Pulsed dye laser treatment | DermNet (2023)

Author: Anoma Ranaweera, Medical Writer, Auckland, New Zealand, June 2014.

What is a laser?

LASERs (light amplification by stimulated emission of radiation) are sources of high-intensity monochromatic (single wave length) coherent light that can be used for the treatment of various dermatologic conditions depending on the wavelength, pulse characteristics, and fluence (energy output) of the laser being used and the nature of the condition being treated.

Various kinds of lasers are available; they are differentiated by the medium that produces the laser beam. Each of the different types of lasers has a specific range of utility, depending on its wavelength and penetration.

(Video) Pulsed dye laser treats a variety of red skin marks | Ohio State Medical Center

What is a pulsed dye laser?

  • A dye laser is a laser which uses an organic dye mixed in a solvent as the lasing medium.
  • Some of the laser dyes include rhodamine, fluorescein, coumarin, stilbene, umbelliferone, tetracene and malachite green.
  • Some of the solvents used include water, glycol, ethanol, methanol, hexane, cyclohexane and cyclodextrin.
  • A high energy source of light such as a fast discharge flashlamp or an external laser (eg, ruby laser or ND:YAG laser) is needed to "pump" the liquid beyond its lasing threshold.
  • The dye solution is usually circulated at high speeds, to help avoid triplet absorption and to decrease degradation of the dye.
  • The incoming light excites the dye molecules into the state of being ready to emit stimulated radiation.
  • Pulsed dye lasers produce pulses of visible light at a wavelength of 585 or 595 nm with pulse durations of the order of 0.45–40 ms.
  • Pulsed dye laser treatment can be combined with radiofrequency to enhance effects; lower PDL doses possible with the combination can reduce adverse effects.

How does the pulsed dye laser work?

  • The pulsed dye laser, when used for dermatological applications, works on the principle of selective thermolysis.
  • The selected wavelength of laser light is absorbed to a high degree by the target structure (called chromophores) compared to surrounding tissue.
  • The pulse duration of laser energy is shorter than the target structure’s thermal relaxation time, which is the time taken for the target to cool by 50% of its peak temperature after irradiation.
  • This ensures that the impact of thermal energy is limited to the target structure and does not affect the surrounding tissue.
  • When pulsed dye laser light hits the skin, it is reflected, transmitted, or absorbed.
  • Absorbed energy is most responsible for the clinical effect because it is converted to thermal energy (heat) by the intended targets (chromophores), thereby killing the diseased cells.
  • The skin chromophores commonly targeted by the pulsed dye laser is haemoglobin in blood.
  • Complications result when energy intended for the target chromophore is non-selectively diffused and absorbed by surrounding tissues and structures.
(Video) Pulsed-Dye Laser Treatment in a Child With a Nevus Simplex
(Video) Pulsed Dye Laser Treatment of Infants’ Port-Wine Stains

What is a pulsed dye laser used for?

The following skin disorders may be treated with pulsed dye laser (PDL) beams using an US Federal Drug Agency (FDA)-approved machine such as Vbeam Perfecta® (Candela Corporation, Massachusetts, USA) or flashlamp pulsed dye laser (Cynosure VLS, Massachusetts, USA).

Cutaneous vascular lesions

  • PDL is useful in the treatment of port wine stains (vascular malformation), superficial haemangiomas and a variety of acquired cutaneous vascular lesions, including telangiectasis, cherry angiomas and poikiloderma of Civatte.
  • Light energy emitted by the flashlamp-pumped PDL is primarily absorbed by oxyhemoglobin contained within blood vessels, thus minimising thermal damage to other structures.
  • Laser treatment parameters are based on several factors, including lesion location, lesion morphology, and patient skin type.
  • Spot sizes ranging from 2–10 mm are used to deliver a fluence averaging 5–10 J/cm2.
  • The use of larger spot sizes and a higher fluence permits deeper dermal penetration and destruction of larger blood vessels.
  • Lower energy densities are necessary in anatomic locations with an increased risk of scarring, such as the anterior chest, neck, and periorbital area.
  • The physician should apply laser pulses in a nonoverlapping manner to prevent excessive thermal damage (burns) that could result in blistering and scarring.
  • Port-wine stains treated with the pulse dye laser and a cryogen-cooling device have been shown to have a significantly better response at 585 nm than at 595 nm.
  • In general, port-wine stains fade by 80% after 8–10 treatments. Lesions on the face or neck tend to respond more quickly than those on the lower extremities.
  • For the treatment of port-wine stains, hemangiomas, and facial telangiectasias, the 585 nm pulse dye laser has the best clinical track record for both effectiveness and safety, regardless of patient skin phototype.

