Laser Treatments

“Laser treatment” is not a single procedure. In dermatology, laser refers to a broad group of technologies based on the principle that concentrated light energy at a specific wavelength is absorbed by a selected target in the skin. One device may target the pigment melanin, another may target hemoglobin inside blood vessels, while another may target water in the skin. For this reason, the same laser is not used for very different concerns such as sun spots, persistent redness, visible capillaries, acne scars, skin texture, fine lines or unwanted hair.

In a successful treatment, the key question is not simply “Can a laser be used?” but which target should be treated, with which wavelength, at what depth and with how much energy. Skin type, tanning status, the diagnosis of the lesion, treatment area, previous procedures, medications and the patient’s expected recovery time are assessed together. Particularly for pigmented lesions, a lesion with an uncertain diagnosis should not be treated with laser solely for cosmetic reasons before a dermatologic evaluation has been performed.

How do lasers work in the skin?

When laser light is absorbed by the targeted chromophore in the skin, light energy is converted into heat in a controlled manner. The aim is to create the desired biological change in the target structure while protecting surrounding healthy tissue as much as possible. Melanin is the main target in pigment treatments, hemoglobin in vascular treatments, and water content in ablative and certain fractional procedures. Pulse duration, spot size, energy density and the cooling system are important components of this selectivity.

Which types of lasers are used?

• Pigment-targeting lasers: Work through melanin in suitable sun spots, freckles and selected pigmented lesions.
• Vascular lasers: Target hemoglobin within blood vessels in visible capillaries, persistent facial redness and selected signs of rosacea.
• Fractional lasers: Create microscopic treatment columns rather than treating the entire skin surface uniformly, supporting tissue renewal; they may be considered for acne scars, pores, lines and textural irregularities.
• Ablative lasers: Can produce controlled resurfacing of the skin surface for more pronounced renewal; recovery is generally longer.
• Non-ablative lasers: Largely preserve the skin surface while producing a thermal effect in deeper layers; social downtime is usually shorter, although more sessions may be required.
• Hair-removal lasers: Aim to reduce hair growth over the long term by targeting melanin in the hair follicle; device selection depends on hair color and skin type.

What is laser treatment used for?

• Sun spots, freckles and suitable pigment irregularities
• Facial redness, visible capillaries and vascular changes associated with rosacea
• Acne scars, selected surgical or traumatic scars and textural irregularities
• Fine lines, photoaging and skin rejuvenation
• Reduction of unwanted hair
• Selected benign superficial lesions when the device and indication are appropriate

Which areas can be treated?

The face, neck, décolletage and backs of the hands are among the most commonly treated areas. Depending on the technology, the back, chest, arms, legs and other body areas may also be treated. However, parameters for thinner or more sensitive regions such as the eye area, neck and décolletage are planned differently from those used on thicker areas of facial skin. Using the same device at the same settings on every body area is not appropriate.

What is assessed before treatment?

The examination includes skin phototype, recent sun exposure or tanning-bed use, characteristics of the pigmentation or vascular structure, active infection or cold sores, wound-healing tendency and current medications. Previous fillers, threads, surgery or other energy-based procedures should also be disclosed. When appropriate, a test spot or lower initial parameters may be preferred.

How is it performed?

The treatment area is cleansed and the protective equipment required by the device is used. Cooling alone may be sufficient for some procedures, while deeper or ablative treatments may require a topical local anesthetic. Laser pulses are delivered to the target area in a planned pattern. Treatment duration varies according to the size of the area and the technology used, ranging from several minutes to longer sessions.

How many sessions are needed?

There is no single standard number of sessions. A small number of treatments may be sufficient for some superficial pigment targets, while vascular treatments, scar treatment, skin rejuvenation or hair removal may require a longer series. The interval between sessions is determined by the biological effect produced by the device and the time needed for the skin to recover. The response to the first session may influence the energy settings and intervals used in subsequent treatments.

When are results seen and how long do they last?

The timing of results depends on the target. In pigment treatments, spots may first darken and then gradually clear from the surface; in vascular treatments, fading may be gradual; and in procedures aimed at collagen remodeling, the main changes develop over weeks and months. Laser treatment does not stop natural aging or future sun damage. Regular sun protection, appropriate skin care and, when needed, periodic maintenance sessions are therefore important for maintaining results.

What may occur after treatment?

Temporary redness, warmth, mild swelling and sensitivity may be expected after many procedures. Pigment-targeting treatments may cause temporary darkening and fine crusting, while ablative treatments may involve more pronounced redness, peeling and a longer recovery period. Use of an unsuitable device for the patient’s skin type or unnecessarily high energy may increase the risk of burns, prolonged redness, hyperpigmentation, hypopigmentation and, rarely, scarring.

