Is a bubble normal after V beam for spider angioma? (Photos)

Question

Not sure how to describe, but I had V beam for a spider angioma on my nose 3 days ago. The angioma had a little bump in the center and now after the v beam the bump looks more like a bubble/blister, it has gotten bigger each day since the v beam treatment. Is this normal and if so what is the healing process? Will it fall off? Leave an indentation? I am using hydroquinone to prevent discoloration. The first picture is the day of the procedure and the second one is 3 days after.

William Groff, DO · Answer

I appreciate your concern, but I assure you that what you are seeing is what we would expect after a Vbeam treatment for an angioma. I would expect the mark to continue to improve until it is virtually undetectable. I would avoid using hydroquinone at this stage and make sure you protect the area from direct sun exposure until it heals fully.

Deborah H. Atkin, MD · Answer

Hello, The result from your treatment looks entirely in line with what we expect to see. There is some purpura and swelling in the central part of the lesion. I    know it can look alarming, but you will be pleased with the result.

John Troccoli, MD, FAAD · Answer

Thanks for your question.  The photo on the day of the treatment looks perfectly normal, and purpura after the Vbeam treatment is to be expected. The photo 3 days afterwards also looks normal, and also shows fading of the purpura from the first photo. The Vbeam can also cause some localized swelling, which may look like pinpoint blisters. It appears that the swelling is mostly confined to the "body" of the spider angioma and less so at the edges. You should end up with a good treatment result, and the entire angioma may resolve after just one treatment.
I would hold off on applying Hydroquinone until complete healing has taken place, as it might be irritating.  Strict sun avoidance is the most important after care, and you should also apply Vaseline or Aquaphor to keep the area moist.. Sometimes a thin crust/scab may develop once the swelling subsides, and the dried-up angioma will peel off on its own (do not pick it off !)

Is a bubble normal after V beam for spider angioma? (Photos)

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Is a bubble normal after V beam for spider angioma? (Photos)

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