Trish: I’m here today with Dr. Jeffrey Hsu, who’s a specialist dermatologist based in Chicago in the USA, and we’re going to have a talk about the Excel V and treatment for lasers, so just to give you, for all the viewers out there who want to know about lasers for veins. Thank you so much for taking the time today.

Dr. Jeffrey Hsu: Well, thank you very much, Trish, for asking me to be here.

Trish: Pleasure. I watched your presentation before, and I’m really intrigued. I’ve got veins myself, and it’s like “Where do I start? What do I do?” Can you tell us a little bit about the Excel V and where that fits in and who that would suit?

Dr. Jeffrey Hsu: Right, right. Well, the first thing that people ask me usually is what to do about the veins on their face. Usually the little capillaries, or what we call telangiectasia, around the nose and on the cheeks… usually from too much sun exposure on skin that’s usually what we call skin type I and II, which is usually Caucasian skin. Over time, and this is none of your fault, this is purely based on genetics and purely based on exposure, you will get these tiny little blood vessels on the cheeks and on the nose.

This is what the main device, the main tool I use for treating those veins. It’s called Excel V by Cutera. Usually, in simply one to two treatments, you can clear these blood vessels very effectively with very little pain, very little discomfort, and a little bit of swelling over the redness for about a day or two. No cutting, no bleeding, no bruising. The veins just disappear. That’s a very easy treatment for me to do, and I do that all day long in Chicago.

Trish: That’s like when the nose gets all those little red capillaries on it?

Dr. Jeffrey Hsu: Exactly right. Exactly right. Again, I think the, there’s social stigma sort of attached to that, isn’t there? A lot of men actually get it done, because they go to work and people are wondering in the back of their minds “Are they drinking?”

Trish: Yes. “Is he drunk?”

Dr. Jeffrey Hsu: Exactly right. Exactly right, but by far, the majority of time, this is something genetic, this is something environmental, and it’s something you can’t get away from, especially when you have light skin tone. This is really a Godsend for many of my patients.

Trish: All right. It’s really good for the capillaries, and what about, like, the legs in the veins, like spider, spider veins and the bigger, the big ones that … Can this work for that, as well?

Dr. Jeffrey Hsu: It certainly can, and, well, you know, it’s part of the whole treatment paradigm, isn’t it?

Trish: Mm-hmm (affirmative).

Dr. Jeffrey Hsu: I think you have to understand where the veins are, how big they are, and what the sources are. If you have larger varicose veins, I’m afraid you’re going to have to see a vascular surgeon for some deeper procedures, but if it’s a superficial vein problem, spider veins or blue veins, this laser actually does a beautiful job.

Trish: Okay.

Dr. Jeffrey Hsu: I often use it in complement with what I call sclerotherapy, which is injection of the medicine into the veins, and then I use, go to the laser to clean up tiny little blood vessels that the injection cannot get to. The two together actually creates, actually, a very good treatment paradigm.

Trish: Okay. Depending on the patient, depending on what they need, this could be a good starting point for where you’ve got little veins, because it might, the spider veins and the little … What were the other ones ?…

Dr. Jeffrey Hsu: What we call reticular veins.

Trish: Okay.

Dr. Jeffrey Hsu: They’re blue veins that are feeding the spider veins.

Trish: Oh, okay. Oh, okay. The big ones fed the little ones. That’s why they go red.

Dr. Jeffrey Hsu: Exactly. Exactly right. I think a lot of patients actually out there don’t know that you can do this. A lot of people think that “Well, I must… This has to be done with some sort of surgery. There’s going to be pain. There’s going to be downtime. There’s going to be a scar.” Absolutely not. There’s no scar. There’s very little discomfort, really no recovery required.

Trish: Yep.

Dr. Jeffrey Hsu: We have come a long way in the treatment of leg veins.

Trish: Well, that was going to be my next question. Does it hurt?

Dr. Jeffrey Hsu: Well, it does, there’d be some discomfort.

Trish: Yeah.

Dr. Jeffrey Hsu: No pain, no gain, right? There’s going to be some discomfort involved, but I think for most part, it is not something that requires any sort of anaesthesia. It’s irritating. It’s annoying, but it doesn’t stop anybody from going through and completing the treatment. I think what most people, most of my patients are more concerned about is that “Is there going to be any sort of scar? Is there going to be sort of long term problems with the procedure?” Zero, unlike surgery.

Trish: How long does it take? I suppose it depends on the size of the area, but …

Dr. Jeffrey Hsu: Yeah. You are absolutely right. It is a tedious procedure, because we’re using a very tiny little laser beam to trace all the vein one by one by one, so it does take some time. The larger the area we have to treat, of course, the longer it’s going to take.

Trish: Yeah, and you could probably do it in a couple of … Is it just one session only, or…

Dr. Jeffrey Hsu: Depends. You know, again, depends on the type of vein. I typically, I don’t want to overpromise, so even though by far the majority of the time, even with one treatment, you can see a difference, to really get to a point where the patients are happy, that 70, 80, 90 percent of the veins are gone, I’m probably estimating two to three treatments.

Trish: Okay. All right. Great. Well, thank you so much for your time today.

Dr. Jeffrey Hsu: Yeah. You’re very welcome.

Trish: If you suffer from spider veins, or you’ve got veins, or you want to do something about your veins, want to find a practitioner who’s probably got the Excel V device to treat you, just drop us an email at or click on the link below this video. Thank you so much.

Dr. Jeffrey Hsu: Thank you very much.


Trish is a plastic surgery blogger. She is passionate about wellbeing, health and beauty, and doesn't mind a little bit of 'help' from the amazing cosmetic and beauty procedures that are available today. Trish spends her days talking to women and men who are looking for suggestions and advice on procedures that are available to them. Cutting through the sales pitch and hype, a down-to-earth response on general information is what you will get.

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