This paper is stating that even though the latest versions of the Pulse Dye laser don’t produce the same amount of purple/black scabbing as previous versions, it can still produce a lot of redness, swelling and pain. I know that I looked like a koala with a black scabby nose after my pulse dye laser treatment a few years ago. Sadly my treatments didn’t really help my symptoms, but the Pulse Dye Laser has had several technology updates since then.
Clinically Significant Facial Edema After Extensive Treatment With Purpura-Free Pulsed-Dye Laser, Alam M.; Omura N.E.; Dover J.S.; Arndt K.A., Dermatologic Surgery, Volume 29, Number 9, September 2003, pp. 920-924(5)
Background. Long-pulsed pulsed-dye lasers permit treatment of facial erythema and telangiectasia with purpura-free technique, which may be more comfortable for the patient than purpura-inducing treatment. However, there are anecdotal reports of treatment-associated discomfort even when purpura is not elicited.
Objective. To determine whether patients experience clinically significant erythema, edema, and pain after purpura-free treatment with pulsed-dye laser.
Methods. In this prospective, controlled study, subjects included 15 patients who were undergoing purpura-free treatment of diffuse erythema and fine telangiectasia of at least half the facial surface area with purpura-free pulsed-dye, and it included 15 age, gender, and skin-type matched control subjects who were undergoing similar treatments but with the induction of trace to mild purpura. Patients were seen in person and were surveyed by phone regarding symptoms and signs during their postoperative courses.
Results. Postoperative erythema of a mean 3.3-days duration and 3.4/5.0 intensity was reported by 73% (11 of 15) of the purpura-free patients. Among purpura patients, the duration was 5.6 days. The intensity was 4.0, and again, 73% of patients reported this finding. Postoperative edema occurred among 87% of purpura-free patients, but such edema occurred in all of the purpura patients, in whom it lasted longer and was more intense. Symptomatic eye swelling and uncomfortable/painful edema were seen in 27% and 20%, respectively, of purpura-free patients, but in 40% and 53% of purpura patients. Among purpura-free patients receiving fewer than 250 laser pulses per treatment, erythema and edema lasted less than 1 day and 2.5 days, whereas the mean durations were 3.4 and 5.0 days for purpura-free patients receiving greater than 250 pulses.
Conclusion. Extensive purpura-free treatment for erythema and telangiectasia of the face with the long-pulsed pulsed-dye laser can lead to clinically significant erythema, edema, and discomfort in patients. The duration, magnitude, and frequency of these undesired effects are markedly less with purpura-free treatment compared with purpura-inducing treatment and are also less for less extensive purpura-free treatments.
36 comments ↓
I had pulsed dye laser (V beam) treatment a day ago. yesterday I experienced swelling in my cheeks with definite “lumpy” feeling throughout the area of the cheeks where the doctor went over twice, due to the visibal area of where I was the most afflictated. Today I can barely open my eyes due to the execisive swelling of the areas around, especially under and inside areas of my eyes.
My doctor claimed there would be only minor redness, for 6-12 hours of the areas treated. But no swelling?
I am not sure if I will go for the follow up visit as I was planning or paid for. Anyone else have this experience?
jj…how are you now after the Vbeam. I am about to have one. Was told it would take about 7-10 days of downtime since I am doing a purpura treatment. Sounds like that is what you had. Can you keep us updated please.
I had a combination vbeam laser and IPL treatment two days ago. The pain from the procedure was tolerable without any medication. I looked a little welted that day, but nothing horrible. I went to bed. The next dayI woke up and looked like a freak. My eyes and cheeks were badly swollen. I thought I had had an allergic reaction to the steroid cream. I immediately went back to the dermatologist, who assured me that this happens to 85% of the patients. I took the prednizone and iced, then slept on top of ten pillows the second night. This morning I woke up and the swelling is double what it was yesterday. One of my eyes is almost swollen shut. I stay home with kids, but if I had to go to work it would not be possible. So when they say “swelling” beware. It is severe and happens to most, from what I am told.