When may treatment be postponed or unsuitable?

Treatment may be postponed or a different method selected in the presence of an active infection or open wound in the treatment area, active cold sores, recent intense tanning, certain photosensitizing medications, uncontrolled inflammatory skin disease or conditions that impair wound healing. These considerations do not apply equally to every laser; suitability depends on the specific technology. Treatment may be performed during breastfeeding; however, the device, local anesthetic and any accompanying products should be assessed by the physician.

Basic care before and after treatment

• Avoid sunbathing and tanning beds before treatment and inform the physician if the skin is tanned.
• Provide complete information about medications and active skin-care products being used.
• Avoid scrubs, exfoliation and irritating active ingredients for the period recommended by the physician after treatment.
• Use a gentle cleanser and an appropriate moisturizer.
• Reapply broad-spectrum sunscreen regularly.
• Do not pick at crusts or areas of temporary darkening.

Frequently asked questions

Can every dark spot be removed with a laser? No. The type and diagnosis of the lesion are decisive. Suspicious, newly developed or changing pigmented lesions should first be evaluated by a dermatologist.

Can laser treatments be performed in summer? Some technologies can be used more cautiously throughout the year, but tanning and intense sun exposure increase the risk of side effects for many light- and laser-based procedures. Timing should be determined according to the device and skin type.

Can one device solve every problem? No. Pigment, vessels, scars, laxity and hair are different targets. The best plan may require an appropriate sequence or combination of different methods rather than a single device.

Fractional radiofrequency is based on the controlled insertion of very fine microneedles into the skin and delivery of radiofrequency energy directly into tissue at a selected depth. It is commonly known as the “Gold Needle” treatment. Systems such as Scarlet X are examples of this technology group. Its main difference is that it does more than needling alone: controlled heat is generated in the dermal layer reached by the needles to support collagen and elastin remodeling.

Needle depth and energy level are not fixed. Thin periocular skin and thicker cheek tissue, or a superficial pore concern and a deep acne scar, are not treated with the same parameters. For this reason, the correct depth, correct energy and appropriate patient selection are as important as the device itself in fractional radiofrequency treatments.

How does Gold Needle treatment work?

The microneedles create very small, controlled channels in the skin. Radiofrequency energy is delivered through the tips or a selected portion of these needles, creating a controlled thermal zone in the dermis. This controlled injury may stimulate the healing response and fibroblast activity, supporting new collagen formation. The result therefore develops as gradual remodeling over weeks and months rather than as an immediate “filler” effect.

Which concerns can it be used for?

• Suitable atrophic acne scars, particularly rolling and boxcar scars
• Enlarged pores and textural irregularities
• Fine lines and early signs of aging
• Mild to moderate skin laxity
• Supporting tissue quality on the neck and décolletage
• Selected surgical or traumatic scars and certain stretch marks

Why is it used for acne scars?

Acne scars are not all the same. Some are superficial, while others are deep or tethered to underlying tissue. Because fractional radiofrequency specifically targets dermal remodeling, it may help improve skin texture in suitable scar types. It may not be sufficient on its own for deep, tethered scars; combinations with subcision, fractional laser or other techniques may be required.

Which areas can be treated?

The face, cheeks, forehead, jawline, eye area, neck, décolletage and backs of the hands are common treatment areas. With appropriate patient selection, body areas such as the abdomen, arms, legs or buttocks may also be considered for textural concerns and stretch marks. Because skin thickness and subcutaneous anatomy differ by region, needle depth is adjusted accordingly.

How is it performed?

Before treatment, the skin is evaluated, active infection or cold sores are ruled out and a topical local anesthetic is applied. The planned area is then treated using a sterile, single-use microneedle tip. Depending on the device, needle depth, energy and number of passes or pulses are individualized according to the treatment goal. Procedure time varies with the size of the area.

Is the procedure painful?

A topical anesthetic significantly improves comfort, although stinging, warmth or a brief burning sensation may still be felt during pulses. Sensitivity varies according to the treatment area, depth and energy used. Warmth and tenderness may persist for several hours after the procedure.

How many sessions are performed?

The number of sessions depends on the treatment goal. A shorter series may be sufficient for general skin quality and mild pore concerns, while more sessions may be needed for pronounced acne scars or stretch marks. Sessions are usually spaced several weeks apart to allow the skin to recover. The response to the first treatment may guide depth and energy settings for subsequent sessions.

When are results seen?

During the first days, the skin may appear fuller because of swelling; this temporary appearance is not the final result. Because collagen remodeling takes time, changes in texture and firmness become more noticeable over weeks and may continue to develop for several months. For acne scars, the goal is generally not to erase scars completely but to gradually reduce their depth and shadowing.

