Sun damage takes many forms, I have two types of damage one that is pigmented and the other that is vascular. The vascular damage has been identified as a Polikderma of Civatte by Dr. Howard Sobel, a New York Dermatologist & Dermatologic Surgeon. The damage is located on my neck and is comprised of red brown patches of telangiectasias with sparse perifollicular skin, and it is known to occur most commonly on the lateral aspects of the neck of fair skinned, frequent sun exposed individuals. Characteristically there is a sparing of the central sub mental region of the neck, where mild atrophy and hyper pigmentation can also be present.
Dr. Howard SobelDr Sobel, previously identified sun damage that was pigmented and further identified a different damage that was vascular, requiring different treatment. I was previously treated over my entire face o and neck with IPL (intense pulse light) by many other doctors without any improvement. Dr. Sobel used a pulse dye laser called a V Beam. This laser was totally unknown to me. The V-Beam in Dr. Sobel’s practice had been successfully used on this type of issue where the blood vessel had been severely dilated on the face, however, he advised that just after the treatment there would be a purplish blue mark similar to a bruise, where the skin had been treated. This laser was going to be the definitive treatment to help remove these tiny blood vessels and restore my skin’s youthful look.
First treatment (above) 5 weeks after (below)Understanding how this laser works, Dr Sobel brings into the discussion photos of vascular sun damage on the neck, so that I can visually see the same problem as my own. Educating the patient on the correct type of damage, why and how it happened, and the solution to be taken is where you feel that the Dr. has the patience to walk you through the process.
Second treatment (above) Third treatment (below)It would be necessary to have a series of 4 treatments over a period of four months, the first treatment will be on a moderate to high setting, helping to give an indication as to the depth of treatment in subsequent weeks. This laser is a pulsed dye laser that has a cooling system so that with each pulse you feel an ice cold spray of water hitting the skin. In no way was this uncomfortable. The wavelength is 585 nm which corresponds to the absorption of oxyhemoglobin in our blood
Dr Sobel one of his treatment roomsWith no discomfort, the neck area over the following 24 hours did actually turn purple (purpura) however with each passing day this lightened, the skin on the neck area was slightly swollen but within a few days the normal color returning to the neck with a marked improvement of the blotchy redness and a reduction of visible telangietasias (blood vessels). After a 5 week period returning for the second treatment, and reflecting on the photos taken prior I could see visible marked improvement from the first treatment. The laser settings were lowered and did not have to penetrate as deep due to the improvement of the uneven red tones on the sides of my neck. It even seemed to tighten the skin as well.
Dr Sobel clinic receptionAfter the second treatment, again no discomfort however with this treatment no purple marks on the neck at all but just redness and swelling for 5 days, which is exactly what Dr. Sobel had advised me would happen. The third treatment was equally as successful and at the rate of improvement a fourth treatment may not be required. For a consultation on any sun damage issues contact your dermatologist or Dr Howard Sorbel Skin & Spa Cosmetic Surgery Centre, 960A Park Avenue, New York, NY 10028. 
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