13.05.2025

Laser Cutera Excel V+: Exclusive interview with Dr Stefanescu

The Cutera Excel V+ Laser is revolutionising the treatment of vascular lesions. In this interview, Dr. Stefanescu explains how the Cutera Excel V+ laser effectively and safely treats skin problems ranging from rosacea to spider veins and port-wine stains.

Can you explain how the Cutera Excel V+ laser works for the treatment of vascular lesions?

This vascular laser has two different wavelengths, 532nm and 1064nm, using an LBO (Lithium Triborate) crystal, which gives it great stability and unique performance for the effective and safe treatment of a wide range of benign vascular and pigmentary lesions by selective targeting (selective photothermolysis) of haemoglobin and melanin. During the treatment of vascular lesions, the laser light is absorbed by the haemoglobin present in the veins and the heat produced causes photocoagulation without causing thermal damage to the adjacent tissue. The heat is transmitted to the vascular wall, which leads to the destruction of the vessel and prevents recanalisation.

What types of vascular conditions can be treated with the Cutera Excel V+ laser?

The Cutera Excel V+ laser has been approved for the treatment of benign vascular lesions. The lesions treated include facial telangiectasias and periorbital blue veins, rosacea, diffuse erythema of the face and neckline (poikiloderma of Civatte), ruby and star angiomas, telangiectasias and reticular veins of the legs, or even venous lakes of the lips and congenital malformations of the «wine stain» type (flat naevus).

Laser Cutera Excel V+ | Swiss Medical Network

What are the advantages of the Cutera Excel V+ laser over other methods of treating vascular lesions?

For the treatment of vascular lesions, there are a number of medical devices that are used, such as the PDL (Pulsed Dye Laser – 585nm and 595nm), the KTP laser (532nm), the alexandrite laser (755nm), the diode laser (800-900nm) and the Nd:YAG laser (1064nm). The 532nm and 1064nm wavelengths used by the Cutera Excel V+ laser are considered the most effective and safest for the treatment of superficial vascular lesions. In addition, this laser benefits from a unique cooling system created by the brand with a sapphire window that minimises pain and prevents skin burns. Finally, post-treatment recovery time is fast, with little or no interruption to daily activities.

Are there any side effects or risks associated with the use of the Cutera Excel V+ laser?

The risks of vascular laser treatment are generally minimal. Very rarely, side effects (localised redness and swelling, superficial bruising) may occur, but these disappear within a few days. The risk of skin burns is virtually zero if the treatment is carried out correctly and if there has been no exposure to the sun in the month prior to treatment.

How does a Cutera Excel V+ laser treatment session work?

The session is performed without anaesthesia. Protective goggles are used by the doctor and the patient. A cooled gel is placed on the skin to reduce the sensation of heat. The laser shots are made on small round areas of a predefined diameter. They are fired one after the other, closer and closer together, along the entire length of the vessel to be treated. You may feel a sensation of heat or burning. The coagulation process will cause sclerosis of the vascular walls, which will occur gradually over several weeks. The procedure usually lasts between 15 and 30 minutes and can be repeated after 6 weeks.

How many sessions are generally necessary to obtain optimal results?

Several sessions may be necessary to obtain the desired results. The number of sessions depends on the extent of the lesions to be treated.

Is the Cutera Excel V+ laser suitable for all skin types?

Yes, this laser is suitable for all skin phototypes from I to VI according to the Fitzpatrick classification.

What are the typical results that patients can expect after treatment with the Cutera Excel V+ laser?

Immediately after the session, there is redness (erythema) on the lesions that have been treated, which normally disappears within 2 to 4 hours. Localised swelling (subcutaneous oedema) is also possible and can last for 2 to 3 days. Bruising (superficial haematomas) normally disappears in 7 to 10 days. Sensitivity varies depending on the area, with larger and deeper vessels causing more painful sensations. Small dots of brown scabs may sometimes appear, particularly for very superficial red vessels (or also for rosacea) and last for a few weeks. Depigmentation or light marks on the skin (achromia) or brown spots (hyperpigmentation) may sometimes appear on the treated areas. These are temporary and generally disappear after a certain period of time (3 to 6 months).

Are there any special precautions that patients should take before or after treatment with the Cutera Excel V+ laser?

It is essential to avoid exposure to the sun for 30 days before and 30 days after treatment. SPF50+ sunscreen on the treated areas is necessary if exposed to the sun within 4 weeks post-treatment. A soothing cream will be prescribed to calm the feeling of warmth, and cold compresses or refrigerated gel packs can be applied after the treatment. Hot baths and saunas are not recommended for the first 2 days. Creams with irritating potential (tretinoin, retinol, benzoyl peroxide, glycolic/salicylic acid, astringents) should be avoided for 7 days after treatment.

Dr. med. Adrian Stefanescu | Swiss Medical Network

About the expert

Dr Adrian Stefanescu is a specialist in angiology and internal medicine at the Clinique de Genolier. He specialises in the following areas:

the care of outpatients and hospitalised patients with arterial, venous, lymphatic and microcirculatory vascular disease
the diagnosis of vascular diseases
the outpatient treatment of varicose veins using minimally invasive methods
the management and conservative treatment of primary or secondary lymphoedema.
arteriovenous mapping for the creation of haemodialysis fistulae and their follow-up in case of malfunction.
aesthetic treatment with vascular laser

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