Question: How is the pulse dye laser different from the fractional laser? Is one better than the other for improving spider veins on the face?
Answer: A pulsed dye laser is not a fractionated laser, but it is a laser that is absorbed by hemoglobin or blood and, therefore, is quite effective at treating vascular lesions on the face. A fractionated laser is any sort of laser that is broken up into small tunnels or dots that treat the skin. There are non-ablative fractional lasers that simply heat up tunnels in the skin and create denaturation of collagen. This then allows the healing process to increase the collagen and improve the skin quality. Ablative fractionated lasers actually vaporize tunnels into the skin. This creates a much more intense healing process with more intense collagen deposition and, therefore, overall will be much more effective than the non-ablative modalities, but there is a downtime associated with these types of lasers. Overall, fractionated lasers are not typically used for spider veins, so I would recommend consideration of the pulsed dye laser though I personally feel that the YAG laser or even broadband light can be just as effective or even more effective than a pulsed dye laser and they seem to have a lower propensity for bruising. Ultimately though, I really think it is your provider who will be able to make recommendations since they would be the ones who have experience with the specific laser that they have available.