Angiomas – Ruby spots – Venous lake

The term angioma refers to a localised abnormality of the blood vessels.

“Laser center Basel/Saint-Louis : your expert in vascular lesion treatment

The Basel/Saint-Louis laser center offers advanced medical solutions aimed at treating vascular lesions such as port-wine stains, spider angiomas in adults and adolescents, venous lakes, and ruby spots or angiokeratoma of the scrotum. The Biolaser medical center is equipped with high-quality technology for the treatment of these vascular anomalies.”

Located in the heart of Saint-Louis, and near Bern and Zurich

Angiomas – Ruby spots – Venous lake

An angioma is a benign skin condition characterized by an abnormal growth of blood vessels. It is a vascular formation that can either be present at birth (congenital angioma) or develop later in life (acquired angioma).

There are several types of angioma: stellate angiomas, ruby spots, flat angiomas and venous lakes of various origins.

  • Plane angiomas or “wine stains” present as a pale pink to dark red “wine stain”.
  • These are congenital vascular malformations that affect about 0.5% of births and vary in size and shape.
  • The lesions are flat without relief and disappear more or less completely on pressure, without murmur, quiver or flutter and having the same temperature as normal skin.
  • Plane angiomas may be responsible for aesthetic damage with psychological repercussions when they are extensive and/or located on exposed areas.
  • Plane angiomas persist without a tendency to spontaneous disappearance and their surface area increases in proportion to the growth of the child.
  • In adults, the wine stains become progressively darker and thicker, due to the progressive increase in the number and size of capillaries over time.
  • Stellar angiomas are frequent and benign vascular lesions without pathological significance, seen at any age and particularly during pregnancy (they often disappear after delivery).
  • They are vascular ectasias (arteriolar dilatation) arranged in a star shape centred by a capillary from which a tree of radial telangiectasias starts. The larger ones are sometimes pulsatile.
  • The peripheral arborescences disappear with vitropression, while the central point persists. The stellate angioma then recolours from the centre.
  • They preferentially affect the face (lips, nose, cheeks) and the extremities (forearms, back of hands and fingers).
  • Treatment with vascular laser or IPL are the therapeutic methods used, but recurrences are possible.
  • Ruby spots are also very common and commonplace on the skin after the age of 40-50.
  • They are late-appearing vascular ectasias (dilations) of no pathological significance, the origin of which is unknown.
  • Ruby spots are small punctiform growths of a few millimetres in size, bright red, flat or protruding, often on the covered areas (trunk).
  • Treatment with laser or IPL is possible for aesthetic purposes.
  • These are frequent and benign vascular lesions (dilations) appearing late, without pathological significance, whose origin is unknown.
  • Venous lakes of the lips are frequent after 60 years of age, they look like a small varicose vein of purplish-blue colour on the lip.
  • They can be treated by laser if they are not too large, otherwise they must be surgically removed.

Angiokeratomas of the scrotum are benign skin lesions that typically appear as small, reddish-purple elevations. They most often occur after the age of 30 and are usually found on the skin of the scrotum, although rarely, they can develop on the skin of the penis or glans. These lesions are generally harmless, causing no symptoms, and are not associated with poor hygiene or sexually transmitted diseases. The exact cause of angiokeratomas is not fully understood, but they are not contagious.

While these lesions are benign, some individuals choose to have them removed for aesthetic reasons or due to bothersome symptoms. Treatment options for scrotal angiokeratomas typically include:

  • Laser Treatment: Laser removal is a common method for eliminating angiokeratomas of the scrotum. A targeted laser is used to destroy the abnormal blood vessels, reducing or eliminating the lesion.
  • Electrodesiccation: This method involves the use of a heated electrode to burn and destroy the affected tissues. It is an effective option for the removal of angiokeratomas.
  • Cryotherapy: Cryotherapy involves freezing the lesions using liquid nitrogen, leading to their destruction. This is a less invasive treatment option.

