Pink spot of capillaries on tip of nose

[faieust]

Hi Doctor,

I have medium/light-medium olive skin (about type III if I had to take my best shot at nailing the type--Indian). About 2 and a half months ago, I was in an icy cold wind a spot showed up on my nose (which is sensitive due to Benzoyl Peroxide usage) that was very red. After a couple weeks, it settled into a pinkish area about 3 millimeters around. I've seen three doctors about this. One Doctor said it was some capillaries and that they could resolve or could not. Another Doctor, a PA-C, immediately hit it with two light zaps of a gentle-yag. If anything, it made it a little worse rather than better (though I can't tell, it might just be the same actually). That was a month and a half ago. Another Doctor I saw last week said that the Gentle Yag is the wrong thing to use for that and that I should use a Pulsed Dye Laser.

You can see the problem. I'm concerned about using the pulsed dye because of the risk of hyperpigmentation on my skin because of my tan color. One doctor used the Gentle Yag, another said that is the wrong thing to use and that I should use pulse dye/v-beam. Another doctor I asked online said I could use a Yag laser (Nd:Yag).

They are very thin pink capillaries that from a distance in the light just looks like a pinkish spot with fairly defined edges. They look kind of deeper and fainter in the skin than other pictures of  telangiectasias I have seen on people's noses.

Would do you think? Do you think it might be worth getting another shot of Gentle Yag or do you also think that is a bad idea for what I have? I need some suggestions. I want to be as conservative as possible to minimize the risk of hyper or hypo pigmentation.

Thanks.

[faieust]

Hi Doctor,

Thank you for the reply. I felt that after a month, it was starting to resolve but when I went to the PA-C, who I specifically told that I wanted to leave it alone, he said he wanted to take a look at it and I thought the gentle yag machine was a scope or something, and he hit it with two light zaps of the Gentle Yag. I was really upset about it because it was healing fine on its own.

My follow up question is, do you think that the use of the gentle yag permanently made the situation worse or did it just delay the healing and could it still resolve itself?

Thanks.

[Alan Rockoff, MD]

If I were you, I would do nothing for 6 months.  This sounds like a vascular effect that will take care of itself if you leave it alone.  Trying to laser it may well delay this healing.  Waiting will give you your best chance for clear skin with no pigment changes.  If the redness is still there after the summer and you have no tan over and above your normal color, the V-Beam might be a good choice if you still need anything.

Best.

Dr. Rockoff