Non-vascular skin conditions

  • PDL is also widely used to treat several nonvascular conditions including plane warts, angiofibroma (tuberous sclerosis) and pyogenic granulomas.
  • PDL has been shown to be beneficial for these conditions in fair-skinned (Fitzpatrick skin types I–III) individuals.
  • The procedure is repeated at intervals of 4-6 weeks up to an average of 3 sessions.

The laser parameters used are:

(Video) Q & A: Pulse Dye Laser (PDL)

  • Plane warts: spot size 5 mm, fluence 5.5–7.5 J/cm2, wavelength 585 nm, pulse duration 0.45 ms (single pulse per lesion)
  • Angiofibroma: spot size 5 mm, fluence 6–8.5 J/cm2, wavelength 585 nm, pulse duration 0.45 ms (2 pulses per lesion)
  • Pyogenic granuloma: spot size 5 mm, fluence 7 J/cm2, wavelength 585 and 595 nm alternately, pulse duration 1.5 ms (4–5 pulses per lesion).

Melasma

  • Melasma is an acquired pigmentary disorder characterised by brownish hyperpigmented patches usually on the face.
  • The role of pulse dye laser in melasma treatment is controversial with studies showing conflicting results.
  • At least one study has shown that 3 sessions at 3-week intervals with fluence up to 10 J/cm2 and pulse duration up to 20 ms is effective in the treatment of patients with melasma.

Burn and hypertrophic scars

  • The 585 nm PDL has emerged as a successful alternative to excision in patients with hypertrophic scars following thermal burns.
  • Multiple studies have shown the PDL's ability to decrease the redness and thickness of a scar, while significantly decreasing itch and improving the cosmetic appearance of the scar.

Nail psoriasis/plaque psoriasis

  • Several studies have proven the efficacy of PDL in the treatment of plaque psoriasis. Two published studies indicate PDL may be effective on nail psoriasis.
  • Biological agents are probably more effective, however.

What does the laser procedure involve?

It is important that the correct diagnosis has been made by the clinician prior to treatment with PDL laser, particularly when pigmented lesions are targeted, to avoid mistreatment of skin cancer such as melanoma. The patient should wear eye protection, consisting of an opaque covering or goggles, throughout treatment.

  • Treatment with the PDL laser consists of placing a hand piece against the surface of the skin and activating the laser. Many patients describe each pulse to feel like the snapping of a rubber band against the skin.
  • Topical anaesthetic may be applied to the area, but is not usually necessary.
  • Skin surface cooling is applied during all hair-removal procedures. Some lasers have built-in cooling devices.
  • Immediately following treatment, an ice pack may be applied to soothe the treated area.
  • Care should be taken in the first few days following treatment to avoid scrubbing the area, and/or use of abrasive skin cleansers.
  • A bandage or patch may help to prevent abrasion of the treated area.
  • During the course of treatment patients should protect the area from sun exposure to reduce the risk of postinflammatory pigmentation.
  • After treatment, loose clothing should be worn to avoid rubbing, the treated area should not exposed. Swimming, saunas, hot baths and contact sports should be avoided until the treated area is healed.

Are there any side effects from pulsed dye laser treatment?

Side effects from pulse dye laser treatment are usually minor and may include:

(Video) Laser treatment for facial flushing & capillaries | 1 year update! Is it worth it?