Recovery after treatment

Redness, mild swelling, warmth and pinpoint marks may occur during the first few days. Some patients may develop very fine crusting. Most people can return to social activities relatively quickly; however, recovery may be longer when deeper treatment settings are used.

• Gentle cleansing and intensive moisturization are preferred during the first days.
• Retinoids, peels, strong acids and irritating active ingredients should be paused.
• Sauna, Turkish bath, very hot showers and intense exercise should be temporarily limited.
• Sunscreen should be used regularly.

Who may not be a suitable candidate?

Treatment may be postponed or avoided in the presence of active infection or cold sores in the treatment area, open wounds, active eczema, uncontrolled inflammatory disease, significant bleeding disorders, certain electronic devices or implants, active cancer treatment or a pronounced tendency to form keloids. Blood thinners and medications that may affect wound healing must be disclosed to the physician. The procedure may be performed during breastfeeding; the local anesthetic, aftercare products and any accompanying treatments should be assessed individually by the physician.

How is it different from fractional laser?

Fractional laser delivers energy through light and, depending on the laser, creates superficial or deeper microscopic columns. Fractional radiofrequency delivers energy directly to a selected depth through needles. Surface effects, recovery time and the risk of pigmentary changes may therefore differ. For problems such as acne scars, the two technologies are not necessarily competitors; depending on scar type, they may be used alone or in combination.

Is it the same as Dermapen?

No. Dermapen performs mechanical microneedling, whereas fractional radiofrequency combines microneedling with radiofrequency energy delivered into the tissue. The targeted tissue depth and thermal effect are therefore different.

BBL (BroadBand Light) is an energy-based treatment that uses different filters to select portions of a broad light spectrum and target pigment and vascular structures in the skin. Unlike a laser, it uses broad-spectrum light rather than one narrow wavelength. With appropriate filter selection, pulse duration and energy settings, it may be considered for sun spots, freckles, superficial redness, selected visible capillaries and signs of photoaging.

One of the main uses of BBL is photorejuvenation, an approach aimed at improving overall skin tone and appearance. The goal is not only to target a single spot but also to reduce diffuse pigmentation, redness and uneven tone associated with sun damage in a more comprehensive way. However, not every patient with heat- and light-sensitive pigment conditions such as melasma is suitable for BBL.

What is the difference between BBL and IPL?

BBL is technically part of the intense pulsed light family. Differences between systems relate to filters, pulse control, cooling mechanisms, energy distribution and the technical capabilities of the device. It is not accurate to generalize that “BBL is always superior to IPL”; correct indication and parameter selection are as important as the device name.

How does it work?

Depending on the target, light energy is absorbed by melanin or hemoglobin. In pigmented areas, targeted melanin is heated and may temporarily darken before gradually clearing from the surface. In vascular targets, hemoglobin absorbs the energy and may help reduce the visibility of the vessel. Cooling systems are used to protect surrounding tissue and improve patient comfort.

What is BBL used for?

• Superficial sun-related pigmentation and freckles
• Photoaging on the face, neck, décolletage and backs of the hands
• Diffuse uneven skin tone
• Superficial redness and selected visible capillary patterns
• Improving overall brightness and a more even appearance

Which pigmented lesions should not be treated?

Not every brown lesion is a “sun spot.” Moles, atypical pigmented lesions or lesions with an uncertain diagnosis should be evaluated dermatologically before BBL treatment. Melasma also requires a more cautious plan because heat and inflammation may increase pigmentation in some patients.

How is it performed?

The skin is cleansed, the eyes are protected appropriately and the device handpiece is positioned over the treatment area. Filters and parameters are selected according to the target. A brief sensation of heat or a feeling similar to a rubber-band snap may be experienced during each pulse. Procedure time depends on the size of the area and is usually relatively short for small areas such as the face.

How many sessions are needed?

Noticeable improvement may be seen after a small number of sessions for superficial pigmentation or mild redness, while diffuse sun damage and multiple targets may require a series. Sessions are spaced to allow the skin to recover. Periodic maintenance may be preferred for some patients to help preserve results.

What happens after treatment?

Short-lived redness and warmth may occur. If pigment has been targeted, the spots may appear darker for several days and then gradually clear from the surface. These darkened areas should not be peeled or picked. Vascular treatments may cause temporary redness, mild swelling or, rarely, bruising.

Results and longevity

BBL may help reduce existing sun damage and vascular appearance, but new sun exposure, natural aging and chronic tendencies such as rosacea continue. New pigmentation can develop without regular sun protection. Therefore, the expectation that “spots will never return permanently” is not realistic.

Who may not be suitable?

