Pain, Swelling and Redness after Pulse Dye Laser Treatments

Written by on January 4, 2006 in laser therapy, pulse dye laser, swelling with 54 Comments

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.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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54 Reader Comments

  1. Natalie says:

    @ JR – sorry to hear that things are not healing up as well as they should.
    And thanks for the suggestion. I actually did reach out for some advice from a medical malpractice lawyer – it was not going to be worth the time, effort and possible expense.
    I still have two large (nickle sized) dead-white spots where I had the worst burns. They are still as vivid as ever – and it’s been two years.

    @Michelle – sounds like you and JR had the same reaction (brown skin).

  2. sarah says:

    The people who r commenting after only a couple of days or weeks of treatment need to give it more time. It takes aa lot longer to sEe the final results. After every ipl treatment I had I freaked out 2 weeks in and thought it wasn’t working, but it was.

  3. Jnut says:

    I had IPL on my face on Monday 5/1/11. I had the normal redness. When I woke up the next morning my face was swollen. I’ve had IPL about 6 times over 3yrs and I have never had this happen. Can anyone answer why this happened. It has to be some kind of reaction if it never happened before. How long does the swelling last? Why did it happen this time and not the others? Would a cortisone shot help the swelling? It’s been almost 4 days swelling hasn’t went down…when should I be MORE concerned!

  4. JR says:

    My doctor did not explain why this would happen, only that “everyone is different”. Perhaps you have developed a sensitivity or your doctor used a stronger setting this time. I would contact your doctor and be insistent – don’t settle for them telling you to ice it and take ibuprofen. You have to be your own best advocate. In my case, oral prednisone helped, but it makes you feel nutso. My swelling was down pretty well in 7-8 days. But bruising did not completely subside for over 5 weeks

  5. KATHY says:

    I HAD IPL TREATMENT ON FRIDAY. BEFORE I LEFT OFFICE MY FACE WAS BLACK WITH BRUISES. I WENT BACK IN BECAUSE IT LOOKED SO BAD. She said it was normal and gave me an ice pack. Next morning so much swelling I looked like an alien. Horrible. Purple marks all over my face. Nose swelled, didn’t even look anything like me. I hope this gets back to normal someday. I’ve been using witch hazel, arnica, and today I am going to get some vitamin k cream. 🙁

  6. tony says:

    I have just had my first IPL for red face and a few broken veins. i am 42 and suffered with this for years. up until a year or so ago i just put it down to genetics,allergic reaction to booze,cheese, hot temperatures etc and did some research.
    So, i had my IPL about 16 hours ago .My face is a bit red, nowhere near as bad as it was and ever so slightly swollen. the broken ,dilated veins around my nose and cheeks have all but disapeared,which i’m happy with .the dermatolagist said being fair skinned i’ve reacted fantastically to the treatment,so much so that he thinks 3 treatments should be all that’s required. I am very happy, like everyone else, i’ve put up with this for years and i can finally see IP Light at the end of the tunnel. I’m in for round 2 in another 3 weeks and i’ll keep you guys posted

  7. Donita says:

    My v-beam laser treatment for rosacea and spider veins was scheduled for 2 weeks earlier, but they phoned me and said the doctor wouldn’t be available and could I come in Nov. 30. I had the treatment on that day. The doctor said something about Christmas and laughed. The next day even my eyes were swollen and my face was dark purple all over the cheeks, nose and chin. There is no way that the bruising will disappear in 2 weeks’ time like they originally said. Why didn’t they tell me not to have it done so close to Christmas? Fortunately I don’t really celebrate Christmas so don’t have parties to go to, but what if I did? They don’t give you the true picture of what will happen and how long it will take to heal. They’re just interested in making money. I will never have this procedure done again.

  8. Jody says:

    Thank you all so much for sharing your stories. I’ve had this acne rosacea for at least 25 years (I’m 40) – I don’t go anywhere without my makeup on, it’s been a nightmare, flares up terribly with gluten and rice. Sometimes it’s as though my face is burned. Finally went to a Dr. and he recommended laser. I got test spots done last week on my neck under my ear. THANK GOD he did test spots, one swelled up quite a bit for three days then settled. This morning the same area swelled up once again and had a pustule. Hard to see with a mirror but two of the test spots look a little funny, ? scarred. My appt to get my face done is tomorrow, I’ll go show him the test spots, but after reading your testimonies I think I’ll not get it done. I’ve lived with it this long, I guess I’d better not make it worse…

  9. JR says:

    It has been a year since my treatment. Although I was totally unprepared for the pain, swelling and bruising, I have to admit that I am happy I don’t have spider veins on my cheeks and fewer on my nose. I am not sure if I would do it again or not. I think I would consult with a plastic surgeon or two in hindsight. Last year, all I did was make an appointment with a dermatologist, who said it would work without downtime and went for it. I have learned that lasers can be dangerous and it is hard to know what type of reaction each individual will have. I also think the “test spot” idea is a good one. I believe that you can get the results with a lower setting and fewer zaps over multiple treatments and not have the pain, bruising and swelling – not sure, but if you are still considering, it might be worth asking. I will say that the nurse at the office where I went made some sort of comment like “well, at least you know it worked”. Geez, that was kind of weird. Like, if you don’t look like godzilla after the treatment, it might not have worked??

