Types & Causes of Vascular Lesions

Vascular lesions are abnormalities in the blood vessels (veins, capillaries, and arteries) and can vary widely in appearance, location, and severity. They are generally categorized into two types: benign and malignant. Here, we'll focus on the more common benign types and their causes:

Types of Benign Vascular Lesions

· Telangiectasias (spider veins): commonly found on the face and legs. Small, dilated blood vessels are visible near the surface of the skin, often appearing as red or purple lines or webs.
· Cherry angiomas typically appear on the trunk and increase with age. Small, round, red spots that are caused by an overgrowth of small blood vessels.
· Port-Wine Stains (Nevus Flammeus): Caused by dilated dermal capillaries and often present from birth. Birthmarks that appear as flat, pink, red, or purple marks on the skin.
· Hemangiomas: usually present at birth or appear shortly thereafter. Benign tumors of the blood vessels can be superficial (capillary hemangiomas) or deep (cavernous hemangiomas).
· Rosacea: often mistaken for acne. A chronic skin condition characterized by facial redness, small dilated blood vessels, pustules, and papules.
· Varicose veins: often associated with pain or discomfort. Enlarged, twisted veins typically appear in the legs.

Causes of Vascular Lesions

· Genetic Factors: Many vascular lesions, such as hemangiomas and port-wine stains, are congenital and may have genetic predispositions.
· Aging: The likelihood of developing certain vascular lesions, like cherry angiomas and telangiectasias, increases with age.
· Hormonal Changes: Pregnancy, menopause, and the use of hormonal medications can contribute to the development of spider veins and varicose veins.
· Sun Exposure: Chronic sun exposure can lead to the development of spider veins, especially on the face.
·  Lifestyle Factors: Standing or sitting for long periods, lack of exercise, and obesity can contribute to varicose veins.
·  Medical Conditions: Conditions like rosacea and chronic liver disease can lead to the development of certain types of vascular lesions.
· Skin Trauma or Injury: Physical damage to the skin can sometimes result in the formation of vascular lesions.

Common Treatment Equipment & Principles

Various medical aesthetic devices are available for the treatment of vascular lesions (such as spider veins, cherry angiomas, rosacea, etc.), offering effective solutions. Here are some of the commonly used devices for treating vascular conditions:

· Pulsed Dye Laser (PDL)
Principle: It emits a specific wavelength of light that is absorbed by hemoglobin in the blood vessels, generating heat to shrink or destroy the abnormal vessels.
Application: Particularly effective for treating rosacea, cherry angiomas, hemangiomas, and spider veins.

·  Nd:YAG Laser
Principle: It emits a longer wavelength of light that penetrates deeper into the skin, reaching deeper or larger vascular lesions.
Application: Effective for spider veins, certain types of hemangiomas, and deeper vascular lesions.

· Intense Pulsed Light (IPL)
Principle: Uses multiple wavelengths of light to target vascular lesions at different depths.
Application: Effective for treating superficial vascular lesions like spider veins and rosacea.

· Radiofrequency (RF) Therapy
Principle: Utilizes high-frequency radio waves to generate heat and shrink vascular tissues.
Application: Suitable for treating small vascular lesions, especially around the nostrils and on the face.

· Microwave Therapy
Principle: Uses microwave energy to heat and destroy abnormal blood vessels.
Application: It can be used to treat superficial vascular lesions.

Principles and Advantages of Different Equipment

IPL / DPL
IPL (Intense Pulsed Light) describes the use of intense pulses of non-coherent light distributed over a range of wavelengths from 400nm to 1200nm. The technology utilizes specific wavelength ranges to target various chromophores in the skin. This enables effective treatment of a broad spectrum of conditions, including acne, vascular and pigmented lesions, skin photoaging treatments, and hair removal.
DPL (dynamic pulsed light) is considered an advancement over IPL. It combines both laser and light technology, leading to a more targeted approach.
The main difference between IPL and DPL is that IPL utilizes a single light source, while DPL uses multiple pulsed lights at different wavelengths to provide outstanding results for safer, faster, and more comfortable treatments. Additionally, IPL is typically used to target surfaces, while DPL can be used to target deeper layers of skin.