Treatment may be postponed in tanned skin, after recent intense sun exposure, with active infection or cold sores, while using certain photosensitizing medications, or in uncontrolled skin disease. In darker skin types, epidermal melanin absorbs more light, so more conservative parameters or alternative treatments may be required to reduce the risk of burns and pigmentary changes. BBL may be performed during breastfeeding; device settings and any accompanying products should be planned following physician assessment.

When is the best time to have BBL?

Autumn and winter are often more practical because sun exposure is lower. However, whether the skin is tanned and whether adequate sun protection can be maintained after the procedure are more important than the specific month of the year.

Frequently asked questions

Why can spots look darker after BBL? When pigment is targeted, melanin-containing areas may temporarily appear darker. This is often part of the treatment response and usually resolves as the pigment clears from the surface.

Can it be used for rosacea? It may be used for redness in selected patients; however, vascular-targeting lasers such as Derma V may be more suitable for prominent capillaries and specific vascular targets.

Does it help melasma? Melasma is a complex pigment condition with a tendency to recur. Because heat can worsen the condition in some patients, BBL is not automatically a first-line option; suitability should be determined through dermatologic evaluation.

Endolift X is a minimally invasive dermatologic procedure in which laser energy is not delivered from the skin surface; instead, very thin and flexible optical fibers are advanced beneath the skin through small entry points so that energy can be delivered directly to the target tissue. The procedure uses a 1470-nanometer diode laser. This wavelength interacts with water and fat within tissue to produce a controlled photothermal effect.

The purpose of Endolift X is not simply to “melt fat.” Depending on the patient’s anatomy and treatment area, it may be considered to support tightening of the subcutaneous connective tissue, stimulate new collagen formation, reduce mild to moderate laxity and improve the appearance of limited fat deposits in suitable areas. It may be considered particularly in patients with reduced facial contour definition, irregularity along the jawline, limited submental fat and mild to moderate skin laxity.

Although the procedure does not require a surgical incision or sutures, it is not completely superficial or non-invasive; the optical fiber is advanced through an anatomical plane beneath the skin. Treatment planning, energy level and the directions in which the fiber is moved should therefore be determined by a physician with a detailed understanding of facial and body anatomy. Endolift X is not a direct substitute for a face-lift or neck-lift surgery in cases where advanced excess skin requires surgical removal.

How does Endolift X work?

The 1470 nm laser energy creates controlled heat in subcutaneous tissue. The effect can be explained through three main targets:

• Connective-tissue tightening: Controlled heat may support short-term contraction of connective-tissue septa and existing collagen fibers; some patients may notice a mild early tightening effect.
• Collagen and elastin remodeling: The controlled healing response initiated after treatment may support fibroblast activity and new collagen formation. The main result therefore develops gradually over weeks and months.
• Reduction of limited fat tissue: When appropriate depth and energy are used, the procedure may help reduce small localized fat deposits, particularly in areas such as the submental region and jawline.

What concerns can Endolift X be used for?

• Loss of jawline definition
• Limited fat beneath the chin with mild overlying laxity
• Mild to moderate laxity of the lower face and lower cheek area
• Loss of facial-oval definition related to skin laxity and limited fat tissue
• Mild or moderate neck laxity
• Small fat deposits and skin laxity in selected body areas such as the abdomen, inner arms, thighs, above the knees and around the buttocks in suitable patients

Which areas can be treated?

The jawline, submental area, lower face, cheeks, perioral region, neck, selected areas around the eyes and, in suitable patients, the abdomen, inner arms, thighs, above the knees and around the buttocks may be considered. Each area differs in skin thickness, fat volume and neurovascular anatomy. The thickness of the optical fiber, energy, treatment depth and direction of fiber movement are therefore adjusted according to the area.

How is Endolift X performed?

Before treatment, the area is photographed and anatomical landmarks are marked. The skin is cleansed with antiseptic solutions and local anesthesia may be administered when needed. A very thin, flexible optical fiber is inserted beneath the skin through a small entry point similar to a needle puncture. The fiber is advanced in the correct anatomical plane in a controlled manner while laser energy is delivered along the planned lines. At the end of the procedure, the area is cleansed and cooling may be applied if needed.

For areas such as the face and submental region, treatment may take approximately 30–90 minutes depending on the scope of the procedure. Body treatments may require different treatment times and energy planning as the treated area becomes larger.

Is Endolift X surgery?

No. There is no large surgical incision, no sutures are used and excess skin is not surgically removed. General anesthesia is usually not required. However, because the optical fiber is advanced beneath the skin, the treatment is not completely non-invasive; it is a non-surgical but minimally invasive laser procedure.

Is the procedure painful?