I had Laser treatment yesterday on my face and was told to expect some mild swelling. This morning I was not prepared for what I saw in the mirror, the underneath of both my eyes had swollen up terribly and through today had become worse.I was so concerned I phoned the surgery but was assured this was perfectly normal.
I think they ought to make it more clear just what you can expect, I read that you could go straight back to work and carry on as normal, no way would I go back looking like this. Luckily I am off work all week so hopefully the swelling will have gine by then.
oh my gosh wow i had pulsed dye laser treatment yesterday and i thought the swelling was bad a couple hours later but i woke up this morning and can hardly see because my cheeks are in the way!!!! i didnt even recognize myself in the mirror! hey does anyone know how many days it takes for this to go away cause i got to go back to work on friday!
swelling, prolonged because you develop lyphedema, the vbeam clogged your lymphatic vessels hence swelling. sorry to tell you i have been fighting this prolonged swelling for months. have had lymphatic drainage to the face about 10 times i am very dissapointed no one tells you this
I got a IPL treatment 4 days ago and I’m still extremely swollen under my eyes, I look like I’ve got 2 water jugs! Is there any way to speed this process up, I’m tired of looking like a freak of nature.
I had IPL on a Friday afternoon with the assurance that I would experience some redness that could be covered up with makeup by Monday. Wrong.
Not only is my face swollen twice it’s sice this morning (Sunday) but I had bruising that looked black (kept ice on for a day and a half), blisters (still have a few today) and bleeding from the crusting which is starting to accelerate… I keep my skin covered with antibiotic ointment.
I have started a course of homeopathic arnica… I wil post here again to report how long this takes to subside. (I wish I could post a picture to show y’all how bad this looks).
I had this done on Thursday. It’s Sunday now, and I look like a freak – lots of fluid build-up around my eyes (in my eyelids, under my eyes, on the sides of my nose). I’m starting to realize i will not be able to return to work tomorrow and I’m horrified about this whole situation.
I’ve had this treatment a few times before without this result, but this time, my dermatologist turned the setting way up (without asking my permission first), and this has been the result. The assured me the swelling would be no more than usual with the higher setting. WRONG. I will be canceling my next appointment for sure. This is insane.
I received the v beam laser treatment for my cheeks and nose last night around 6pm on the low setting for the first time. It feels exactly like rubber bands slapping you in the face at full force probably between 20-30 times. The pain is bearable, but stung more than I expected. Bit of a burning smell, too, from the hair follicles of my beard (I shaved that morning). I iced the area twice last night. This morning when I woke up, there was minor swelling under the eyes.. looks like black eyes might be forming. My nose swelled up more than anything else overnight, but I was still able to go into work just 14 hours after the procedure. We’ll see how the swelling progresses through the weekend… Definitely easier being a guy with 2 black eyes than a woman. Good luck!
This is a follow-up to my posting on 11.16.08 -
I ended up being (unplanned) out of work for a week because the burns looked so awful on both sides of the face and the nose… and I could not apply make-up.
It has now been nearly two months and I have several spots that look like they will take at least half a year to heal (serious red scar tissue), and some dark spots where there were none before.
I can’t say whether the plastic surgeon had the machine set too high (she claims it was 50% lower than the recommended setting) – somehow I doubt it.
For those considering laser and are reading this series of comments, strongly recommend that – IF you have a great deal of broken capillaries – be prepared for some serious aftereffects if you go for a ‘heavy’ dose of laser.
If I had been given the choice, I would have opted for a series of much gentler treatments.
This is a follow-up to my earlier posting -
I ended up being (unplanned) out of work for a week because the burns looked so awful on both sides of the face and the nose… and I could not apply make-up.
It has now been nearly two months and I have several spots that look like they will take at least half a year to heal (serious red scar tissue), and some dark spots where there were none before.
