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Thread: My 1st VBeam...with some purpuric

  1. #21
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    Nope, just wanted to be able to stick it up like that. Thanks.
    Rob

  2. #22
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    Ok so my understanding from these articles and the information my doctor gave me is that there are different techniques used for different rosacea symptoms.

    For diffuse background redness) where there are no visible individual vessels are present, subpurpuric treatments are preferred ( usually 10mm spot size, 10ms pulse duration and 6-7.5 J/cm2 Energy) If the redness seems to persist after 2-3 treatments, pulse duration should be decreased to 6-7ms and energy should be increased to 8-8.5 J/cm2. These settings could be purpuric or subpurpuric depending on the patient.


    For broken vessels (talengencia?), lower spot size and pulse duration (3ms maybe) is preferred to zap individual vessels.

    I also believe that talengencia is much easier to treat than diffuse redness. Also you need more treatments if you choose to have subpupuric treatments than purpuric ones.

    For diffuse redness, like I said subpurpuric treatments are preferred but some argue that purpuric treatments are better for long term maintenance.

    Also, almost all articles say that you need 2-4 treatments, making it sound like you should not have more than 4 treatments. Is it because any treatment afer the 4th one is less likely to improve redness because of diminishing returns?

    What if you had 4 conservative treatments but want to have more aggressive treatments? Should you go for 5th or 6th maybe?

    Any other opinions?
    Why do we fall? So that we can learn to pick ourselves up again..

  3. #23
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    Francois,
    Your understanding mirrors my own.
    However, I don't believe the inference can be made that 4 treatments are a max. I have had at least 8 or so.
    Some below and some above purpuric threshold. On diffuse redness, sub-purpuric worked fine. On individual telangiectasia, sub-purpuric levels were ineffective.
    Yours,
    Rob

  4. #24
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    Quote Originally Posted by melissawohl View Post
    Thanks for that article Francois!
    Really informative.

    These are the settings she uses on me each VBeam give or take whatever she adjusts depending on my reaction at the time. She is thoughtful as she's doing the VBeam. The VBeam before this one she did a double pass on my left cheek and I noticed no difference but since I flush asymmetrically anyway I'm not sure I would be able to tell.

    At this most recent VBeam she only went over each cheek once but she covered a lot of areas and included part of my jaw line. She preflushes me (at my request) by putting the heat on in the exam room at full blast and my whole face was red including the sides of my face and not just my central cheeks which is usually the area she confines the treatment to. I did not let her do my forehead or chin this time as I don't usually flush there but I do sometimes. I find that when she treats just my face it also improves my ears. Weird.

    I don't get purple bruises Francois but my face gets covered in red swollen circles where the swelling lasts for at least 3 days (I am still a bit swollen and it is day 4 now) and the red patches last for a few weeks albeit fading each week a bit more. Impossible to cover with makeup for at least a full week afterwards.

    Darlene, I do not know what the 34 means. She also uses DCD settings (no clue what that is either) 20/10. I would be curious to know but the reason I never asked her is that I don't want to be too high maintenance a patient if you know what I mean. If I'm going to her I better trust her at least to determine the treatment parameters etc. but at my next VBeam I'll try and remember and ask her.

    How are you guys doing in terms of healing/symptoms?
    Darlene, do you have any swelling left? How do your bruises look?

    Best wishes,
    Melissa

    BTW It hurts a lot each Vbeam pulse. i thought it would get easier over time but no, not really.
    Hi Melissa and everyone else....love the info being shared it is soooooo helpful!!!!

    Melissa I am very very swollen still....my eyes were just about swollen shut all day yesterday....my face is swollen up like a beach ball and my skin color is sorta like an umpa-lumpha from Willy Wonka movie!

    Today I woke up and my eye area isn't nearly as swollen and I could easily get my contact lens in...but I am very swollen all over. She treated my entire face....I need it all treated unfortunately. Except my temple area...I think next time we could skip that....I'll see what she and the doc think.

    Melissa I don't think it's weird that your ears are helped my treating your cheek area only....that lady I ran accross said the same thing....in fact her ears and neck flushed badly and after purpuric treatments it all stopped...she never treated her neck and her eyes come to think of it also...they cleared up for her also.

