Andrea Willey, MD,1 R. Rox Anderson, MD,2 Jose L. Azpiazu, MD,3 Abnoeal D. Bakus, PhD,4
Richard J. Barlow, FRCP,5 Jeffrey S. Dover, MD, FRCPC,6,7 Jerome M. Garden, MD,4
Suzanne L. Kilmer, MD,8 Nerea Landa, MD,3 Dieter Manstein, MD,2 E. Victor Ross, MD Jr.,9
Neil Sadick, MD, FACP, FAACS,10 Emil A. Tanghetti, MD,11,12 Dina Yaghmai, MD,4
and Brian D. Zelickson, MD
Lasers in Surgery and Medicine 38:1–15 (2006)
This entire PDF can be downloaded! It has invaluable information with pictures. Go here and then scroll down, look on the right hand side for "Get PDF":
http://onlinelibrary.wiley.com/doi/10.1 ... 6/abstract
The picture (Fig. 6B) may show what some here have experienced with depressions and dents. It seems vessels are overheated and led to a 'depressed' area in the skin. No blister or open sore, just a depression in the skin.
The complication occurred as a result of intermittent failure of the CSC device caused by bubbles present in the supply line between the cryogen canister and laser hand piece. Several weeks post-operatively, the cryogen bubble detector in the hand piece was found to be defective, which resulted in the intermittent loss of CSC. The complication is not easily avoidable given the absence of signs of device malfunction during treatment.
Post-operatively, the patient developed erythema and swelling in the treated areas, followed 1 month later by hyperpigmentation over the larger vessels. The final treatment outcome was cutaneous depression and scarring at 3 months (Fig. 6B). The complication occurred as a result of overheating of larger vessels with inadequate time allowed for heat
dissipation required for larger vessels. The lack of blistering indicates adequate cooling of the sapphire tip. This complication may have been avoided by using caution in treating larger vessels and increasing the time interval between successive passes.