I can’t say whether the plastic surgeon had the machine set too high (she claims it was 50% lower than the recommended setting) – somehow I doubt it.
For those considering laser and are reading this series of comments, strongly recommend that – IF you have a great deal of broken capillaries – be prepared for some serious aftereffects if you go for a ‘heavy’ dose of laser.
If I had been given the choice, I would have opted for a series of much gentler treatments.
Hiaya Natalie.
Thanks for letting us know how you are getting on All the best for your continued healing !
davidp.
Dear Natalie
I am extremely concerned that you have had such an extreme reaction following your pulsed dye treatment. We use Rosacea Phototherapy at our clinic. Although it is normal to look high in colour for an hour or two following treatment, you should return to normal by the following day.
elan medical skin clinic
I have not had this done yet but I was told by the nurse of my Derm who sees this every week to expect 3 weeks to be out of work. I’m taking her advice because I believe after having something like this done, there is no way you would possibly return to normal the following day. I’m not sure what the definition of normal is, but I don’t want to go to work with swelling, scabbing or bruising.
for the last year and half i have had redness on cheeks and broken veins on side of nose..This is going from perfect light glowing skin.. I had the IPL laser treatment done on tuesday am. went home, iced it, it seemed lighter in color. more pinkish. I woke up this morning and the left side was totally swollen up to my eye and could barely see out of it. My face continues to be red but i do notice the veins on sides of nose has diminshed.I took today off from work after thinking i could go in no problem. I had this done years ago without any problems ( I think the problem was not as extensive as it was now) i have been out of work two days and have no choice but to work tomorrow. i do notice the contsant burning feeling is gone but the red is still very bright. I am hoping it does calm down alittle of all this and 500 bucks of my money is all for nothing. i did puchase Obaji rosacea products too. i DO hope this clears up. its very frustrating to try EVERYTHING and then opt for the laser treatment with regret
day three.
the swelling is going down of left side of face. my side is nose is thinning out from swelling, inside of eye is back to being flat and i am starting to see those love hate wrinkles come back as under eye flattens out..my eye does not feel pressed against my cheek anymore and when i smile, my cheeks are back in alignment. I still have a very dry burn similiar to a sunburn. went to drs today just to see what i should do about it.they were horrified that i did this on my own and that i am no way a medical professional. After that rant, they told i was burnt by the procedure. duhhhh. and that there was nothing they could do or put on it. i am prob going to ignore that and put at least Neosporin on it to soothe it. I explained as calmly as I could that after over a year and half, all they do is give me hydrocortisone 2.5% to put on face, predisone and allergy pills(nothing works,just temp takes away the seriousness of it) and send me on my way. I have received Zero help from them when they know this has been a huge stresser for the last 7 or so months since i am frustrated by it and could not do it everyday anymore.
i just dont know how long this redness is suppose to last. kinda defeats the purpose when i did to get RID of the redness. lol
Thanks for the update Jill. I also have redness and vessels. My derm has been very good so far. I just had KTP laser done on Monday for the vessels and he also did a test spot with the Vbeam. He has been honest and told me that new vessels always do come back since our body continually branches off new vessels. So far I have scabs in the spots where he did the KTP, which is to be expected. The spot where he did the Vbeam is still purplish and I was told to expect about 3 weeks for that to clear but that everyone is different and their bodies heal differently. He did recommend IPL but only with a very reputable doctor since the spa like facilities have been known to burn people. I’m debating on if I should go for the IPL. I really don’t want to do the Vbeam since I could not walk around with my entire face looking purple for 3 weeks and based on what I have right now, there is no way to cover it with makeup.
