to be treated at least a couple of hours BEFORE coming in for treatment, because freshly shaved skin is often somewhat more sensitive.

While some areas of the body like the nose are more sensitive than others, many patients report little or no discomfort. If there is unusual discomfort, please let us know so that we can apply more cooling or adjust the settings on the laser.

People who have had injection sclerotherapy (or treatment with the electric needle, or with other lasers like the KTP laser) usually report that CoolGlide® causes less discomfort, and sometimes there is almost no discomfort.

Our careful use of cooling gel pads, and application of the gold-plated cooling head of the CoolGlide® contributes greatly to the comfort and safety of our patients. In addition, with our CoolGlide® Excel laser we have the ability to adjust the frequency of laser pulses, the power level, the pulse duration and the beam width in sensitive areas, to maximize your comfort.

When treating leg veins, we often find it helpful to apply a vibrating massager within 1-2 cm of the area being treated. This vibration analgesia usually distracts the nervous system enough that discomfort is prevented or greatly reduced.

EMLA™ anesthetic cream is occasionally used in very sensitive areas or by those who think they have a very low pain threshold. EMLA™ can be purchased without a prescription, and a very thick layer should be applied an hour before the procedure. Most people do best with vibration and cooling gel packs, and do not bother with EMLA anesthetic cream.

Most people find it helpful to simply take two or three Tylenol and/or Advil 2 hours before coming in for treatment. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time. You should pamper yourself on laser day: for example, make sure you are not hungry or thirsty when you arrive for your laser appointment, because people who are hungry or thirsty tend to be more sensitive.

What will happen after treatment?

Redness often has faded greatly by the next day. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favourite moisturizer, for example, Cliniderm™ Moisturizing Cream.

The treated blood vessels, in particular on the legs, may appear slightly more obvious or a bit darker for the next week or two, but this is seldom a major cosmetic problem, and generally less obvious than after injection sclerotherapy. Occasionally on the legs and infrequently on the face there can be isolated superficial bruising which generally is a nuisance and resolves within a week or two on the face, or several weeks on the legs without needing any treatment.

Why do the blood vessels sometimes look more obvious for several weeks after treatment?

After the blood vessels are treated with laser energy, they sometimes swell up slightly, and the body moves in to begin the job of removing the treated vessels.

Sometimes portions of the vessels will seal off immediately, and a bit of blood stays behind in the treated vessels, causing temporary red or purple coloration. If this happens, the blood in the vessels is usually reabsorbed along with the vessels themselves by the body over a period of several weeks to a couple of months on the legs, without needing any additional treatment. If a little pocket of old blood persists it can easily be removed if you wish.

Because the CoolGlide® laser can produce a longer, gentler pulse there is much less chance of purpura or bruising compared to treatment with tunable dye lasers like the V-Star™ or V-Beam™. Patients who have previously been treated with dye lasers are always impressed by the fact that they look good immediately after CoolGlide® treatment, with little or no discoloration of the skin.

Are there any restrictions on my activity after treatment?

Since the laser does not burn or cut the skin in any way, no bandages are necessary. You can return to work the same day and resume all your regular activities. To reduce the chance of uneven tanning in the treated area, you should minimize sun exposure and tanning for a week or two after treatment.

Consultations about Cutera CoolGlide® laser removal of hair and blood vessels can usually be arranged within two or three weeks simply by calling our special LaserLine at Toll free: (866) 707 3222. Treatment can sometimes be done on the same day as the consultation, or within a couple of weeks.

Our staff, who have had Cutera CoolGlide® laser treatment themselves, can take the time to discuss your wishes and options, and answer your questions. No referral is required.

Pre-treatment instructions:

1. Please try to minimize tanning for a week or two before treatment: a fresh tan can interfere a bit with the effectiveness of the CoolGlide® Laser treatment, though this is less of a problem than with older, short wavelength lasers.
   
   
2. Please do not wear makeup on the areas to be treated, or at least wear makeup that is easy to remove before treatment so that we can easily see all the vessels you would like to get rid of. If makeup absorbs laser energy, less energy will reach your unwanted blood vessels, and if the makeup heats up it could irritate or burn your skin. Makeup can be re-applied immediately after Cutera CoolGlide® laser treatment, if you wish.
   
   
3. Please shave or clip the areas to be treated the day before treatment or on the morning of treatment. This way, the skin will be less sensitive. Excess hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the unwanted blood vessels where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin.
   
   
4. Some people find it helpful to simply take two or three plain Tylenol and/or Advil 2 hours before coming in for treatment. Some women who find that they are less sensitive after their menses prefer to schedule their treatment sessions to avoid the premenstrual and menstrual time. You will be less sensitive if you are well rested, well fed, and not thirsty when you have your treatment. You should pamper yourself on laser days!

During the treatment, remember that: We want to be doing this FOR you, not doing it TO you. Unexpected discomfort is Nature’s way of telling us something is wrong, so please tell us and we will go slower, apply more cooling, or adjust the power of the laser for you. The laser does not work better if it hurts more, so there is no point being really tough.

Post-treatment instructions:

1. Redness often has faded greatly within a day or two. It would not be uncommon for the skin to be slightly drier that evening and to require more of your favourite moisturizer, for example, Cliniderm™ Moisturizing Cream. The treated blood vessels may appear slightly more obvious for the next week or two, but this is seldom a cosmetic problem, and generally much less obvious than after injection sclerotherapy.
   
   
2. Try to avoid tanning for a week or two after treatment, because occasionally the tan could be somewhat irregular (lighter and/or darker in the treated areas.) Ombrelle-60™ and Anthelios-60 are excellent sunscreens.
   
   
3. You do not need to purchase support stockings or special creams, and there is no special routine for you to follow.
   
   
4. Blistering or scaling after Cutera CoolGlide® laser removal of blood vessels is very rare, but usually resolve over a few days or a week with a bit of Polysporin or aloe vera cream several times a day. Please call us if this happens, or if you have any other problems or questions.

CoolGlide® Laser Removal of Unwanted, Unsightly Blood Vessels on the Face, Legs and Other Part of the Body

Niagara Falls Dermatology & Skin Care Centre Limited
Kevin Smith, MD, FRCPC Dermatologist
Fellow of the Royal College of Physicians and Surgeons of Canada
Certified in the United States by the American Board of Dermatology
Suite 201, 6453 Morrison Street, Niagara Falls, Ontario

Please call Toll Free: 1-866-707-3222 if you have questions about laser removal of unwanted blood vessels, or to arrange a prompt, confidential laser consultation and treatment. No referral is needed for non-OHIP consultations and treatments.

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