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Red Spot Removal

Author: Dr Naomi / 27 Oct 2015

Red spot removal is performed with our sciton BBL laser /IPL or with a hyfrecator

PROCEDURE FOR RED SPOT REMOVAL

1. Consultation

Patient is to arrive with no makeup and no history of use of self tan/ spray tan for at least 2 weeks

The doctor will take a history

A. skin type and tanning

B. previous treatments and their success, complications etc

C. discussion of desired outcome

D. Assess risk of PIH

Doctor will examine the patient

If the patient is Fitzpatrick 1-2 (fair skinned) then they can go ahead with the treatment on the day. If they are darker skin toned or at risk for PIH (Post inflammatory Pigmentation) then they will be advised to use topical lightening agents for 8 weeks prior to treatment. These topical agents are sold at our clinic.

Photographs will be taken

There is opportunity to ask the doctor questions about the procedure

Consent form will be given to the patient with a discussion of risks, benefits, pros and cons of the treatment. If the patient signs the consent form, the procedure will go ahead.

The treatment for red spots with BBL

The appointment is 30 minutes

The patient will lay on the treatment bed

All makeup will be cleansed off the face.

Goggles will be worn by the patient to protect the eyes

Clear ultrasound gel will be applied to the areas to be treated.

The laser will be used on each individual spot, multiple pulses may be required to ascertain the correct power. The procedure is painful, but most patients tolerate it very well. I do not like to use any form of anaesthetic when removing red spots and hemangioma as I really need to know that I am not causing excessive damage to the skin. If I use a topical anaesthetic, then the patient is not able to give me this important information, and this could lead to side effects including hypopigmentation or scarring. Also topical anaesthetic can shrink capillaries, so we do not want this when we are trying to remove thme. Typically patients will describe the pain during red spot removal as a 4/10.

After the treatment, the ultrasound  gel is gently cleaned off the skin.

Immediately after the treatment

A sunburn-like feeling is common after treatment. This is normal

Sunscreen or makeup may be applied immediately after the treatment to the treated area.

The patient may purchase a soothing gel for post laser care.

What you should see on the skin after the treatment

Day 1 there may be redness in the treated area and darkening of the red spot, it may be purple or grey, or it may be gone completely.

Over the next few days the redness will reduce and the red spot may turn into a fine scab in the shape of the original spot. At approx day 7-14 days the “scab” will start to lift/ crumble revealing beautiful fresh skin underneath, or there may still be some of the lesion still apparent. If the lesion is still visible, you will need to have a second treatment

At home care after treatment

The sunburn-like feeling will last several hours and then nearly disappear.

Sun should be avoided. Be aware that while driving one is exposed to the sun

Sunscreen should be applied every morning and reapplied as often as is practical

A hat should be worn.

Soothing gel may be purchased from the clinic and used twice daily.

Do not use acid or antiaging face products for 2 weeks after treatment.

Do not pick the area if there is a scab

Please contact Dr if there is any blistering after the treatment. This is not normal and means that the power was too high. This requires treatment.

If you are at risk of PIH, the doctor will have given you instructions to buy some corticosteroid from the chemist to reduce the inflammation and lower your risk of PIH. This should be used for 7 days, twice daily. You should start your lightening agent again at day 7 unless advised otherwise by your doctor

2-4 weeks later. Review appointment with the doctor

Results will be reviewed with the doctor. the 2nd treatment can be performed on this day if it is required

Treatment 2

Treatment 2 will be at some time from 2 weeks to 4 weeks after treatment 1.

Treatment 2 will proceed exactly as treatment 1.

After 2 treatments

95% of patients will be delighted after 1-2 treatments of red spot removal. The 5% who are not should have a 3rd treatment, minimum 14 days after treatment 2. This can occur when the red spot is very large.

Complications/Risks

Facial Redness: nearly always occurs, should resolve within a few days

Facial Swelling: this can occur especially in the under eye area is treated. This should resolve within the week.

PIH (post inflammatory hyperpigmentation) ie the laser can cause areas of brown pigmentation due to inflammation and the patient’s susceptibility to this. It is less common in the lighter skin tones.

Patients who are at risk for PIH are treated very differently to those who aren’t. Prevention is important, ie prelightening  is important, and steroids may be necessary after the treatment.

Blistering: This is very uncommon. If this occurs, the patient needs to call the doctor urgently

Infection: The patient may  notice a combination of the following:  redness, tenderness, swelling, pain and pus. This needs to be treated urgently. The doctor must be contacted immediately

Hypopigmentation/scarring: This is very uncommon, but possible if too high powers are used.

Recurrence of removed red spots is rare, but if one is genetically predisposed to getting red spots, then it is likely that more will grow and regular treatment will be required

Cost of red spot removal

1-2 red spots $360

3-5 red spots $600

6-25 red spots $850

26-50 red spots $1300

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