What is Excel V?

Excel V is a laser that reduces dilated blood vessels in the skin. At our clinic, we use it to improve telangiectasia accompanying rosacea.

When hemoglobin inside a blood vessel absorbs the laser light, it generates heat that contracts the vessel. Excel V uses two wavelengths, 532 and 1064 nanometers, so treatment can be selected according to the condition of vessels ranging from fine red ones to thicker blue ones.1

We check whether there are vessels to treat

At our clinic, we recommend Excel V only when telangiectasia is confirmed. A common example is fine, visibly dilated vessels around the nose or on the cheeks.

Fine vessels can be hard to distinguish with the naked eye, especially against an overall red background. We therefore magnify the skin with dermoscopy to check for vessels that can be treated. Distinguishing diffuse facial redness from individually dilated vessels is an important part of choosing a treatment.2

If telangiectasia is not confirmed, Excel V alone is unlikely to improve the redness. We consider treating dermatitis first in those cases.

Magnified skin image showing a dilated vessel and finer surrounding vessels under dermoscopy

We treat while watching small vessels and their response

Preparing to see the vessels clearly

Protective eyewear is required during laser treatment. However, it can darken the view and make small vessels difficult to see.

Our clinic uses protective eyewear with high visible-light transmission and illuminates the treatment area with a loupe light while protecting the eyes. This lets us see the position of small vessels and how they change after each laser pulse.

Orange laser safety glasses fitted with an illuminated loupe light

Adjusting the laser to the vessel's response

While applying the laser, we watch whether vessels fade or shrink. The videos below show how vessels change in the treated areas.

If the response is insufficient, we reassess the vessel and surrounding skin and adjust the settings.

Video showing a vessel's response during Excel V treatmentPlay video
Magnified video showing a vessel fading immediately after Excel V treatmentPlay video

You should notice an effect from the first session

If the telangiectasia is suitable for treatment, you should be able to notice a reduction in the vessels from the first session. The effect should not appear only after completing several sessions.

The example photos below show the change after one treatment. From left to right, they show the area before treatment, immediately afterward, and one day later. Redness from heat remains immediately after treatment, but the vessels have already decreased.

Polarized dermoscopy photos comparing vessels around the nose before treatment, immediately afterward, and one day later

Not every vessel disappears in one session. We generally plan for two or three treatments, and much of the expected change is visible by about the third. The number needed depends on the remaining vessels and their response.

Vessels may dilate again over time. If that happens, we examine the new vessels before deciding whether to treat again.

If you notice no effect at all after the first session, we need to reassess whether there are vessels to treat or whether the redness is due to dermatitis before simply adding sessions. See our article on Excel V results for more on how we assess the effect and perform treatment.

How is it different from Vbeam?

Vbeam also targets hemoglobin inside blood vessels. Both devices treat dilated vessels, but they use different wavelengths.

Excel V uses 532 and 1064 nanometers. Vbeam Perfecta uses 595 nanometers, while Vbeam Prima adds 1064 nanometers. It is therefore important to know which Vbeam model is being compared.134

Hemoglobin absorbs the 532 and 595 nanometer wavelengths to different degrees. The 532 nanometer wavelength of Excel V is absorbed more strongly by hemoglobin in vessels than Vbeam's 595 nanometer wavelength.5

See our comparison of Vbeam and Excel V for more on wavelengths, the devices, and cost.

Cost

KRW 200,000 per session

VAT included · Genesis mode excluded

Downtime and aftercare

Redness and swelling can occur immediately after treatment. Bruising may appear where vessels are dense or the response is strong. It usually lasts about a week.

Scabs may form in areas with freckles or dark spots and usually last about a week as well.

If a scab forms, do not pick it before it falls off on its own. No other special aftercare is needed. Contact the clinic if you develop blisters or if pain or swelling progressively worsens.

Frequently asked questions

Should I receive Excel V whenever I have facial redness?

We first check whether telangiectasia is present. At our clinic, we recommend Excel V only after dermoscopy confirms vessels to treat. If the redness is mainly due to dermatitis, we consider treating the dermatitis first.

Will all the vessels disappear in one session?

You should notice an effect from the first session when the vessels are suitable for treatment, but not every vessel will disappear at once. More treatment may be needed for remaining vessels; we generally plan for two or three sessions.

Can vessels appear again after treatment?

Yes. Vessels can dilate again over time. We check the new vessels and the current condition of the skin before deciding on additional treatment rather than repeating a fixed number of sessions.

Can bruising or swelling occur?

Yes. Areas with marked telangiectasia may bruise or swell, sometimes for about a week.

References

  1. Cutera. Official Excel V product and safety information.
  2. Micali G, Gerber PA, Lacarrubba F, Schäfer G. Improving Treatment of Erythematotelangiectatic Rosacea with Laser and/or Topical Therapy Through Enhanced Discrimination of its Clinical Features. J Clin Aesthet Dermatol. 2016;9(7):30–39.
  3. Candela. Vbeam product information and Perfecta wavelength.
  4. Candela. Vbeam Prima 595 and 1064 nanometer wavelength information.
  5. Prahl S. Molar extinction coefficient data for hemoglobin by wavelength. Oregon Medical Laser Center.