  • Pain during treatment (reduced by contact cooling and if necessary, topical anaesthetic)
  • Redness, swelling and itching immediately after the procedure that may last a few days after treatment.
  • Rarely, skin pigment may absorb too much light energy and blistering can occur (a burn). These symptoms recover.
  • Changes in skin pigmentation. Sometimes the pigment cells (melanocytes) can be damaged leaving darker (hyperpigmentation) or paler (hypopigmentation) patches of skin. Generally, cosmetic lasers will work better on people with lighter than darker skin tones.
  • Bruising (purpura) affects up to 10% of patients. It usually fades on its own.
  • Bacterial infection. Antibiotics may be prescribed to treat or to prevent wound infection.
(Video) Pulsed Dye Laser: Facial Redness Removal - with Dr. Sameer Bashey | Over 50

FAQs

How long does it take to see results from pulsed dye laser? ›

Pulsed-Dye Laser Skin Therapy Results

Most patients see a dramatic reduction, if not a complete removal of skin discoloration, though it may take some time (3-9 months) before the skin pigment adjusts to completely match the surrounding area.

What happens after pulsed dye laser treatment? ›

Possible side effects following a pulsed dye laser treatment include crusting, blistering, scarring, purpura, hypopigmentation or hyperpigmentation, and infection at the treatment site.

Can pulsed dye laser make rosacea worse? ›

Answer: Laser Treatment And Rosacea

IPL has the ability to flare the rosacea. I typically tell my laser patients to avoid any triggers and use only physical sunblocks post treatment.

Can you exercise after pulse dye laser? ›

Avoid swimming, heavy exercise, sauna/steam, and hot showers for the first 24 hours. Avoid facials or any skin treatments for at least a week after. Makeup can be applied gently as soon as 2 hours post treatment.

How effective is pulsed dye laser treatment? ›

Pulsed dye laser treatment can be effective for a variety of skin conditions, including rosacea, facial redness, port wine stains, hemangiomas, hypertrophic scars, keloids, and telangiectasis. The doctors on our Dermatologic Surgery team are experts in using the most advanced pulsed dye laser technology.

How many pulsed dye laser treatments do you need? ›

You'll probably need multiple pulsed dye laser sessions

For the best results, three to six treatments are usually required – but this may depend on various factors, such as the size, depth and nature of the redness being treated.

Is pulsed dye laser permanent? ›

Are the results of Pulse Dye Laser Treatment Permanent? Permanency of results depends on many factors, like the condition being treated, or lifestyle of the patient.

How long does it take for PDL to heal? ›

New bone, PDL, and cementum were observed in 64.3% of the teeth, with significant (P <0.05) increases in the percentages of cementum over time. Sequential labeling confirmed healing at both 6 and 12 weeks.

Does pulse dye laser help wrinkles? ›

The Pulse Dye Laser can also be used for facial wrinkle reduction, also known as NAR (Non Ablative Resurfacing).

Does rosacea come back after laser treatment? ›

The effects of Vbeam laser treatment aren't permanent. Rosacea is a chronic condition that progresses with age and sun exposure. Redness and visible veins will continue to appear, but a treatment session every one to two years should lessen those symptoms.

Will my rosacea ever go away? ›

There's no cure for rosacea, but treatment can control and reduce the signs and symptoms.

How many laser treatments are needed for rosacea? ›

Typically, people with rosacea need anywhere from two to eight sessions spaced around 6 weeks apart for the best results.

How long does swelling last after pulsed dye laser? ›

What are the potential side effects of PDL? Swelling: Swelling is the most common side effect following treatment, especially under the eyes. It may occur within a few minutes after treatment and often lasts 3-5 days.

How do you reduce swelling after PDL? ›

Using ice packs (or frozen peas in a bag) every hour for 10-15 minutes on the day of the procedure can reduce swelling. If you have had an internal eye shield, you will need to patch the eye for 4 hours and apply eye ointment (Chlorsig) twice daily for 3 days.

What happens if you drink alcohol after vbeam? ›

Do not drink alcohol or take aspirin, ibuprofen, vitamin E, or fish oils for three days prior to, and three-to-five days after, your laser treatment. Using these may increase the likelihood of bruising.

Does pulsed dye laser flatten scars? ›

The results showed that one pulsed dye laser treatment improved the scar erythema and flattening of hypertrophic scar by 57%, while two treatments improved these scar characteristics by 83%.

