Port wine haemangiomas (birthmarks) are probably the most common type of vascular disorders which cause red discolorations of the skin. These blood vessel changes are usually of no medical consequence but present major cosmetic disabilities to some individuals. In the past, a person with a birthmark had the choice between living with the disorder or risking excessive scarring from surgical removal or radiation therapy Target specific vascular lasers have essentially eliminated this risk, thereby offering many individuals a new lease on life.

The most current and advanced of the vascular lasers are the Variable Pulse Width (VPW) and the flash lamp pumped pulsed dye (Dye) lasers. The argon laser was the first vascular laser to be used. It is no longer recommended for this purpose because there is too much heat dissipated which may result in scarring. Other vascular lasers have the same problem but to a lesser extent.

Facial veins begin to appear as we age and are largely the result of excessive sun exposure although heredity does play a role. Fine, superficial veins respond well to the Dye laser, whereas the VPW laser is often required to get rid of deeper, larger vessels, An additional benefit of the VPW laser is that it does not leave a bruise, whereas the Dye laser does.

Sclerotherapy is still the treatment of choice for leg veins, however lasers and other photothermal instruments are beginning to make inroads into this area as well. If the veins on the legs are very fine giving a blush like appearance or thick and resistant to sclerotherapy then a vascular laser such as the VPW laser may be used, Sclerotherapy and light treatments for leg veins are discussed in more detail in Chapter 15.

Benign blood vessel tumors also begin to crop up as we get older. Some people may mistake them as blemishes on their face and wonder at the appearance of large numbers of them over their torsos and limbs. They are of no medical consequence but many people like to have them removed with a vascular laser for cosmetic reasons.

The red discoloration found in scars can also be reduced or removed with the VPW or Dye lasers, softening the cosmetic disability caused by the scar, particularly if it appears on the face.

Radiation therapy for cancer will cause dilated blood vessels to appear on the skin of the treated area. This is particularly common on the chest after radiation is used for the treatment of breast cancer. These can be removed with the VPW or Dye lasers.