The lasers used for angioma treatment at the Biolaser Center in Basel/saint-louis

  • To effectively treat vascular lesions, the centre uses the best technological innovations in laser and pulsed light (IPL). Vascular laser or IPL treatment is recognised as the safest and most effective treatment for flat and stellate angiomas, ruby spots and venous lakes.
  • Both lasers destroy abnormal vessels by photocoagulation, targeting the haemoglobin in the dilated vessels with great precision.
  • This treatment allows for precise action without leaving scars or damaging the surrounding skin.

The course of a treatment session for angiomas in Basel/saint-louis

  • Do not apply any make-up or cosmetic products to the area to be treated before the session.
  • The area to be treated must not be tanned.
  • It is compulsory to wear protective glasses during the session in order to protect the eyes of the professional and the patient from the light intensity.
  • After the treatment, the doctor will suggest a cream with soothing and healing properties. It is essential not to expose the treated area to the sun: the application of an effective sun protection is essential.

Stellate angiomas/ruby spots/venous lacerations:

  • The treatment usually consists of one or a few 15-minute sessions spaced 4 to 6 weeks apart. On average, 2 laser or pulsed light sessions are sufficient to erase these lesions.
  • The treatment is done with a “pen” type handpiece.
  • During the laser treatment, the patient feels, depending on the power used, a tingling sensation or a very short burning sensation that is completely bearable.
  • No anaesthesia is necessary.
  • A moisturising cream is applied to the skin at the end of the session.

Plane angiomas :

  • This is a long treatment that requires several sessions (passages).
  • The first session consists of a test session, after taking photographs of the angioma, to evaluate the response to the laser on a small surface. The result of this test session will be assessed after 8 to 12 weeks.
  • It is not possible to predict the total number of sessions required (which can sometimes exceed 10). The lightening of the angioma is progressive but rarely leads to its total disappearance, especially if the angioma is thick.
  • Treatment should be started as soon as possible as the area to be treated will be smaller and the thickness of the skin reduced.
  • Contact anaesthesia with an anaesthetic cream applied under an occlusive dressing two hours before the session.

Follow-up and care after vascular laser or IPL treatment in Basel/saint-louis

Immediate follow-up :

Stellate angiomas/ruby spots/venous lacerations :
  • The skin may show some redness or slight swelling. These effects fade very quickly.
  • Scabs may appear as early as the second day. It is necessary to wait for them to fall off by moisturising them and not to scratch them in order to avoid residual scars.
Flattened angiomas :

They are marked, on the treated area, by a purplish coloration (purpura) which regresses after about ten days. It may be associated with :

  • A swelling (oedema) which may last 2 to 3 days and which is more important in the peri-ocular regions.
  • Small, thin crusts which will disappear spontaneously in a few days and which should not be removed.
  • A few temporary phlyctenes (blisters or bubbles) may occasionally be observed.

Care after the sessions :

  • Local care by spraying thermal water and soothing cream should be done for 4 to 5 days.
  • Make-up and camouflage are authorised immediately after the session.
  • Sun protection with a sun block is essential in the aftermath of the treatment.

Possible risks :

There is a small risk of after-effects after the treatment. This risk is increased if many treatments have been performed on the same area:

  • Hypopigmentation, i.e. skin that is slightly whiter than normal. These white spots fade spontaneously with time.
  • Hyperpigmentation, i.e. brown spots that disappear in a few months. This hyperpigmentation is more frequent in darker skin types and is favoured by sun exposure.
  • Other types of scars have been described (atrophic, sclerotic, hypertrophic) but they have become exceptional with current techniques.

Good and bad indications for vascular laser treatment

Stellate angiomas/ruby spots/venous lacerations :

Wrong indications :

  • Ongoing infection of the area to be treated.
  • Tanned skin.
  • Phototypes V and VI.
  • As with all laser treatments, pregnancy is a contraindication in principle.

Plane angiomas :

• Unilateral planar angioma of the face.
• Flattened angioma in the open area of the face, not very extensive.
• Age of onset of treatment: infancy or early childhood
• Very extensive planar angioma.
• Plane angioma in a patient with very pigmented skin.
• Plane angioma of the middle face.
• Very pale planar angioma.
• Haemangiomas or “strawberries”: correspond to red or purplish lesions in relief appearing in the first weeks of life. These haemangiomas disappear completely and spontaneously in most cases.
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