The hemoglobin absorbs the energy of pulsed light selectively, which will lead to blood warming, thrombosis, and dilated blood vessels. The blood cannot pass through the diseased blood vessels, so it lacks nutrition and becomes atrophy; thus, it is eventually metabolized by the human body so as to achieve the purpose of treating telangiectasia. But normal blood vessels have less hemoglobin to absorb less energy so they are not affected.

Advantages of IPL / DPL in Vascular Treatment
·  Broad-Spectrum Light: IPL devices emit a broad range of light wavelengths, which can be filtered to target different skin issues, including vascular lesions.
· Versatility: Effective for a variety of superficial vascular lesions like spider veins, rosacea, and cherry angiomas.
·  Large Area Treatment: Capable of treating larger areas quickly, making it suitable for patients with extensive vascular lesions.
· Additional Skin Benefits: Alongside vascular lesion treatment, IPL can improve overall skin tone and texture, reducing pigmentation and signs of aging.
· Customization: The range of wavelengths allows for customized treatments based on the specific vascular lesion’s characteristics.

Q-Switched Nd:Yag

Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) is a crystal used as a laser medium. "Q-switched" refers to the technique of producing a high-intensity laser beam in very short pulses (nanoseconds). This allows the laser to emit powerful bursts of light energy in a controlled manner. The Q-switched Nd:YAG laser operates primarily at two wavelengths: 1064 nm and 532 nm.

By targeting hemoglobin in the blood vessels using the principle of selective photothermolysis at specific wavelengths (usually 1064 nm), the Q-Switched Nd:YAG laser is ideal to treat various vascular lesions, including spider veins and hemangiomas. This process heats and collapses the targeted vessels, leading to their absorption by the body with minimal impact on surrounding tissues due to the laser's short, high-intensity pulses.

 
Advantages of Q-switched Nd:YAG Laser in Vascular Treatment

· Targeted Precision: The Q-Switched Nd:YAG laser offers more precise targeting, which is particularly beneficial for well-defined vascular lesions.
· Deeper Penetration: Its wavelength allows for deeper penetration, making it effective for deeper-seated vascular lesions that IPL may not reach.
· Adjustable Wavelengths: The laser can be adjusted to different wavelengths (1064 nm and 532 nm), providing flexibility in treating a variety of vascular lesions.
· Reduced Skin Absorption: The 1064 nm wavelength is less absorbed by melanin, making it a safer option for darker skin types compared to IPL.
· Rapid Pulses: The fast, high-energy pulses are effective in collapsing the blood vessels without excessive heating of the surrounding tissue.

Diode Laser

In the medical aesthetics and dermatology industries, diode lasers are versatile and can be safely used on different skin types, including medium to darker tones, which makes them a popular choice in dermatological practices for hair removal, skin rejuvenation, and a variety of skin conditions, including vascular and pigmented lesions. They utilize semiconductor technology to produce a specific wavelength of light (typically around 800 to 810 nm) that is adept at targeting the melanin in hair follicles.

Our SOA K3 has 4 wavelengths of 755, 808, 940, and 1064 nm, which has greatly expanded its penetration range to improve the accuracy and flexibility of hair removal. The 940nm wavelength targets hemoglobin in blood vessels deeper within the skin. This helps to prevent hair regrowth by affecting the blood supply to hair follicles. It's also used for treating vascular conditions like telangiectasia, hemangioma, or other vascular conditions. The photochemical effect produced by the working laser makes deep collagenous fiber and elastic fiber rearranged and restores skin elasticity, which enhances skin metabolism and makes skin moist, delicate, and elastic at the same time. 

Precautions During Treatments

· Sun Protection: Always use broad-spectrum sunscreen with SPF 30 or higher.
· Skin Care Regimen: Follow a gentle skincare routine to avoid further irritation.
· Regular Follow-ups: Monitor skin response and adjust treatments as needed.
· Avoiding Certain Medications: Some medications can worsen pigmentation. Consult your doctor before starting treatment.
· Dietary Control: It is recommended to consume fresh and healthy foods during the treatment period and to control the intake of oil, salt, sugar, spicy foods, and other stimulating foods.
· Patient Selection: Not all populations are ideal candidates for IPL or Q-switched laser, such as those who have photosensitive signs or taken photosensitive drugs, have undergone some invasive skin treatment projects in the past week, or have used effective skincare products within three months. Many other prohibited populations are not eligible for treatment. Therefore, a thorough skin assessment, multiple intensive treatments, and a professional doctor's consultation during treatment are crucial to achieving optimal results.