Couperose and neck redness

Couperose or Erythrosisfaciei

Couperose (Erythrosisfaciei) is a harmless skin condition where certain parts of the face have an abnormal red dyschromia. The most sensitive areas are the cheeks and / or the nose, but sometimes the forehead and parts of the chin can also be affected.

In the superficial dermis are numerous small blood vessels that are closed under normal circumstances. Temperature changes, efforts, stress, drinking hot beverages or alcohol, eating hot food or certain herbs can dilate these capillaries, which creates a red complexion. In susceptible people, the capillaries dilate with mild inducing factors. But, after a while, the blood vessels remain in a continuously dilated state, which explains the general redness in the face. This redness and the fine veins clearly showing beneath the skin is called couperose. In some cases, couperose can become infected. This is then called rosacea. In a further stage still, the skin will start to show bulges and create rhinophyma, sometimes also referred to as a strawberry nose. Rhinophyma mainly occurs in men and is absolutely not an indication of excessive drinking, as these patients are often accused of. Such sensitivity to the surface veins in the face is rather familial determined and can grow worse as a result of sun exposure and the use of sunbeds.

Neck redness or Erythrosiscolli

Neck redness (Erythrosiscolli) is very similar to couperose. A thinning of the skin or a severe irritation sometimes creates an unsightly reddish-brown stain in the neck region. These patches are more common in women and do not respond to creams or peels.

Laser treatment of couperose and neck redness

The laser devices we use, produce a very powerful light wave with specific wavelengths, which is perfectly aimed at the target it needs to reach. In couperose or neck redness, the red blood cells in the dilated capillaries are our target.

Due to the high energy dose and the extremely short pulse duration, selective damage of these deviating capillaries is created. Laser treatments are very targeted and precise thus the surrounding cells and tissues hardly suffer any damage. The damaged capillaries are then cleared by the body and replaced by normal capillaries.

The optimal result of the laser treatment – depending on the type of laser device – is only apparent after 1 to 2 months after treatment. After which, a second treatment can be carried out. Depending on the severity of the couperose or neck redness, 2 to 5 further treatments may be necessary.

Types of laser devices for the treatment of couperose or neck redness

Currently, there are three types of laser devices at the Cutaneous Laser Centre which can be used for the treatment of couperose or neck redness:

• the Excel V variable pulse 532 nm Nd-YAG laser
• the Palomar Starlux G
• the Candela V-beam pulsed dye laser

These three laser systems include a cooling system which cools the epidermis during the treatment. As a result, higher quantities of energy can be administered and the pain is reduced to a minimum. In certain patients, the treatment can be performed alternately with one and then the other laser device.

When are the above laser devices used?

• In the case of permanently dilated capillaries just below the skin surface (telangiectasia), that have the aspect of fine individual visible veins or of a more general redness
• In the case of more or less bulging redness or flushing (reactive flushing)
• In the case of redness, whether or not combined with pigmentation (generally in the case of Erythrosiscolli in the neck or neck redness, for example)

Is laser treatment of couperose or neck redness painful?

• Laser treatment of couperose or neck redness is generally well tolerated by most patients.
• Mild pain is typically experienced as a tingling feeling.
• The cooling system integrated into the laser device helps to significantly reduce pain.

What to expect after treatment?

• After treatment, there can be slight redness (erythema) to the treated area. 
• Sometimes, some swelling can also occur in the area of the lower eyelids the day after the treatment. This usually lasts a maximum of three days.
• Scab formation is rare.
• If you have irregular pigmentation of the epidermis i.e. sometimes a light greyness can occur, this will disappear after a few days.
• When the pulsed dye laser is used, sometimes a purpuric dyschromia may occur during the first few days. 
• The risk of scarring or textural changes is negligible. Rare problems occur in the nostril fold when there had been insufficient contact with the chill tip.
• The risk of a temporary brown dyschromia (hyperpigmentation) or lightening (hypopigmentation) of the treated skin area is also negligible. With these devices, you can also be treated during the summer period as long as your skin is not pigmented too strongly and you have not been actively exposed to the sun or a sunbed during the 4 weeks previous to treatment. Depigmentation is only to be feared after recent pronounced UV-exposure (sun or sunbed).

Aftercare following laser treatment for couperose or neck redness

• For comfort reasons, it is recommended to cool the skin down after treatment with cold, wet compresses or washcloths, for example, or possibly with Flamigel.
• In the case of any scab formation, you can also apply Flamigel 2 to 3 times a day on the treated area. 
• If you want to wash your face, we recommend to only dab it lightly with water.

What you also need to know

• People with couperose are also often prone to hot flushes with red dyschromia in the face as a result, also called flushing. Laser treatment can help improve this problem considerably but probably not solve it entirely.
• Unfortunately, sensitivity from the development of couperose cannot be eliminated permanently with laser treatment. That is why, after a few years, you can expect a resurgence of the problem. This can be solved by an annual maintenance treatment. The number of treatments that can be performed with this type of laser device is unlimited. Adverse long-term effects are certainly not to be feared. The stimulation of new collagen formation as a result of the laser treatment would actually have a rejuvenating effect.
• During the treatment, the patient, the physician(s), the staff and any attending family have to wear special glasses to protect the eyes from the laser light.
• Before and after treatment, digital photographs can be taken to optimally assess the evolution and end-result.

If you have any question about the laser treatment for couperose or neck redness, do not hesitate to contact us.