Good luck with your healing and here’s hoping for a speedy recovery!
thanks kristie.
at first you worry “did i make the wrong choice?” but that is just the first couple days. The Neosporin has soften the burn tonight, its much lighter now. The swelling is acceptable now. my cheeks seem to be longer than usual still but every day it looks better.I know i would never do cheek implants after seeing this. he hee. I understand about the makeup, even with it i would have “hot spots” showing thru. My treatment never blistered or scabbed. I do know NOT to sleep on the side of your face, squished in the pillow, i think that is what caused most of swelling since it was that side. Skin too tender and soft for that. and i think she did ALOT of passes, i flared it up by accident that morning using witch hazel to get it really clean for the procedure.my bad. so she prob did overkill, more than she would had , had i not put witch hazel on. could explain some of my post prod issues.
let me know how it goes..good luck
It’s been almost two weeks since I had the KTP and my vessels are already coming back. So far they look lighter but it’s the same ones back. The test spot to ged rid of the redness (that was done on the purpuric setting) is also gone and it did not get rid of my redness one bit. Maybe I’m one of those that laser does not work for or maybe I need to try different lasers or a higher setting.
I guess I need to resort to the makeup. I really hate walking around with that stuff on. I could live with the redness (I am really red and it’s permanent) but the vessels are so gross to look at.
hey Kristie
sorry it didnt work for you… i seem to see alittle redness back..more like an allergy to some $^#&#%&# thing…. what i have no idea…
i used cetaphil without water and the redness burning feels better. soothes my skin.
Hi all,
I had the Vbeam laser treatment a week ago for redness of my cheeks and some broken blood vessels. I had a similar experience where the physician told me I may have “a little swelling” the next day. Needless to say, I had to call out of work. I was unrecognizable! It did improve the next day. However, the past few days I have noticed my skin is all bumpy in the treated areas! Has anyone else experienced this? My redness does seem to be slightly better. I will probably have to go back for a second treatment. That is, if the bumps go away! I’m a little nervous.
ONE YEAR UPDATE: Happy holidays to everyone…
So – a year after the IPL and all the broken capillaries have returned – and worse – there are red ‘bumples’ where there were none. I also have scar tissue in three areas where there particularly bad burning… Do you think I should ask for a refund? Or maybe sue for damages?
My skin is such a mess now I want to weep each time I look in the mirror.
thanx for the update natalie…i just went for a consultation and the sugeested this v beam….after reading this i will not be getting it
Hi all,
I’ve suffered from Rosacea for many years and it was getting worse over time. I have a subtype that does not involve much by way of pustules, but the capillaries under my face had proliferated to the point where I looked like I had a mild sunburn most of the time, and severe sunburn the rest of the time.
I got tired of hearing that I needed to wear sunscreen, here’s some metrogel, let’s try antibiotics, etc. and trying the same things over and over, so I finally decided to head to Duke, figuring that if they couldn’t solve my problem, I would just have to adopt a more Zen-like approach and accept my skin instead of continuing to struggle.
I had a consult with Claude Burton, who does laser procedures for a number of different skin/blood vessel conditions, including rosacea. We spent a couple months tinkering with the front-line treatments – oral antibiotics, metrogel/cream, retin-a, etc. We also tried a couple things that are currently experimental – beta blockers (which I couldn’t tolerate because I have asthma) and topical application of nose spray (people have been using that experimentally because of its anti-dilation effects). When we’d exhausted all of those, I decided I wanted to try a laser procedure in December.
First he did a test spot to see how well I’d tolerate it and how to calibrate the laser. He tracks how long it takes for the swelling/coloration to go down for each of his patients and has a chart on the wall. I would say the majority of his patients say they’re better at around day six, with some taking much longer than that to recover. My spot faded to my “normal” red after five or six days.
When I went in on the day of treatment, they looked at the one test spot and decided there wasn’t enough of an effect and that they would need to turn up the intensity of the laser (I’m sure that they had a more scientific way of putting it).
He worked quickly, applying the laser in a pattern around my face. I didn’t find it super-painful, but I would say it was extremely unpleasant between the stinging sensation and the popping sound of the laser. The whole thing took about ten minutes and I left a bit stunned and holding ice packs.