Local anesthesia improves comfort, although pressure, pulling, stinging, warmth or brief burning may still be felt as the fiber is advanced. The level of discomfort varies according to the treatment area, energy, thickness of fat tissue and individual pain threshold. Tenderness on touch or a feeling of tightness may persist for several days afterward.

How does the skin look after treatment?

Mild to moderate swelling, redness, bruising, tenderness, small entry points, temporary asymmetry and a feeling of firmness or irregularity beneath the skin may occur early on. Swelling may be more noticeable during the first 24–72 hours in some patients. Bruising and edema may decrease within a few days or may persist longer depending on the treatment area.

How long is recovery?

Many people can return to daily activities within a few days, but it is not realistic to expect “no visible sign immediately after the procedure.” Mild swelling may last several days, bruising approximately one to two weeks, and tenderness or subcutaneous firmness may persist longer. It is useful to allow adequate recovery time before an important social event.

What should be considered after Endolift X?

• Keep the treatment area clean and follow the aftercare recommended by the physician.
• Avoid unnecessary pressure, firm massage, gua sha and intensive lymphatic drainage during the first days.
• Temporarily limit sauna, Turkish bath, very hot showers, intense exercise and excessive sweating.
• Avoid aggressive cosmetic procedures on bruised or tender areas.
• Protect the skin from the sun and use an appropriate sunscreen.
• Do not start antibiotics, painkillers or other medications without medical advice, and do not stop current medications without physician guidance.

Can massage be performed?

In some patients, gentle massage or lymphatic drainage may be recommended later to help manage edema or subcutaneous firmness, but it is not mandatory for everyone. Early, firm massage may increase bruising and tenderness. The physician performing the procedure should determine when massage can begin.

When is the effect seen?

A mild early change may be noticed because of contraction in existing collagen fibers, but the appearance during the first days is affected by swelling. The first meaningful changes may become visible within several weeks, skin firmness may become more noticeable within 1–3 months, and collagen remodeling may continue for 3–6 months. Final evaluation should therefore be made after several months rather than immediately after treatment.

How many sessions are performed?

Endolift X is often planned as a single-session treatment. However, the degree of laxity, amount of fat, treatment area, energy used and response to the first procedure influence whether an additional session is needed. “Single session” does not mean that the desired result is guaranteed after one treatment for every patient.

How long do the results last?

The effects of collagen remodeling and limited fat reduction in suitable areas may last for a long time; however, natural aging, gravity, weight changes, new fat accumulation, collagen loss and sun damage continue. Longevity is influenced by age, skin structure, weight stability and lifestyle. Additional supportive treatments may be planned in later years when appropriate.

Does Endolift X make the face slimmer?

The aim is not to slim the entire face. In suitable patients, reducing limited fat in the submental area or along the jawline may make facial contours appear more defined. However, unnecessary fat loss in areas where volume is important for a youthful appearance, such as the mid-cheek, temples and under-eye region, may lead to hollowness, asymmetry and an older appearance. Areas where fat reduction is desired and areas where volume should be preserved must therefore be planned separately.

Does it completely eliminate a double chin?

The appearance of a double chin is not caused by fat alone. Skin laxity, a recessed chin, neck-muscle anatomy, prominent salivary glands and genetic anatomy may also contribute. Endolift X may provide benefit when limited fat and mild to moderate laxity are present; with significant excess fat or advanced skin sagging, liposuction, neck-lift surgery or other methods may be more predictable.

Who may be considered a candidate?

• Adults with mild or moderate skin laxity
• People who have lost jawline definition
• Patients with limited fat beneath the chin or in selected body areas
• Those who do not want surgery but accept a minimally invasive procedure
• Suitable candidates with realistic expectations regarding results and recovery

When may it be unsuitable or postponed?

Active infection or cold sores, open wounds or active eczema, significant bleeding disorders, uncontrolled diabetes, conditions that impair wound healing, active cancer treatment, a pronounced tendency to form keloids, allergy to local anesthetics and certain implants or filler materials that alter the anatomy of the treatment area are important considerations. Medications, including blood thinners, should not be stopped without medical advice. Endolift X may be performed during breastfeeding; local anesthetics and post-treatment products in particular should be assessed by the physician.

Side effects and possible complications

Swelling, redness, bruising, tenderness, tightness, temporary firmness, numbness or tingling may occur. Less commonly, infection, prolonged edema, hematoma, burns, irregular fat loss, depressions, asymmetry, pigmentary changes, prolonged pain, vascular or nerve injury and scarring are possible. Because of the neurovascular anatomy of the face and neck, working in the correct tissue plane is particularly important.