    The doc gave me a topical VitK enzyme lotion to put on bruised areas.....so I have been only putting on my cheek areas as this is the only place I have bruises...some look very bright blood dark red and the others are dark purple/black almost with a red circle border. Geez, the 2 that were done on my lower eye area are super dark bright red....not raise though, they are all flat marks everywhere.

    I wish I did undertstand what the settings mean myself....If I could get ahold of the PA on the phone she might be able to tell me...she was super nice....I was very nervous since it was my 1st ever with this machine and forgot to even ask her...I am sure she would have told me.

    I doubt I will be able to cover those marks on my face with any foundation! I don't care about them though...that part doesn't bother me at all it's the swelling and increased redness everywhere that get's to me more. My skin feels very dry too...like I am getting a lite layer of build of dead skin cells...YUK.

    Since I am only on day 2 post tx I am sure I will need at least a week for this swelling to go away!

    Oh heres something else I remembered....both the doc & PA told me I really don't have much visible veins...they just pointed out the ones I had...he called them angio somethings....and told me the VBeam would get rid of those in one treatment...so I guess I don't have the webbing of viens (tet?)...more diffuse redness. So diffuse redness is caused by inflammation in the tissues? and not dialted viens? That part confuses me! I may not understand that correctly!
    Dx 1998

  5. #25
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    Quote Originally Posted by Lookout View Post
    So diffuse redness is caused by inflammation in the tissues? and not dialted viens? That part confuses me! I may not understand that correctly!
    I've always thought that permanent redness could be caused by constantly dilated veins, though some people seem to have it caused by inflammation, so I don't know. I'm not sure how exactly you tell...

    I'm glad things went well! Hopefully everything will heal up soon. =]

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    Just wanted to say a big hello to Melissa and Darlene all the other people that are at home this Friday afternoon recovering from vbeam! Sounds like there's a few of us.

    Just had a maintenance treatment this morning. It's been two years since my last one but the doctor said my face didn't look that bad, which is encouraging.

    I'd just about forgotten how much fun they are. Nothing like a swollen, red face that sort of looks like pulp to start the weekend off.

    Darlene, let us know how your bruising is subsiding. I've got a couple of bruises, nothing major, but am going to get my nose bruised for the next treatment since it's so resistant (thought I'd go for two maintenance treatmentst since it's been so long).

    I'm going to read Francois' article and the I'm off to watch "No Country for Old Men" for the second time. Great film. I'm not a fan of violent movies but this has so much else going for it that it's worth a second viewing. The rest of the weekend will be similarily spent watching movies and reading, which is a good thing!

    Take care, everyone

  7. #27
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    Hey Chelsey,
    I'm glad your treatment well!
    Today was my first day out and it wasn't too bad but I didn't even bothering covering the red circles. I just applied some cover up to the apples of my cheeks and went out. My swelling is almost all gone now but I am very red.

    I loved No Country for Old Men. I just covered my eyes over the violent parts! Super movie and I'm glad it won!
    It is nice to relax and watch movies and read after a laser or IPL treatment. Some relaxation for the mind and soul.
    If you haven't seen Juno I recommend that. A fun movie that was surprisingly enjoyable.

    Have a great weekend and best wishes for a speedy and successful recovery!
    Melissa

  8. #28
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    Another article regarding settings:

    http://www.skinandaging.com/article/6157
    Why do we fall? So that we can learn to pick ourselves up again..

  9. #29
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    Wonderful info....I am thinking about the doc that says he looks for a bluish blush to appear in the treated area then when that happens he moves to another area...I never turned blue but dark purple/black looking with very bright dark red marks also....no blue...that's kinda confusing to be...as I have bruised on my legs and they get black/blue/yellow/green! Not usually dark bright red....maybe I am reacting strangely to this laser? I hope not!
    Dx 1998

  10. #30
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    Francois,
    Thanks for that info.
    I really appreciate learning about the different treatment perspectives and parameters.

    Darlene,
    Don't worry. I'm sure your reaction is normal.
    I get very red circles that last for weeks. I tried but couldn't cover them even with lots of dermablend. It just makes me more interesting looking when I'm out and about in public.

    Best wishes,
    Melissa

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