Shlomit Halachmi, MD, PhD

Without being able to see the red spots, I have to assume that it is a blood vessel (spider angioma) and that if you push on it, the blood clears from it.

Spider angiomas usually respond well to the VBeam, if it is used with ideal parameters.  It may take more than one treatment.  The Cutera, operated at 532nm, might be effective.  The Cutera operated at 1064nm is too aggressive for a small spot on the face and should probably be avoided.

Laser works by providing a light that the target (blood vessels, brown spots, or the water in skin) can absorb.  Calcium does not absorb light in the range of medical lasers.  Therefore, laser is not likely to dissolve or break the small deposits of calcium.




I treated someone in the past with the same condition, and attempted to remove the skin in small areas over each spot.  We treated a few test spots to assess whether the treatment was likely to be helpful.  Unfortunately, it was not.  

Doxycyline causes "photosensitivity" - a condition in which the skin is more sensitive to light.  It depends what kind of light, though...

With doxy, there is significant sensitivity to sunlight, largely attributable to sensitivity to ultraviolet light.  UV light has wavelengths of less than 400nm.

Laser hair removal devices, and LightSheer in particular, use light with wavelengths of 800nm or longer.  Therefore, doxycycline will have a less severe impact in the light range use for laser hair removal than in sunlight.

That said, Lumenis, the manufacturer of LightSheer, warns against treatment when photosensitizing medications. And - lower risk does not mean no risk.  Patients should discuss with their providers how to proceed, after providing full information on the dose of doxycycline they are taking.

Laser hair removal works as follows: the light emitted by the laser is absorbed by the brown pigment in hair.  This causes the hair to heat up.  The hot hair transfers heat to the cells around it that form the hair.  After a series of treatments, the hair becomes thinner, lighter, and eventually - gone.

It does not matter which device is used to heat the hair - so switching is fine!

Laser hair removal works as follows: the light emitted by the laser is absorbed by the brown pigment in hair.  This causes the hair to heat up.  The hot hair transfers heat to the cells around it that form the hair.  After a series of treatments, the hair becomes thinner, lighter, and eventually - gone.

Laser hair removal takes a series of treatments.  In some parts of the body you can achieve complete or nearly complete hair removal: the underarms, bikini line, and lower legs (below the knee).  In younger adults, particularly women, 8-12 treatments may be needed.  Women who are a bit older may need 6-8 treatments.

Areas that are more stubborn (need more treatments) are the forearms and upper legs.

Areas that require significantly more treatments are the male back and chest, or any area where the hairs are very thin before treatment.

In addition, laser treatment needs to be performed with more gentle parameters in dark skin, to reduce the risk of burns.

But - there are two additional elements at play.

First, hair growth on the face may have a hormonal component.  If so, the hair will continue to grow so long as the hormonal trigger for growth is in place.  Tests can be performed to assess whether this is the case.

Second, there is a phenomenon called paradoxical hair growth.  It is observed primarily in young women, with olive complexion, and on the face and neck.  For reasons not entirely understood, up to 10% of women undergoing laser or IPL treatment for hair removal in this area may have paradoxical growth of more hair.  If this is the case, further laser hair removal is not likely to be beneficial.