What is the difference between V Beam and Excel V lasers for rosacea?

Question

I was wonder which one is better for erythematotelangiectatic rosacea? Flushing, some dilated capillaries, no papules or pustules. Only flushing

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Holly C. Hanson, MD · Answer

There are several differences between the Vbeam laser and the Excel V laser.  The first being the wavelength.  The Vbeam is a 595nm Pulsed Dye Laser.  The Excel V laser has 2 wavelengths, 532nm and 1064nm.  Excel V’s wavelength is much better absorb by the red color (hemoglobin)in the vessels being treated, resulting in more heat getting into the vessels, and thus, more effective treatment.  Typically, the longer the wavelength, the deeper the laser is capable of going.  So basically, by the addition of the 1064 laser, spider veins, and deeper blue vessels of the face and legs can now be treated.
Another difference is the way the lasers cool the epidermis, so the laser beam can heat the vessels and not the top of the skin.  Vbeam has a cryogen or cool ice shot that comes out just prior to the laser beam to cool the skin.  The Excel V has a sapphire cooling tip that allows for cooling of the exact area that is treated.  It also allows for pre, parallel, and post pulse cooling, leading to a safer and more comfortable treatment, with less risk to the skin.
In my experience, the Excel V is excellent at treating background redness and dilated blood vessels, both of which can be features of erythematotelangiectatic rosacea.  However, flushing is more difficult to treat with either laser.

What is the difference between V Beam and Excel V lasers for rosacea?

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