Difference between Endolift X and liposuction

Liposuction is a surgical procedure in which fat is physically removed from the body with a cannula. With Endolift X, laser energy is delivered through a thin optical fiber; large volumes of fat are not mechanically suctioned out. It may therefore be considered when a small, localized fat deposit is accompanied by skin laxity, whereas liposuction may be more effective for more substantial excess fat.

Difference between Endolift X and Gold Needle

During Gold Needle treatment, multiple microneedles enter the skin vertically and deliver radiofrequency energy into the dermis; acne scars, pores, surface texture and general collagen support are more prominent targets. With Endolift X, a thin optical fiber is advanced horizontally in the subcutaneous tissue plane and laser energy is delivered directly to the subdermal area. Facial contour, jawline, submental area and subcutaneous tightening are more typical targets of Endolift X.

Derma V is one of the laser platforms used to target vascular structures. The main treatment target is selective absorption of laser energy by hemoglobin within blood vessels. In this way, the procedure may be used to reduce the appearance of visible capillaries, diffuse redness and particularly the vascular component associated with rosacea.

In rosacea, simply saying “the skin is red” is not enough. Some patients have diffuse, persistent background redness; others have individually visible vessels around the sides of the nose and cheeks; and in some, episodic flushing is the dominant feature. Treatment with vascular lasers such as Derma V should be individualized according to the type, diameter and depth of the vascular structures and the patient’s skin phototype.

How does Derma V work?

When laser energy is absorbed by hemoglobin in the target vessel, a controlled thermal effect is produced in the vessel wall. The aim is to allow the visible vessel to fade over time while protecting the surrounding skin as much as possible. The cooling system helps protect the epidermis and improve treatment comfort.

What is it used for?

• Visible capillaries on the cheeks, sides of the nose and face (telangiectasia)
• Persistent redness associated with rosacea
• Vascular changes accompanying recurrent flushing episodes
• Selected superficial vascular lesions
• Selected pigment and vascular concerns following physician assessment

What does it treat in rosacea, and what does it not treat?

Vascular laser treatment specifically targets the redness and visible capillary component. Papules and pustules, sensitivity, burning and trigger-related symptoms of rosacea may require a separate medical treatment and skin-care plan. A vascular laser is therefore not the entire treatment of rosacea by itself; it is one component aimed at the vascular appearance.

When is it particularly considered?

It may be considered when individually visible vessels around the cheeks and nose are prominent, diffuse background redness has become persistent, or the vascular appearance continues despite medical control of inflammation. The diameter and depth of the target vessels directly affect device parameters.

How is it performed?

The skin is cleansed, the eyes are appropriately protected and the target vessel or area of redness is treated with the device handpiece. Short laser pulses are delivered with cooling. Brief warmth or a stinging sensation may be felt during treatment. Procedure time varies according to the size of the area.

How many sessions are needed?

A single prominent vessel and diffuse rosacea-related redness do not require the same session plan. Multiple sessions may be needed depending on vessel diameter, density, background redness and the response of the skin. Because rosacea is a chronic tendency, new vessels may develop later even after successful treatment and periodic maintenance may be required.

When are results seen?

Some vessels may fade early, while improvement in diffuse redness may be more gradual. Temporary redness or swelling after treatment can mask the final result. The outcome is usually assessed more accurately after several weeks.

Aftercare and precautions

Temporary redness, mild swelling, tenderness and, with some parameters, bruising may occur. During the first days, limiting excessive heat, sauna, Turkish bath, intense exercise, alcohol and triggers that markedly flush the skin may improve comfort. Sun protection is important to reduce the risk of pigmentary changes.

Who may not be suitable?

Treatment may be postponed with active infection or cold sores, recent tanning, certain photosensitizing medications or uncontrolled skin disease. In darker skin types, epidermal melanin can also absorb energy, so parameters should be selected more cautiously. The procedure may be performed during breastfeeding; the individual skin condition and treatment parameters should be evaluated by the physician.

A comprehensive approach to rosacea

Recognizing daily triggers is as important as laser treatment in rosacea management. Sun exposure, hot environments, very hot beverages, spicy foods, alcohol, stress and unsuitable cosmetic products may increase flare-ups in some patients. When needed, topical or systemic medical treatment is used to control inflammation, while vascular laser treatment targets persistent redness and visible capillaries.

How is it different from BBL?

BBL uses broad-spectrum light and can target both pigment and vessels, whereas vascular lasers such as Derma V may provide a more selective approach to specific vascular targets. The preferred method depends on background redness, the presence of individual visible vessels, accompanying pigmentation and skin type.

Derma V for leg capillaries and varicose veins

Derma V may also be used to reduce the appearance of fine capillaries, spider veins and suitable superficial vessels on the legs, in addition to vascular concerns on the face. Laser energy targets hemoglobin within the vessel and creates a controlled thermal effect; the treated vessel may fade and become less visible over time.

