A. It sounds like you are describing dermatosis papulosa nigra, a benign, inherited condition where tiny, dark, sometimes rough raised "moles" grow on the face and neck. Although it is inherited it does not start to appear in most people until their 30's. It is usually seen in patients with Caribbean or African heritage. If there is one or two in particular that are easily irritated because of collars or necklaces, then insurance will allow and cover the removal. If you have many and they are not irritated, you should do the Iridex 532 laser. It has a small and precise spot size and is very safe on darker skin. In fact, I have been using this technology since 1998. I am on my 3rd updated version of this technology. I have never seen a scar or discoloration in my practice using this laser.
Q. I have blue veins on my legs. I have had sclerotherapy help the spider veins, but have had limited success on these blue ones. Should I try laser?
A. It is hard for me to answer this specific to you because every situation is unique. Some people do well with blue veins if I use the Excel V long pulsed 1064 laser. It is the first laser that I have felt worth purchasing for my practice to treat leg veins. I do, however, feel that in most patients, I try foam sclerotherapy with Asclera before using the laser. It is the technique I find the best for vessels that are blue on the legs. The nice thing about the Lupo Center is that you have options!
Q. Dear Dr Lupo: I have a simple question: which is better for spider veins: sclerotherapy or laser?
A. That is not just a simple, but an easy question to answer as well. Sclerotherapy is more effective, less painful and more cost-effective (less expensive over a course of treatments) than any laser device on the market. Don't let that little needle dissuade you. You will barely feel it and the new sclerosant, Asclera, does not burn upon injection.
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