Vascular and pigmented lesions in Calgary

Vascular and Pigmented Lesionsat Rejuvenation Dermatology Calgary South.

Red spots are blood vessels and brown spots are pigment, and each is treated with a laser built for that target. Broken capillaries, cherry angiomas, port-wine stains, sun spots, freckles and flat birthmarks all clear well when the diagnosis is right. At Rejuvenation Dermatology Calgary South, Dr. Paul Kuzel, a board-certified dermatologist, examines every lesion before it is treated, because a few brown spots are not what they seem.

14Years of training FRCPCRoyal College certified VPAlberta Society of Dermatologists
What they are

Red is blood, brown is pigment.

A lesion's colour tells you its target. Lasers work by being absorbed by one thing and ignored by everything else, so red and brown are treated with different wavelengths.

Vascular lesionsDilated or excess blood vessels in the skin. Broken capillaries from sun and rosacea, cherry angiomas that appear with age, spider angiomas, venous lakes on the lip, and vascular birthmarks such as port-wine stains and haemangiomas. They blanch when pressed.
Pigmented lesionsExcess melanin, in the surface or deeper. Sun spots and age spots, freckles, flat brown birthmarks such as cafe au lait patches, seborrhoeic keratoses, and the pigment left behind by inflammation. They do not blanch.
The ones that are not lesionsMoles are pigment and also cells, and a few pigmented spots are early skin cancers. These are examined with a dermatoscope, biopsied where there is doubt, and never lasered.
The common lesions

Capillaries, angiomas, birthmarks, sun spots and freckles.

What each looks like, where it comes from, and what treats it.

Vascular

Broken capillaries

Fine red threads on the nose, cheeks and chin, from sun, rosacea, heredity or pressure. VBeam, one or two sessions.

VBeam
Vascular

Cherry angiomas

Small bright red domes on the trunk and limbs that increase with age. Harmless. VBeam or electrocautery in one session.

Vascular

Port-wine stains and haemangiomas

Vascular birthmarks. Port-wine stains are flat and permanent without treatment; infantile haemangiomas grow then shrink. Both are treated with VBeam, earlier being better.

Birthmarks
Pigmented

Sun spots and age spots

Flat brown lentigines on the face, chest and hands from cumulative sun. PicoWay clears them in one or two sessions; Fraxel where they are diffuse.

Sun damage
Pigmented

Freckles and cafe au lait patches

Genetic freckling that darkens with sun, and flat tan birthmarks. PicoWay lightens both; freckles return with sun exposure.

Freckles and moles
Pigmented

Seborrhoeic keratoses

Waxy, stuck-on brown growths that appear with age. Harmless, but sometimes mistaken for melanoma and vice versa. Removed with CO2 laser, cryotherapy or curettage after examination.

CO2 laser lesion removal
Why a dermatologist

Some brown spots are not what they seem.

A laser removes colour from whatever it is pointed at. The job of the physician is to make sure the colour was not the only warning.

Dermoscopy before every laserLentigo maligna, an early melanoma of sun-damaged skin, looks like a sun spot. Pigmented basal cell carcinoma looks like a mole. Dr. Kuzel examines every lesion with a dermatoscope and biopsies anything in doubt. A lasered cancer is a cancer that is harder to find.
Moles are never laseredA mole that bothers you is removed surgically and sent to pathology. Laser destroys the tissue a pathologist would need, and can leave pigment behind that later mimics recurrence.
Melasma is not a sun spotIt is hormonal and inflammatory, and an aggressive pigment laser makes it worse. It is diagnosed clinically and treated with prescription therapy first.
Medical and cosmeticAssessment of any new, changing or unusual lesion is medical and covered by Alberta Health Care with a referral. Removal of a harmless lesion for appearance is cosmetic and is not covered. Dr. Kuzel says which is which before treatment.
The lasers

VBeam for red, PicoWay for brown.

The clinic keeps a laser for each target and a surgical laser for raised growths. Red and brown are commonly treated in the same visit.

Red

VBeam pulsed dye laser

Yellow light absorbed by haemoglobin. Seals capillaries, angiomas and vascular birthmarks. The standard vascular laser.

VBeam
Red, deeper

Nd:YAG 1064 nm

Reaches larger, bluer and deeper vessels such as venous lakes, vessels around the nose and leg veins that VBeam cannot close.

Fotona Dynamis
Brown

PicoWay picosecond laser

Shatters pigment by shock rather than heat. Sun spots, freckles and cafe au lait patches, safe across skin types.

PicoWay
Brown, diffuse

Fraxel 1927 nm

For sun damage spread across a whole area rather than in discrete spots, treating texture and precancer at the same time.

Fraxel
Raised

CO2 laser and cautery

Seborrhoeic keratoses, skin tags and raised angiomas are vaporised or cauterised in one session after examination.

CO2 laser lesion removal
Suspicious

Biopsy and excision

Anything that could be a skin cancer is sampled or removed surgically and sent for examination. No laser.

