Red marks due to blood vessels are not uncommon in our local population and can be distressing if obvious.
What is the best treatment for red marks due to blood vessels close to the skin?
Long-pulsed vascular lasers are best for treating these marks. There are a wide variety of such lasers on the market but they are not as common as Q-switched lasers or fractional lasers. Not all clinics would have a laser suitable for treating blood vessels. Intense Pulsed Light (IPL) with appropriate vascular filters can also be used, but they are not as suitable in my opinion.
Long-pulsed lasers have wavelengths that are strongly absorbed by haemoglobin in the blood. The long pulse duration produces a photothermal effect that causes damage to the walls of the blood vessel. The body then naturally eliminates the damaged vessel.
Examples of such lasers include:
- Long-pulsed green Nd:YAG laser (532nm)
- Yellow laser (577nm)
- Pulsed dye lasers (585nm/595nm)
- Diode lasers (940nm)
- Long-pulsed infrared Nd:YAG laser (1064nm)
Which long pulse vascular laser is best?
The answer: it depends.
Generally, as the laser wavelength increases. absorption in haemoglobin and melanin decreases. The degree of scattering in the skin also decreases hence longer wavelength lasers would be able to penetrate deeper.
Melanin and haemoglobin absorption decreases as wavelength increases (source)
Penetration increases as laser wavelength increases
The most suitable vascular laser would depend on the characteristics of your skin and the targeted blood vessels.
Longer wavelengths such as 940nm diode would be more suitable for larger or deeper vessels, thicker marks or patients with darker skin colour whereas shorter wavelengths such as the pulsed dye laser may be more suitable for small, bright red vessels close to the skin surface. Shorter wavelengths have more melanin absorption, hence they may have a higher risk of complications in dark skin types compared to longer wavelengths.
Based on your description, you may have an angioma, telangiectasia or spider naevus. These are some of the more common red marks caused by blood vessels in Singapore. Generally, most of the vascular lasers mentioned would work but some would be more advantageous in certain scenarios
Angioma (source)
Spider naevus (source)
Do consult a doctor who can advise you in detail. Hope this helps!
Warmest regards,
Dr Wan Chee Kwang