I had scheduled for a Friday and told everyone at work that I’d work from home on Monday as well. I looked insanely hideous for the first two days, and discolored but not freakish by Monday. By Tuesday it was still very visible, but the swelling was down and I was able to cover the spots with a high-quality base. By a week I felt unselfconscious even though I was blotchier than usual, and by ten days there was no sign that I’d had anything done.
As soon as the swelling went down and even before the bruises disappeared, I started to notice a difference. My face, which had been chronically red, was starting to be the same color as my neck and hands. In fact, I worried that I might almost be too pale!!
Over time things normalized and I started to forget what I’d looked like before the treatment. My cheeks got a bit rosier, especially after I started running again (which no doubt encourages angiogeneis or the growth of blood vessels), but nothing like what it had been before.
I went back for a follow-up last week (around 8 weeks post-procedure) and we looked at the pictures and compared them to now – what a GIGANTIC difference!! It turns out that I had had edema – leaking from the capilaries that had given me a puffy look that I’d forgotten about until I saw the photos. I look healthier, much more normal now.
Since there were some areas around my nose that hadn’t been treated as heavily, and because he felt we could do still better, I had another treatment that day (Friday). I would say the effects were about the same – this time I was sort of uncomfortable about the way I looked until that Wed (five days post procedure) and now, 9 days post, I look normal, though I can still see a faint red spot or two where I had particularly dark bruises.
This isn’t a miracle treatment, but if you have the subtype of rosacea that I have – which does not respond to topical creams of almost any sort – it is worth having a consultation with someone *very reputable* (I cannot stress that last part enough). I would not consider this sort of treatment at any place other than a major medical center because there is too much margin for error. Sorry this is so long, but it’s the type of thing I’d have liked to have read before going in for my consult, and I hope it helps.
I just had a test spot done 2 days ago. They told me they do it at a low setting and there is no down time. I was red after, and for the rest of the night I felt a sensation in the spot that felt like a sunburn. I did not have any discoloration or bruising, but I DO have a dent where I never had one. I am going back to them to show them. it is still there at 2 days later. It is definitely visible and you can feel it dent in when you run your hands over the surface. I still feel a slight sensation there as well, and my eye kind of hurts. The test spot was done on the forehead.
I am not a fan. I had a low setting spot treatment only and am hoping this dent it created is not permanent. iI am hoping nothing else will appear in a month from now or longer.
the only plus is the texture looks slightly better, but only very slightly. I would rather try an AHA product for texture.
WHo know if these lasers do damage deeper than the surface of our skin. Who knows if something will show up later because of it. I don’t think it is worth it.
So I had this done on Monday around 1:45pm. Im 32yrs old and of Irish/Rosecea decent. I had this done on my nose and cheeks. Immediatly following the procedure I could see a noticable difference on my nose. Within a few hours my cheeks looked like I was punched in the eyes. By the next day I was back at work with minimal swelling under eyes. It is now Wednesday and I look and feel better than I have in years. My skin looks like it did when I was 18. The results for me are so awsome, my 70 year old father has already made his appointment. He is an old timer from Irland and his entire family is plauged with Rosecea. WOW! what a difference. I highly recomend this!
My first session I had one tiny blisters and good luck with the veins disappearing. For my 2nd session yesterday he said he was using a broader head because the veins were so scattered. More painful than the first time, but no pain, no gain right? WRONG. I woke up at 4:00 a.m. and thought I had a bad cold…couldn’t breathe through my nose. Got up to go to the bathroom and walked into the wall. I couldn’t seem to see where I was going. When I turned on the bathroom light…aaarhhhhh…my eyes were only tiny little slits and I had so much pressure on them they wouldn’t focus. I’m on deadline so headed to work this morning after putting eye packs on my face for 2 hours. Used my biggest and darkest sun glasses. The swelling was better, but in less than 10 minutes it was swelled until I could see my cheeks again. I have been putting eye packs on my face on and off all day. The call to the doctor’s office was useless…..”put some vaseline on it”…what that is supposed to do I have no idea. I was schedule to have a total body lift with this doctor, but I am cancelling that tomorrow. I’m not giving him any more of my money. I understand these things happen, but really, this is my face. They could have at least offered some viable suggestions to help.
