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 that you wish to have eliminated. 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 that 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 a gold plated cooling head which glides over the skin 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 color, 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.
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
How does Cutera
CoolGlide® blood vessel treatment differ from laser hair removal?
When used for laser hair removal, the
Cutera CoolGlide® 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, coagulates
the blood which is then 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® 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
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
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 large blood vessels -thicker than 3 mm in diameter (about 1/8 of
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 a 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.
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
The number of treatments will depend
- the desired degree of blood
- 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 two to four treatments may be needed
on the legs. Treatment can be done every 6 weeks on the face, and every
8 weeks 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.
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
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.
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
- 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
- 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
- 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
- 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 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
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
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.
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. We also may use
the Zimmer cryo device to blow cold air on the area being treated.
Anesthetic cream is occasionally used
in very sensitive areas or by those who think they have a very low pain
threshold. 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
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 favorite moisturizer.
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- You do not need to purchase
support stockings or special creams, and there is no special routine
for you to follow.
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.