Tag Archives: laser

Using the Excel V Laser in People with Rosacea

Once a debilitating disorder, rosacea has become a manageable condition with many treatment options. The key to success starts with identifying an experienced board-certified aesthetic dermatologist who is skilled in identifying the specific subtype and severity of the condition. The next step is tailoring treatment to best suit your expectations.

Today, dermatologists recognize that certain types of lasers offer important options for managing more difficult-to-treat rosacea. In fact, according to the textbook, Update on the Management of Rosacea, “Lasers have created a paradigm shift in the treatment of the redness and telangiectasia [threadlike red lines or patterns on the skin] associated with rosacea.”

Excel V Laser

One option is the Excel V laser, which emits two wavelengths: KTP (potassium titanyl phosphate at 532 nm and Nd:YAG (neodymium-doped yttrium aluminium garnet at 1064 nm). KTP targets redness, hyperpigmentation, and damaged capillaries at the surface of the skin. Nd:YAG is designed to treat deeper, larger purple blood vessels. Following absorption of energy, abnormal blood vessels are sealed off, while hyperpigmented lesions are fragmented, resulting in an overall improved appearance. The results from two studies show how each wavelength contributes to a better outcome in selected patients with rosacea.


KTP targets melanin and oxyhemoglobin, which is present in oxygenated blood. Based on its short wavelength, the KTP laser treats superficial telangiectasia and redness. In one study, there was 62% clearance after the first treatment and 85% clearance three weeks after the third treatment. Patients experienced some swelling and redness following treatment. Because KTP targets melanin, it is reserved for people with lighter skin.


The Nd:YAG laser reaches deeper layers of skin tissue, targeting the lower absorption peak of oxyhemoglobin. In patients with purple facial telangiectasia treated twice, 30 days apart, 73% (11/15) showed moderate-to-significant improvement after the first treatment and at Day 30. At the 3-month follow up evaluation, 80% continued to show improved appearance.

The bottom line.

To achieve the best results, studies are always designed to ensure that patients are best matched to the treatment received. The same is true in a dermatology practice—recommendations are matched to your condition and your desired response. For a consultation and more information about treating rosacea, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Drs. BinstockLayton, and Physician Assistant Cullinane will answer your questions. Call our San Francisco office at (415) 956-8686, or in Mill Valley call (415) 383-5475.




Successful Treatment of Acne Scars in People of Asian Descent

When it comes to treating acne scars, the scaring and pigmentation issues faced by Asian Americans can be as troublesome as the original condition. This is because darkly pigmented skin is more vulnerable to dyspigmentation—an abnormality in the formation or distribution of pigment in the skin.

Non-ablative fractional resurfacing is one of several treatment options for acne scars in people of Asian descent (or anyone, for that matter). During this treatment, a laser delivers heat to targeted areas, while areas of healthy skin are left untreated. The fractional approach allows more rapid healing than if the entire area was treated.

Success following non-ablative fractional resurfacing

The results of two studies in people of Asian descent show that the number of treatments, the time between treatments, and use of the laser must be skillfully combined to get the best results.

For example, in a study of 27 Korean patients, with moderate-to-severe facial acne scars, the doctors assigned them to received 3 to 5 sessions of treatment, each spaced 3 to 4 weeks apart. The patients compared their results 3 months after the final treatment to photographs taken before treatment. Eight patients (30%) said the results were excellent, 16 patients (59%) described the improvement as significant, while 3 patients (11%) concluded they had moderate improvement. Side effects were limited to short-lived pain, redness, and swelling.

In another study of 47 Asians with facial scaring, where the dose and the number of treatments (8 passes or 4 passes) were assigned based on each patient’s needs, both treatments resulted in significantly improved skin texture and acne scarring. There was also improvement in enlarged pores and overall pigmentation irregularity compared to their initial photos. In this study, the risk of post-inflammatory hyperpigmentation was less among those who received 4 treatments.

The bottom line.

Treatments used in both studies were successful and support the role of non-ablative fractional resurfacing as part of a comprehensive treatment of acne scars among people of Asian descent.

Smooth skin and a flawless complexion are highly desired. And the most successful outcomes result from treating the initial concern (facial acne scaring), as well as minimizing changes in pigmentation as shown in the photos. Achieving this balance is where consultation with an aesthetic professional is indispensable. This is because many treatment options, including non-ablative fractional resurfacing, are available.

Photos are courtesy of Solta—pretreatment (left) and post-treatment (right).

Learn more about treating acne and other scars. For a consultation and more information about our approach to correcting acne scars with Fraxel Restore, our non-ablative fractional laser system, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Drs. Binstock, Layton, and Physician Assistant Cullinane will answer your questions. Call our San Francisco office at (415) 956-8686, or in Mill Valley call (415) 383-5475.