It may be considered particularly for fine superficial vessels that appear red, purple or blue. However, large bulging varicose veins or venous insufficiency may require Doppler ultrasound assessment and different vascular treatments.

Frequently asked questions

Can rosacea be completely cured? Rosacea is a chronic condition with a tendency to flare. The aim is to reduce redness and the vascular appearance, control flare-ups and improve skin comfort.

Can the vessels return? Treated vessels may regress, but new vessels can develop later because of the underlying rosacea tendency and environmental factors.

Dermapen is a microneedling procedure performed with multiple fine needles at the tip of a pen-shaped automated device moving vertically in and out of the skin in a controlled manner. The aim is to create microscopic, controlled channels in the skin and support the natural wound-healing response, collagen production and tissue remodeling.

Dermapen does not use radiofrequency or laser energy. This distinguishes it from Gold Needle treatment. Needle depth can be adjusted for different facial areas and different goals; for example, more superficial settings may be used on thin areas such as the forehead or around the eyes, while greater depth may be needed for suitable acne scars.

How does it work?

Microneedles create very small, temporary channels through the epidermis and dermis. This controlled microtrauma initiates the natural repair process, which includes coagulation, inflammation and remodeling phases. Increased fibroblast activity and new collagen synthesis may help improve skin texture over time.

Who may be considered?

• People with mild to moderate textural irregularities
• Those concerned about enlarged pores
• Patients with suitable superficial or medium-depth acne scars
• Those seeking mechanical collagen stimulation for fine lines and dullness
• Patients for whom a more superficial rejuvenation plan without radiofrequency or laser is appropriate

How effective is it for acne scars?

Scar type is important in acne-scar treatment. Dermapen may support tissue quality in superficial and selected rolling scars, but it may not be sufficient on its own for very deep ice-pick scars or scars tightly tethered to underlying tissue. In such cases, combinations with subcision, chemical techniques, fractional radiofrequency or laser may be required.

What is it used for?

• Skin texture and dull appearance
• Enlarged pores
• Suitable acne scars
• Fine lines and overall skin quality
• Combination with selected mesotherapy or PRP protocols when planned by the physician

Can it be combined with PRP, mesotherapy or exosomes?

Because microneedling creates temporary microchannels, some clinical protocols combine it with PRP or selected products. However, not every product applied to or injected into the skin is appropriate for passage through these microchannels. Sterility, suitability of the product for medical use and application technique are important; combinations should not automatically be assumed to be “better.”

How is it performed?

The skin is cleansed and a topical local anesthetic may be applied if needed. A sterile, single-use needle cartridge is attached and the treatment area is covered in a controlled pattern at a depth appropriate for the target. Pinpoint bleeding may occur in some deeper protocols, but treatment success is not based on the principle that “more bleeding is better.”

How many sessions are needed?

A shorter series may be sufficient for general skin quality, while acne scars may require a longer and deeper treatment plan. Sessions are usually spaced several weeks apart to allow remodeling. Because results develop gradually, sessions should not be performed at unnecessarily short intervals.

What does the skin look like after treatment?

During the first 24–48 hours, sunburn-like redness, tenderness, mild swelling and dryness may occur. With deeper treatment, pinpoint crusting may persist for a few days. Because the skin barrier is temporarily more sensitive, post-treatment care should be kept simple.

Recommendations before and after treatment

• Retinoids, peels and products containing strong acids may be paused for the period recommended by the physician.
• Makeup, swimming pools, the sea and intense sweating may be limited during the first 24 hours.
• A gentle cleanser, moisturizer and sunscreen should be used.
• Do not pick at crusted or peeling areas.
• Uncontrolled needling over active acne lesions may increase the risk of infection and spread, so active inflammation should be assessed first.

Who may not be suitable?

Treatment may be postponed in the presence of active bacterial infection, active cold sores, open wounds, uncontrolled eczema or psoriasis, significant bleeding disorders, keloid tendency or conditions that impair wound healing. Dermapen may be performed during breastfeeding; physician assessment is recommended depending on the anesthetic and any accompanying products used.

Difference between Dermapen and Gold Needle

Dermapen provides mechanical microneedling only. Gold Needle treatment combines needles with radiofrequency energy delivered into the dermal tissue, creating an additional controlled thermal effect. Whether one method is more appropriate for deep acne scars, prominent pores or a tightening goal should be determined during examination.

Frequently asked questions

Is it the same as a home dermaroller? No. Clinical devices use sterile, single-use cartridges, controlled depth and professional application. Uncontrolled deep needling at home can increase the risk of infection, pigmentary changes and scarring.