Skin checks
Your visit

Examination first, treatment usually the same day.

Most vascular and pigmented lesions are treated at the first visit once they have been examined.

ConsultationWhat concerns you, how long it has been there, whether it has changed, your sun history and skin type.
ExaminationDr. Kuzel examines each lesion with a dermatoscope, and the rest of the skin if you wish. Anything in doubt is biopsied rather than treated.
Plan and consentWhich laser, how many sessions, expected result and side effects. The price is confirmed before treatment.
TreatmentProtective eyewear. Most spot treatments take minutes and need no anaesthetic. Larger areas and children are numbed.
Follow-upReview at four to eight weeks; repeat where needed. Birthmarks are treated in a course over months.
Aftercare and downtime

By laser.

Red lesions darken or bruise then fade; brown lesions darken then flake. Neither needs time off.

After treatment

  • Vascular laser: redness and mild swelling for a day; treated vessels darken and fade over one to two weeks; bruising for seven to ten days if bruising settings were used
  • Pigment laser: spots darken within hours and flake off over five to ten days; do not pick
  • CO2 or cautery: a small crust for seven to ten days under ointment
  • Gentle cleanser and moisturiser; no exfoliants for a week; makeup the next day on the face
  • Daily SPF 50 and sun avoidance for four weeks; treated skin pigments easily
  • Contact the clinic for blistering, spreading crusting, or unusual pain
  • Not treated on a recent tan, in pregnancy, or on any lesion that has not been examined

Booking and fees

Assessment of a new, changing or unusual lesion is covered by Alberta Health Care with a referral. Cosmetic removal of a harmless lesion is priced per session by area and quoted at consultation.

Referrals by fax to (403) 225-2914. Call (403) 286-6888 for current pricing.

What to expect

Expected outcomes.

Discrete lesions clear best. Broken capillaries, cherry angiomas, sun spots and freckles usually clear or lighten substantially after one or two sessions. New lesions form with time and sun, so maintenance is about protection and an occasional session rather than a course.

Port-wine stains lighten substantially over many sessions and rarely disappear completely. Cafe au lait patches lighten and sometimes recur. Melasma and post-inflammatory pigment improve with combined medical and laser treatment rather than clear.

Lasers do not treat moles, do not treat suspicious lesions, and do not stop new sun spots forming. Sun protection is the treatment for that.

1 to 2Sessions for most spots 0Days off work 100%Examined before any laser
Questions

Questions about red and brown spots, answered.

How much does laser spot removal cost in Calgary?

Cosmetic removal is priced per session by area and quoted at consultation. Assessment of a new or changing lesion is covered by Alberta Health Care with a referral. Call (403) 286-6888 for current pricing.

How do I know if a brown spot is dangerous?

You often cannot tell by looking. A spot that is new, changing, asymmetric, multicoloured, larger than a pencil eraser or different from your other spots should be examined. Dr. Kuzel examines every lesion with a dermatoscope before treating any of them.

Will you laser a mole?

No. Moles are removed surgically and sent to pathology, because laser destroys the tissue a pathologist needs and can hide a melanoma. Every pigmented lesion is examined before any laser treatment.

How many sessions do I need?

One or two for capillaries, angiomas, sun spots and freckles. A course over months for vascular birthmarks. Melasma and diffuse sun damage are treated over a course with medical therapy alongside.

Does it hurt?

Each pulse feels like the snap of an elastic band, and spot treatments take minutes. Most adults need no anaesthetic. Children and large areas are numbed.

Is there downtime?

No time off work. Red lesions darken or bruise and fade over one to two weeks; brown lesions darken and flake over five to ten days. Makeup the next day on the face.

Is laser safe for darker skin?

Yes, with the right laser and settings. PicoWay and the Nd:YAG are among the safest for darker skin; VBeam is used at longer pulses and lower energy. IPL is avoided. Dr. Kuzel sets every treatment for the skin in front of him.

Will the spots come back?

Treated lesions do not usually return, but new ones form with time and sun. Sun protection slows that; an occasional session treats what appears.

Can children be treated?

Yes. Port-wine stains and some haemangiomas are treated in infancy and childhood with VBeam, and earlier treatment gives better results. Children are assessed individually.

Who examines and treats?

Dr. Paul Kuzel, MD FRCPC, a board-certified dermatologist and the founder and Medical Director of Rejuvenation Dermatology Calgary South, examines every lesion and performs the treatment personally. He sees patients in English and Czech.

Begin here

Book a consultation.

Book a consultation with Dr. Kuzel. No referral is needed for cosmetic treatment; a referral covers assessment of a new or changing lesion.

Rejuvenation Dermatology Calgary South
10201 Southport Rd SW #102
Calgary, AB T2W 4X9
Two blocks west of the Delta Hotel

(403) 286-6888
Referrals by fax: (403) 225-2914

Open seven days a week, with early mornings and evenings on weekdays.

Contact Rejuvenation Dermatology

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