  10. sara says:

    I have gotten 2 vbeam laser treatments done for redness caused by a bad microdermabrasion. it was bad! beet red face and veins everywhere. terrible. never would go away either. anyway. the first vbeam he took it easy on me cause i was so nervous. i had some swelling and a little bruising. i saw good improvement. the second one he was more aggresive. i was very swollen for about a week if im remembering right. i was very darkly bruised all over. it was great! i saw much more improvement. the swelling and bruising didnt bother me at all since i didnt have to go anywhere and i had done enough research to know what to expect. of course i had a freakout about 2 weeks later thinking it wasnt guna work. but then about a month or 2 later i started seeing results. i now look almost normal again. altho now im breakingout and my skin still cant handle acne products like it use to.
    anyway. i would suggest jodi go to an integrative doctor. it sounds like you have triggers like gluten and rice. they will run lots of tests on you to find out the root cause of it, food alergies, hormones…and they will treat the cause. find one that uses bioidentical hormones so if its your hormones they will use safer more natural ways to help you. i am going to see an integrative doctor in about 2 months to find out whats causing my acne and hair loss and anxiety-stress issues. im sure stress and hormones imbalance. dermatologists and regular doctors havent been able to help me and i refuse to have to be on antibiotics or birth control forever to help with the symptoms. i am allergic to most antibiotics plus they are very bad for you and birth control only has temporary results and then my body starts showing its symptoms again. i have to be off my birth control for 2 months before they can start testing me. i better look for a good hair loss product and im only 28!! and my face wont tollerate any acne products so my face is going to go craaaaaaaaazzzzy!!!!!
    anyway. i would looooove to do vbeam again!! but its about $1000 for a full face treatment where i go and i just cant afford that. not now anyway. its a bummer cause i think one more treatment would really help finish things off. if you get some dry crusty areas i just dabbed a little triple antibiotic or lotion on it and it helped. it never scarred me or anything. you will look funny for a while tho. maybe 2 weeks. i think that actually might be how long it took me to look normal again. dont let them fool you when they say you can just have the treatment and go back to work. that wont be the case unless you want people to think you had the crap beat outa you. and bruising helped more for getting rid of the redness.

  11. Bob says:

    juste had I beam done 1-6-12…iced it for 6 hours after kept the swelling down alot.next day went to watch football at a local bar and had a veAPPENEDry few people ask WHAT HAPPENED//// a little sewelling on1-8-12.Besides the bruseing all is going very well.
    first trip to the doc and very well pleased with the progress. He removed a lot of sun damage and broken blood vessels.I will go back in on month and have some acne scaring removed.So far so good.
    Will keep you posted

  12. Tara says:

    I’m on my third day after V-Beam treatment. I was also told that it would be simple and some swelling in pulsed areas the first day or so. I was not at all prepared for what I’m experiencing. I should have been told, as according to the fee I was charged, I estimate I had well around 300 pulses.

    The first day was some tenderness and swelling and I iced per the directions. I woke up looking like a hampster the next day, big cheeks and little beady eyes. The third day was even worse with my eyelids now puffing in from the nose. The article above was helpful – I was freaked out concerned that I had an allergic reaction to the aloe vera or the combination of v-beam and doxcycline. Thank you to all for your posts, I understand this is simply the treatment. I was sad however to hear all the anguish you all are experiencing.

    I’m sleeping in sitting positions and drinking lots of water. I’ll try cool compresses now instead of ice and baby aspirin. Any suggestions on a soothing ointment (besides aloe vera) for super allergetic/hypersensitive skin? I’m a little worried about putting anything on my face and having an added reaction.

  13. Jeanne says:

    Hi Tara,
    Hang in there, and I suggest nourishing yourself from the inside out to promote healing. Try juicing, and if you don’t have a juicer, try using a blender and use high-antioxidant foods, like blueberries, tart cherry juice, kale, beets, etc. Avoid foods that can have inflammatory reactions – like gluten/wheat, dairy, alcohol and beef

    Rest assured, it will get better. I left the house after about 5 days, with heavy make up. After 2 weeks I was essentially normal. It has been a couple of years now, and I am glad I did it after all. As you say, though, I sure wish they were better at preparing us for what to expect.
    Jeanne

  14. Lyy says:

    Hi has anyone had swelling on face after a patch test for laser

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