Laser Vascular Lesion Treatment (Hemangiomas & Spider Veins)

Laser treatment of facial vascular lesions including haemangiomas (benign blood vessel tumours presenting as red or purple raised marks) and telangiectasias (spider veins / broken capillaries presenting as fine red or purple threads on the face). At AE Derm MUDr. Helena Závodská uses the Nd:YAG 1064 nm wavelength of the FOTONA 4D system, which selectively heats oxyhaemoglobin in the abnormal vessels, causing coagulation and collapse without damaging surrounding skin.

Facial vascular lesions are among the most common cosmetic concerns treated by aesthetic dermatologists. Telangiectasias — small, dilated superficial blood vessels visible as red or purple thread-like marks — commonly appear on the cheeks, nose and chin as a result of rosacea, chronic sun exposure, genetic predisposition or skin conditions that weaken the vessel wall. Haemangiomas are benign proliferations of blood vessel endothelial cells that may be present from birth (infantile haemangioma) or appear in adulthood, ranging from small cherry angiomas (bright red, domed papules) to larger port-wine stains. Laser treatment of vascular lesions uses the principle of selective photothermolysis targeting haemoglobin: the laser emits a wavelength absorbed strongly by oxyhaemoglobin but weakly by melanin and surrounding tissue. When the vessel wall absorbs the laser energy and converts it to heat, the endothelium is damaged and the vessel coagulates and collapses; it is then gradually reabsorbed by the body's inflammatory clearance process over the following weeks, leaving no visible trace. The choice of wavelength is important: shorter wavelengths (like 532 nm KTP) are very effective for superficial capillaries but carry pigmentation risk in tanned or darker skin; the Nd:YAG 1064 nm used at AE Derm penetrates more deeply and has lower melanin absorption, making it the safer and more versatile choice particularly for dermal-depth vessels and for patients with tanned or darker skin types. MUDr. Helena Závodská delivers the Nd:YAG pulses directly over the visible vessels using the appropriate handpiece configuration for the lesion size and depth. Fine spider veins on the nose or cheeks may clear visibly within two to four weeks of a single session. Larger haemangiomas or more extensive telangiectasia networks typically require two to three sessions for complete resolution. Immediately after treatment the target vessel may appear darker (purpura) or slightly swollen; this resolves within one to two weeks as the coagulated vessel is cleared. No anaesthetic is typically needed for small lesions; topical cream is offered for more extensive areas. Sun protection after treatment is important to prevent hyperpigmentation during healing.