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.
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6 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
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