PDL Treatment for "Diffuse Redness" - Europe

Hi. I've been suffering from a blush on my both...

Hi.
I've been suffering from a blush on my both cheeks for many years. I think it's called "diffuse redness" or erythema. The redness is due to vascular vessels - it disappears for a second when pressing the skin with a finger and comes back a second later after releasing the finger.

I've been thinking a lot about it. I think we can agree that the redness is due to blood that is visible under the skin. However I am not sure whether:
a) the blood vessels are dilated
b) the number of blood vessels is increased
c) the blood vessels are situated not deep enough and that's why the are visible
d) all of the above
e) the skin is very transparent (not enough pigment).

My blush is permanent, but there are other people that blush only occasionally meaning that usually their skin is normal. Because of that I guess we can rule out possibility b), c), e). So I guess the only reason is that the vessels just dilate too much and are visible. In my case I guess they are permanently dilated, however maybe some of them are located not deep enough.

I read many articles on lasers, especially PDL.
1. Early PDLs had 585nm wavelenght that penetrated only 0.5mm under the skin. The light was burst in very short pulses, 0.45ms, meaning that all the energy was delivered in short time resulting in immediate purpura.
2. Newer version of PDL have 595nm that allows deeper penetration, ca 1.2mm. The light can be burst between 0.45ms to 40ms. The short pulses result in immediate purpura as well.

So far I have had 4 PDL treatments with both 585nm and 595nm wavelenght. Each of these treatment produced immediate purpura that lasted about 2 weeks. I have always preferred to have purpuric treatment because I think purpura is a clear indication that some of the vessels were targeted and destroyed. However after 4 treatments the final outcome is hard to tell - maybe it has faded somewhat but then the fading is barely noticeable, so basically I can say that the laser had no positive effect ;-(

I wonder what is going wrong?! I mean - I think the laser penetrates the skin deep enough because there is purpura so for me it means the laser light reached the vessels and destroyed them. It means the depth of penetration is enough. The fluence is okay.

However my doctor told me that purpura can appear even on a "healthy normal skin" if the power is strong enough. She mentioned 10J/cm2, 1.5ms, 7mm, 595nm will result in purpura even on healthy white skin. If this is a case that would be very bad to assess whether the treatment of vascular lesion is efficient as then we didn't know which vessels were destroyed: the healthy ones (not visible) or the dilated ones.

Can anyone do this test on healthy skin to see if purpura can be produced on normal skin?

I found out that some people pre-flush their skin before the treatment but I don't know whether this is wise. If vessels are dilated further dilation means more blood and more spilled blood (more purpura). Unless with pre-flushing (e.g. using a hair drier) we can also dilate some other vessels that usually are not visible but which can enlarge sometimes (stress, weather etc.). However I read that small vessels 20-50um (micro meter) that is 0.02-0.05mm do not respond at all to PDL so maybe enlarging them before the treatment (by pre-flushing) would treat them? They do not respond because there is not enough hemoglobin. But if there is not enough hemoglobin, the laser would not produce purpura, right?

Overall I am a bit frustrated because each time I saw a new doctor they said in my case I would need only 1 PDL treatment but I've had already 4. The downtime with a purpuric setting is around 2 weeks that means taking longer holidays from work. I could accept purpura with pleasure if there was a final positive result of the treatments (paler skin).

I don't know what else I can do to improve the redness. For me the laser works because there is purpura, but when the purpura is gone the cheeks are still permanently red as before the treatment. If there is fading it is so subtle that I would need 100 treatments to achieve the goal.

When working one can have 1 purpuric treatment a year only ;-( I have never tried non purpuric treatments because I was told that they are much less effective and the downtime (swollen skin, additional redness) also takes 5 days to fade. But this I don't know.

I would appreciate if you people could respond somehow to my post.

3 Comments

I am still not sure about the results. Hard to tell. If there is any positive results, it's really hard to tell ;-( I will wait a bit more, I was told I need to wait 2 months to see the final result (if there is any at all).
  • Reply
Thanks for your review, I encourage you to ask a doctor on the site about the pre-flush and any other questions you may have about the treatment. How far apart were you 4 sessions spaced?
  • Reply
I had 4 treatments altogether. The first two were performed slightly more than 10 years ago but I don't remember the space time between them. I was a bit imprecise in the previous email. I think that the first 2 treatment helped me somewhat to reduce the redness, especially on lower parts of both cheeks. Then a good few years ago I changed the place of living for something a bit warmer, especially in winter, but I decided to come back to treatments again. The 3rd treatment was in Dec 2013, and the last one (or latest? sorry for my English) in Apr 2014. I am still healing a bit...

Update

I am still not sure about the results. Hard to tell. If there is any positive results, it's really hard to tell ;-( I will wait a bit more, I was told I need to wait 2 months to see the final result (if there is any at all).

1 Comments

I have had several V beam treatments and they were done by different doctors. What I noticed is that some doctors go deeper and some choose do not go so deep. It was told to me that it doesn't always have to be deep to be effective. Some cases of Rosacea should treated in the upper layers of the skin. So deeper doesn't always give you better results.
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