Is pulsed dye laser the same as IPL? ›

What are the major differences? An IPL is polychromatic, which means the machine emits several wavelengths at once. This means that an IPL can treat several skin conditions at one time. A PDL, as a laser, produces only one wavelength of light.

Does pulsed dye laser remove hair? ›

Pulsed dye lasers will not affect hair growth. The lasers needed to remove hair are different wavelengths and target different things, such as pigment.

How long does pulsed dye laser bruising last? ›

After having pulsed dye laser treatment

The bruising usually lasts for 7-14 days but 1. on average is gone within 10 days. The bruised area often darkens for 1-2 days after treatment and these reactions are normal and nothing to be alarmed about.

How long does laser bruising last? ›

These bruises are noticeable for 7-10 days on average and fade like any bruise. Bruises on the face fade more quickly than bruises on the arm or leg. You can expect to get a lot of strange looks if you are out and about the first few days after treatment.

Does VBeam reduce flushing? ›

What conditions does the VBeam help with? This laser helps lessen or even eliminate the appearance of pink and red spots and patches on the skin. It is the primary treatment for the redness and flushing associated with rosacea.

Does PDL laser stimulate collagen? ›

The Pulsed Dye Laser (PDL) can reduce facial redness, rosacea, broken capillaries and boost collagen production. The PDL uses a concentrated beam of safe yellow light to target blood capillaries in the skin.

Is PDL or IPL better for rosacea? ›

The fluence (energy) used during treatments has a huge effect on your results. The same is true for the PDL. While Pulsed dye lasers are a better option for problematic Rosacea, the practitioner using the laser will still determine how to do the treatment and thus determine the potential outcome.

Does vbeam increase collagen? ›

The Vbeam laser is able to stimulate collagen production and treat vascular, pigmented and certain non-pigmented lesions. This makes the V-beam especially effective for treating vascular lesions, rosacea, varicose veins, and very dark spots that become prominent due to sun exposure.

Does periodontal ligament grow back? ›

The periodontal ligament does not regenerate easily in any areas where it was lost and is prone to periodontal inflammation. Should a patient's advanced gum disease have damaged the jawbone, placing a bone graft may be unsuccessful if the periodontal ligament is not also simultaneously restored.

Can the periodontal ligament regenerate? ›

Regenerating the periodontal ligament (PDL) is a crucial factor for periodontal tissue regeneration in the presence of traumatized and periodontally damaged teeth. Various methods have been applied for periodontal regeneration, including tissue substitutes, bioactive materials, and synthetic scaffolds.

Should the periodontal ligament be removed? ›

Periodontal Ligament

When you bite down and chew, the PDL protects the tooth from shattering by compressing a fraction of a millimeter like a spring. It is standard of care for a traditional oral surgeon to assume that the periodontal ligament adheres to the tooth and is therefore always removed during an extraction.

Which laser treatment is best for face? ›

5 top laser treatments for the face
  • To Give Your Skin an Insta-Glow: Laser Genesis. ...
  • To Rid of Acne Scars: Fractional CO2 Laser. ...
  • To Zap Broken Blood Vessels: Pulsed Dye Laser. ...
  • Instead of a Facelift: Fraxel. ...
  • For Removing Sun Damage: IPL.

What is the best laser treatment for wrinkles? ›

Erbium (Er:YAG) Lasers can be ablative or non-ablative. They promote collagen remodeling, making them popular options for treating fine lines, wrinkles, skin laxity, and age spots.

Is laser treatment good for face? ›

The short answer is, yes. Laser skin treatments can help refresh the skin and improve many skin conditions, including age spots, veins, wrinkles, scars, sagging skin, unwanted hair and tattoos. Lasers can target different structures in the skin.

How do I permanently get rid of rosacea? ›

The symptoms of rosacea can come and go, and there's no permanent cure for this issue. However, with proper treatment and by taking good care of your skin, it's possible to control and manage this condition. The right combination of therapies can minimize your symptoms and help you achieve healthier skin.