Are results immediate? Temporary brightness may occur during the first days because of swelling; the main collagen response develops over the following weeks.

Can it be used for every acne scar? No. Scar type and depth determine treatment choice, and some scars require different procedures.

Plexr is a procedure that creates very small, controlled point effects on the skin surface through a plasma arc generated between the device tip and the skin. The device transfers energy by ionizing the surrounding gas without directly cutting the skin. These controlled surface points are intended to produce localized contraction and a healing response.

It is most commonly considered for mild to moderate upper-eyelid laxity, fine wrinkles and superficial laxity in small areas. Although it is sometimes referred to as “non-surgical eyelid aesthetics,” it does not remove excess skin in the way blepharoplasty does when advanced skin excess is present. Plexr and surgical eyelid surgery are therefore not the same procedure, and the same level of correction should not be expected.

How does it work?

The plasma arc creates controlled superficial effects at very small points in the epidermis. As these points heal, localized contraction and remodeling may occur. The small brown crusts seen after treatment are part of the healing process of these pinpoint treatment areas.

Who may be considered?

• Patients with mild or moderate upper-eyelid skin laxity
• Those with fine lines and superficial laxity in small areas
• Suitable candidates who do not want surgery and understand that the result may be more limited

What is it used for?

• Mild upper-eyelid skin laxity
• Fine wrinkles around the eyes and in selected areas
• Superficial skin tightening in small areas
• Selected applications for certain superficial lesions deemed dermatologically appropriate after the diagnosis has been established

Why is an eyelid examination necessary?

A heavy eyelid appearance is not always caused by excess skin alone. Brow ptosis, muscles around the eyes, fat prolapse, eyelid laxity and eye disease may all influence the appearance. If there are prominent fat pads, advanced excess skin or an eyelid-function problem, surgical assessment may be more appropriate.

How is it different from surgical eyelid surgery?

Blepharoplasty can surgically remove excess skin and, when needed, fat tissue. Plexr instead creates controlled pinpoint effects at the surface with the aim of supporting skin contraction. Surgery may provide a more pronounced and predictable correction, while Plexr may be considered for selected patients with limited laxity who prefer not to undergo surgery.

How is it performed?

The treatment area is cleansed and numbed with a topical local anesthetic. The physician creates small plasma points in a planned pattern using the device. Anatomical boundaries and eye safety are particularly important around the eyes. Treatment duration depends on the size of the area.

What is recovery like?

Pinpoint brown crusts, redness and, especially around the eyes, swelling may occur after treatment. The crusts usually separate spontaneously in about one week and should not be forcibly removed. In some patients, redness may persist for a period even after the crusts have fallen away.

How many sessions are needed?

A single procedure may be sufficient for mild laxity. For more pronounced areas, an additional session may be considered after healing is fully complete. Sessions should not be repeated at short intervals while the skin is still healing.

When are results seen?

Initial tightening may begin to be visible after the crusts have fallen away; the final appearance should be assessed later as the tissue heals and remodels. The result may last for a long time, but it is not “permanent for life” because natural aging continues.

Aftercare

• Do not pick at crusts, and avoid rubbing or irritation.
• Use the cleansing and aftercare products recommended by the physician.
• Heavy makeup or camouflage products during the crusting phase should only be used if approved by the physician.
• Protect the area carefully from the sun and use an appropriate sunscreen.
• Urgent evaluation is required if increasing pain, discharge, marked one-sided swelling around the eye or a change in vision develops.

Is there a risk of color change?

Because the treatment creates superficial inflammation, the risk of post-inflammatory hyperpigmentation may be higher, particularly in darker skin types. Excessive sun exposure can further increase this risk. Skin type and tendency to develop pigmentation are important in patient selection.

Who may not be suitable?

Treatment may be postponed in the presence of active infection, open wounds, active eczema, uncontrolled wound-healing problems, a marked tendency to form keloids, certain eye diseases or situations in which the treatment area cannot be treated safely. Plexr may be performed during breastfeeding; the local anesthetic and post-treatment products should be assessed by the physician.

Crusting period and social planning

Because pinpoint crusting and possible swelling around the eyes can be visible, enough social recovery time should be allowed before important meetings, photo or video shoots, or events. This is not a “lunchtime procedure with no visible signs afterward.”

Frequently asked questions

Can Plexr replace eyelid surgery? Not when there is advanced excess skin. It may be a more limited option for suitable patients with mild to moderate laxity who do not want surgery.

How long do the crusts last? In most patients, they begin to separate within about one week; the timing varies with individual healing and treatment intensity.

Can it be performed on darker skin? Suitability should be assessed according to skin type and pigmentation tendency; a more cautious plan is required in darker skin because of the higher risk of color changes.