I had 4 treatments throughout last year with 6 wks between each. They were fine , I had bruising and it cleared within a week/10 days amd left white skin which was good.
48 hrs ago I had another last treatment and believe me it will be the last !
I didnt have swelling before but reading your blogs I guess he whacked up the power to get one broken vein that has bugged me for years and the little blotchy bits still visable…. I am like miss piggy,shrek and the princess from shrek morphed my eyes are like slits I cant believe I look so ugly when I look back to yesterday pre treatment I looked really well nothing that a bit of tan wouldn’t hide????
I too phoned and they said it’ll go in a day or too …
my family are shocked and disappointed but annoyed with me too as they thought I looked lovely as I was why didnt they tell me that before????
I hope and pray that all this puffiness doesnt stay around my eyes or stretch the fine skin and give me wrinkles where I had none before. Think carefully before having this done I look back now and do regret this last one as I am at home with shutters drawn and hiding from family members thats how bad I look .
I will leave a follow up and hope its like having a baby :you forget all the pain and gorey bits and are happy with the result Please God!
Sallyann – hope that you heal fast…and without any of the effects you mentioned.
I still have “blotches” that are a deep red where I was most badly burned… I also have “dents” as described by Kristen.
In short – every time I look at my skin I want to weep because instead of things improving they are actually getting worse as each month goes by.
Anyone have any suggestions? Is there a way to fix the damage???
Had the laser treatment for redness and veins on 4-22-10. Was told the swelling would go down in 4-8 hrs. 3 days later and my face is still swelling, eyes are like slits. Was sent home with nothing more than samples of creams. The Derm ran the machine at a speed that overheated it twice. Had to wait awhile for the cool down. Not what I was expecting or told, hope it was all worth it. Yes it hurt!
had intense laser on face 2 weeks ago experienced intense swelling for first week and brusing for about 10 days. i have these deep red spots from where i was bruised will these go away it’s been about 19 days now. happy with the results except for these spots, please advise.
My face has healed very nicely. Have just a few small scabs left and no scars. No more redness, more pink shades. Thinking about another treatment but with another Dermist. Well worth the pain.
I have just had my 5th treatment with the pulse dye laser for thread viens.every time i have had the treatment. I have had alot of swelling and deep purle spots ,the swelling usually last around 5/6 days . The brusing turns from purple to red spots after about 1 week and then go a light brown colour similar to a freckle around 10/14 days,a good foundation makeup will cover from now on and 4/6 weeks later from treatment day they should be almost gone.
I was always embarrassed when i had no makeup on because of the red viens on my face and nose,each treatment that i have had the veins have become less and less.
5 treatments later the viens on my face and nose are virtually all gone,im so glad i put up with all the swelling and bruising[no pain no gain] so the say.i have lots more confidence now and i have a vein free face,it was so worth it in the end.
Please if the viens bother you please ‘persevere’ with the treatments
I had My V-Beam Treatment 2 days ago and i’m suprised with a couple of people experience with it because mine wasnt bad at all…The day i did it, i was a little swollen on a little part of my left cheek because i had a vessels there so she passed a couple time on it and of course i was a little red on the cheeks but i am very happy with it! She told me that the bruise on my left cheek would disapear within 7 to 10 days and that i’ll see the result then…Plus she said that if the result wasnt perfect she’ll do some retouch for free! She was really nice! She sais that 1 treatment would be needed so i’m happy!I’ll come back to tell you about the result in 2 weeks if someone’s interrested to know…I also think it’s not expensive…i though it was more expensive than that! I paid 250$ for the treatment on my face…Did you guys paid around the same price?? Thanks ,Bye Bye =)
Any one know of a V-Beam in Hawaii?
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