What is the most effective laser for rosacea? ›

Pulsed dye laser

Erythematotelangiectatic rosacea is the most common form of rosacea and has the most evidence supporting the use of laser therapy for its treatment. Doctors usually recommend pulsed dye laser (PDL) treatment for this type of the condition.

What is the most effective treatment for rosacea? ›

Metronidazole. Metronidazole is an antibiotic drug that reduces inflammation. It is very commonly used in the treatment of rosacea. Metronidazole products are applied to the affected areas of skin once or twice a day in the form of a cream, lotion or gel.

What famous people have rosacea? ›

Some celebrities who are known to have or have had rosacea include:
  • Renée Zellweger.
  • Bill Clinton.
  • Mariah Carey.
  • Cameron Diaz.
  • Lady Diana.
  • Rosie O'Donnell.
  • Alex Ferguson.
25 Apr 2012

Why do people develop rosacea? ›

The exact cause of rosacea is unknown, although a number of possible factors have been suggested, including abnormalities in the blood vessels of the face and a reaction to microscopic mites commonly found on the face.

What do dermatologists do for rosacea? ›

Because there is no cure for rosacea, treatment with prescription medication is often required for months to years to control symptoms. In addition, dermatologists commonly prescribe topical creams, lotions, ointments, gels, foams, or pads, such as: Azelaic acid (Azelex and Finacea) Brimonidine (Mirvaso)

Which laser is best for facial redness? ›

Pulsed-Dye Lasers – The pulsed-dye laser is ideal to address visible blood vessels and background facial redness. These lasers deliver bursts of light that selectively damage blood vessels while keeping the surrounding skin safe.

Can IPL worsen rosacea? ›

Sometimes, IPL can induce rosacea aggravation. Here, we show two cases of erythema rosacea aggravated as pustule in several hours after IPL. Both cases show high density of Demodex after IPL.

How quickly does IPL work for rosacea? ›

The number of IPL photofacial sessions may vary by person. On average, patients need 3 – 4 sessions, every 4 – 6 weeks, to clear up recurrent rosacea symptoms with another treatment about once a year for maintenance reasons. You will work closely with Dr.

Can you shower after pulsed dye laser? ›

i Avoid using any soaps or perfumed products on the treated area for 48 hours after treatment. i Avoid hot baths and showers, saunas and swimming for 24 hours after treatment. i You can apply make-up over the treated area and wash the skin, as long as this is done gently.

Can I use Vitamin C after vbeam? ›

Vitamin C Serum immediately after your treatment and two times a day continuously. The Vitamin C serum is a powerful antioxidant and will help diminish both the redness and pigmentation in your skin, and aid if the positive results of your Vbeam laser treatment.

What wavelength is a pulsed dye laser? ›

Pulsed dye lasers (PDL) use a wavelength of 595 nm and is the gold standard of vascular lesion treatment.

Can I wear makeup after PDL? ›

You can use makeup starting on the second day after treatment. If any crust forms, do not pick it or try to remove it. Bruising usually fades quickly – within 3 to 10 days.

Can I wear makeup after vbeam? ›

You can apply makeup or lotion to the treatment area immediately post-treatment. Q: Can Vbeam be used in delicate areas such as neck and chest? A: Yes! It is safe and effective on delicate skin areas like the neck, chest and hands, in addition to the face.

How long after vbeam treatment do you see results? ›

You'll begin to see results about 4 to 8 weeks after your VBeam treatment. Most patients achieve 25-75% improvement with each treatment.

How many vbeam treatments do I need? ›

We recommend 3 to 5 sessions spaced a month apart to achieve maximum results. In many cases, your results will be permanent, but some conditions may recur.

Can vbeam make flushing worse? ›

Answer: Vbeam for Facial Flushing

The right laser treatment should not exacerbate the flushing. Vbeam is typically a good option for diffuse redness, flushing or vascular lesions.

Can you go in sun after vbeam? ›

Avoid sun exposure for 2 weeks after treatment and use sunblock at all times. Treat the skin gently, as if you had a sunburn, for the first 48 hours. Avoid very hot showers, hot tubs, saunas, and swimming pools for the first 72 hours post treatment.

