Excel V: What You Need to Know

Pros

• The laser has a spot size that adjusts between 2 mm and 12 mm, so it can treat a wide range of skin conditions very precisely. Some doctors on RealSelf consider the Excel V the new gold standard for treating abnormal blood vessels on the face.
• It’s safe for all skin types and skin tones, and it can be used anywhere on the face and body to treat pigmentation issues.
• Each treatment session is fast, usually taking 15–20 minutes. 
• There’s minimal discomfort. Patients usually feel a stinging sensation like a rubber band snap. A topical anesthetic, applied prior to treatment, can help numb the skin, and the handpiece’s proprietary cooling mechanism prevents overheating.
• Side effects, including redness and swelling, usually resolve within a few days. You can typically wear makeup and return to normal activities immediately. 

Cons

• Swelling can be significant if the treatment is performed aggressively, so be sure to discuss aftercare with your provider. 
• It’s normal for blood vessels to become darker—“bruise-like”—or more noticeable following treatment, before resolving after a few weeks.
• Avoiding direct sun exposure on the treated area for two weeks before and after treatment is recommended.
• The Vbeam or intense pulsed light (IPL) might be better treatment options for addressing diffuse redness.
• Some RealSelf members reported experiencing burns with Excel V treatment. 

The laser works by delivering high-power pulses of green laser light energy that cause the blood within the vein to coagulate. This eventually destroys the vessels, which are gradually resorbed by your body. Blood flow is then redirected to veins deeper below the skin’s surface. Removing telangiectasia and other vascular lesions may require multiple sessions, spaced four to six weeks apart.

Treated brown spots will darken and slough off within three to six days. “If only certain spots were treated versus a broad area, it’s quite normal to have some bumpiness from swelling,” says Dr. Travis James, a physician in Spokane Valley, Washington. He goes on to say that swelling should calm down within one to three days, though your provider may recommend a topical steroid, to reduce swelling.

One major advantage of the Excel V laser is that it can be dialed down to precisely treat small areas, making it possible for the laser to eradicate some veins or brown spots in one or two sessions. Dr. P. Alexander Ataii, a physician in San Diego, says that “while most lasers take multiple sessions to achieve noticeable results, many procedures performed with the Excel V will require the least number of treatments.” 

To minimize discomfort and increase safety, the Excel V provides continuous, adjustable cooling.

It takes time for the full results to develop, but many patients see an immediate and significant improvement in pigmented lesions after just one session, says New York City dermatologic surgeon Dr. Ariel Ostad. “This has earned Excel V a reputation as the laser that wows.”

However, results aren’t permanent, and touch-up treatments every one to three years may be necessary to maintain them.

Vbeam is a pulsed dye laser (PDL) that’s long been the go-to for treating facial redness. Dr. Amy Miller, a St. Louis family physician, explains that both lasers are great choices for rosacea, but they vary in how long it takes to fully heal. 

The Vbeam laser literally ruptures capillaries, causing blood to seep out into the tissue and then get “cooked” by the laser’s heat. This can result in a bruise called a purpura, which can take as long as a few weeks to fade. Because of this, the PDL may carry more downtime (if you’ve been treated in a highly visible area) but may require only one or two treatments.

The Excel V’s laser is gentler, collapsing the blood vessels just enough that the body absorbs them, without bleeding or bruising. There’s little downtime, but if the blood vessels aren’t damaged enough, your body may heal them before you see results—so it’s possible that you’ll need more than two treatments. 

RealSelf Tip: “The most important thing is to see someone who has extensive training and understands the physics of lasers so the treatments can be done safely and effectively,” says Dr. Omar Ibrahimi, a dermatologic surgeon in Stamford, Connecticut.

• Average Cost:
• $475

• Range:
• $350 - $750

The price you pay will depend on the size of the treatment area, how many treatment sessions you have, the experience level of your provider, and their practice location.