Does pulsed dye laser flatten scars? ›

The results showed that one pulsed dye laser treatment improved the scar erythema and flattening of hypertrophic scar by 57%, while two treatments improved these scar characteristics by 83%.

How long does it take for PDL to heal? ›

New bone, PDL, and cementum were observed in 64.3% of the teeth, with significant (P <0.05) increases in the percentages of cementum over time. Sequential labeling confirmed healing at both 6 and 12 weeks.

Is pulsed dye laser permanent? ›

Are the results of Pulse Dye Laser Treatment Permanent? Permanency of results depends on many factors, like the condition being treated, or lifestyle of the patient.

How long does bruising last after PDL? ›

With PDL treatment the side effects are mostly minimal. Bruising is the most common side effect, but is not always a side effect. If you do have bruising, it will be most pronounced in the first few days after the treatment, and usually goes away within 3-10 days.

Can old scars be removed by laser? ›

Laser treatment can also make a scar less noticeable, but it cannot get rid of a scar. When you have laser scar treatment, you're replacing one scar with another less-noticeable scar.

Which laser is best for scar removal? ›

Ablative laser resurfacing, with CO2 or Er: YAG lasers, has been shown to be effective for traumatic and surgical scars, especially when resurfaced within 6 to 10 weeks after trauma or surgery or even immediately after surgery.

How can I remove scars from my face permanently? ›

There are scar-removal options that can help remove pockmarks or minimize their appearance.
...
Read on for 10 options to discuss with your skin care specialist.
  1. Over-the-counter (OTC) scar treatment cream. ...
  2. Facial massage. ...
  3. Chemical peels. ...
  4. Microdermabrasion. ...
  5. Dermabrasion. ...
  6. Microneedling. ...
  7. Fillers. ...
  8. Ablative laser resurfacing.

Does periodontal ligament grow back? ›

The periodontal ligament does not regenerate easily in any areas where it was lost and is prone to periodontal inflammation. Should a patient's advanced gum disease have damaged the jawbone, placing a bone graft may be unsuccessful if the periodontal ligament is not also simultaneously restored.

Can the periodontal ligament regenerate? ›

Regenerating the periodontal ligament (PDL) is a crucial factor for periodontal tissue regeneration in the presence of traumatized and periodontally damaged teeth. Various methods have been applied for periodontal regeneration, including tissue substitutes, bioactive materials, and synthetic scaffolds.

Should the periodontal ligament be removed? ›

Periodontal Ligament

When you bite down and chew, the PDL protects the tooth from shattering by compressing a fraction of a millimeter like a spring. It is standard of care for a traditional oral surgeon to assume that the periodontal ligament adheres to the tooth and is therefore always removed during an extraction.

Does PDL laser stimulate collagen? ›

The Pulsed Dye Laser (PDL) can reduce facial redness, rosacea, broken capillaries and boost collagen production. The PDL uses a concentrated beam of safe yellow light to target blood capillaries in the skin.

Is pulsed dye laser safe? ›

The Pulsed Dye Laser, or PDL uses a concentrated beam of light that targets blood vessels in the skin. The light is converted into heat, destroying the blood vessel while leaving the surrounding skin undamaged. The laser uses yellow light, which is very safe.

Is PDL or IPL better for rosacea? ›

The fluence (energy) used during treatments has a huge effect on your results. The same is true for the PDL. While Pulsed dye lasers are a better option for problematic Rosacea, the practitioner using the laser will still determine how to do the treatment and thus determine the potential outcome.

How long does swelling last after pulsed dye laser? ›

What are the potential side effects of PDL? Swelling: Swelling is the most common side effect following treatment, especially under the eyes. It may occur within a few minutes after treatment and often lasts 3-5 days.

Can you shower after pulsed dye laser? ›

i Avoid using any soaps or perfumed products on the treated area for 48 hours after treatment. i Avoid hot baths and showers, saunas and swimming for 24 hours after treatment. i You can apply make-up over the treated area and wash the skin, as long as this is done gently.

Does pulsed dye laser help with wrinkles? ›

The Pulse Dye Laser can also be used for facial wrinkle reduction, also known as NAR (Non Ablative Resurfacing).

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