The marks left after acne are not all the same type of scar.

 

Some remain brown, some remain red, and in some cases, actual depressed acne scars are mixed in as well.

 

The vascular laser treatment we are discussing today focuses more specifically on red marks, meaning vascular redness left on the skin after acne.

If you look at the attached before-and-after photos, you can see several red marks around the cheeks and chin before treatment.

 

In particular, red dot-like marks remain where acne used to be, and the overall skin looks slightly sensitive and uneven.

 

In the after-treatment photo, the redness in the same areas appears generally lighter, and the marks look less distinct.

 

Of course, we cannot judge the entire treatment process from just one photo, but this type of change is similar to the direction we expect when vascular reaction decreases in post-acne redness.

 

So why does redness remain where acne used to be?

 

Acne is not simply a state where sebum is clogged.

 

Inflammation occurs, and as the skin heals from that inflammation, the surrounding blood vessels may dilate or new vessels may form.

 

It is similar to how a wounded area can look red for a while.

 

As the skin tries to recover, blood flow increases, inflammatory cells move in, and materials needed for repair are delivered. In that process, red marks may remain.

These red marks are often called post-acne erythema or post-inflammatory erythema.

 

Simply put, this is not brown pigmentation left behind. It is a state where vascular reaction remains for a long time in the area where inflammation occurred, making the skin look red.

 

That is why repeatedly using pigment lasers or brightening care alone may not create as much change as expected.

 

If the problem is not melanin pigment but vascular reaction, the treatment direction needs to be different.

If you look at the image above, vascular lasers are treatments that target red blood vessels inside the skin.

 

Inside blood vessels, there is a pigment called hemoglobin.

 

Vascular lasers use wavelengths that are well absorbed by hemoglobin, delivering energy selectively to the blood vessels.

 

Heat is generated during this process, and as problematic microvessels or dilated vascular reactions decrease, the redness gradually becomes lighter.

 

The key point here is not “burning the red color.”

 

More accurately, it is a treatment that targets hemoglobin inside blood vessels and adjusts vascular reaction while reducing damage to the surrounding skin.

 

This principle is called selective photothermolysis.

 

The term may sound difficult, but simply put, it means using energy that is absorbed more effectively by the target color, in this case the redness of blood vessels.

 

A representative example is the 595 nm pulsed dye laser, or PDL, which is often discussed in the treatment of post-acne red marks, facial redness, and vascular lesions.

Source : https://cau.scholarworks.kr/item/71a48502-adab-477e-b6bc-0b4128147285

 

In a study by Park et al., researchers compared a 1550 nm non-ablative fractional laser and a 595 nm pulsed dye laser for treating facial redness caused by acne. The study was designed as a split-face, evaluator-blinded, randomized pilot study.

 

In this study, both lasers were reported to be effective and safe for treating acne erythema. The average investigator assessment score was 3.42±0.67 for the 1550 nm fractional laser side and 3.33±0.65 for the PDL side.

 

In patient assessments, the proportion rated as good or excellent was 91.7% for the fractional laser side and 75% for the PDL side.

 

This study is meaningful because it shows that red acne marks are not always something we can only wait out. Depending on vascular reaction and skin recovery status, device-based treatment can be considered.

 

However, vascular lasers do not solve every type of acne mark.

 

They may help red marks, but brown marks may require pigment treatment, and depressed scars may need other approaches such as fractional lasers, RF microneedling, subcision, or collagen boosters.

 

In other words, the key to treating acne marks is first distinguishing whether they are red, brown, or depressed.

If you look again at the attached before-and-after photo, red marks are scattered across the cheeks before treatment.

 

There are small red dot-like areas where acne used to be, and some areas also seem to have a slight brown tone mixed in.

 

In actual clinical practice, instead of simply saying, “You only need vascular laser,” we first separate redness, brown pigmentation, and any depressed scarring.

 

In the photo, after treatment, the red dots appear less distinct, and the overall skin tone looks calmer.

This is the direction we can observe when vascular red marks improve.

 

However, not everyone improves at the same speed, so before-and-after photos should be understood as showing a possible direction of change rather than a guaranteed result.

 

After vascular laser treatment, temporary redness, warmth, swelling, bruising, pigmentation, and rarely blistering may occur.

 

Depending on the settings, vascular lasers can be used in a way that causes bruising or in a way that reduces redness without visible bruising.

 

Stronger treatment may produce faster visible changes, but it can also increase bruising and downtime.

Gentler repeated treatment may be easier for daily life, but it may require multiple sessions.

 

So vascular laser treatment is not something that should always be done strongly.

 

The intensity should be adjusted based on the depth of redness, skin thickness, skin type, tendency for pigmentation, and whether active acne inflammation is still present.

 

If inflammatory acne is still ongoing, stabilizing the acne itself may be more important than only reducing the red marks with laser.

 

That is because new inflammation will continue to create new red marks.

If you look at the image above, not all red marks on the face are located at the same depth or in the same layer.

 

Some redness is a shallow vascular response close to the surface, while some redness remains together with skin repair issues after prolonged inflammation.

 

In some areas, brown pigmentation may also be layered over the redness.

 

That is why the treatment sequence matters.

 

If redness is the main problem, vascular laser treatment may be considered first.

 

If brown pigmentation is present together, pigment treatment, brightening care, and UV protection may also be needed.

 

If depressed scarring is mixed in, vascular laser alone will not fully improve the surface texture, so scar treatment needs to be designed separately.

 

Simply put, acne mark treatment is not about solving everything with one laser. It is about separating redness, pigmentation, and depressions, then deciding the right order.

 

In this context, vascular laser plays a role in organizing red marks.

 

It is not a laser that removes pigment, and it is not a treatment that fills depressed scars.

 

However, for people whose skin continues to look uneven and inflamed because redness is prominent, it can be an important part of treatment.

The reason 595 nm PDL has been studied for post-acne red marks, as in the study by Park et al., is exactly this point.

 

That study reported that both the 1550 nm fractional laser and the 595 nm PDL were effective and safe for improving acne erythema, although the results should be interpreted with the understanding that it was a pilot study.

 

Post-treatment care after vascular laser is also important.

Because the skin can become temporarily sensitive after treatment, it is better to avoid activities that increase heat on the day of treatment, such as intense exercise, sauna, or alcohol.

 

UV protection is also important.

 

Even though this is a treatment for redness, it is not unrelated to UV exposure.

 

If the skin receives a lot of sunlight while it is sensitive after laser treatment, pigmentation may be more likely to remain.

 

Cleansing and skincare should also not be too irritating.

 

Exfoliating products, high-concentration acids, and retinol-based products are better paused immediately after treatment, and it is safer to focus on moisturizing and calming care.

 

To summarize, vascular lasers may help reduce problems centered on vascular reactions, such as red marks left after acne, facial redness, and dilated microvessels.

 

As seen in the before-and-after photo, when red marks left after acne become lighter, the overall skin tone can look much calmer.

However, not every acne mark is a vascular issue.

 

We first need to distinguish whether it is a red mark, brown pigmentation, or a depressed scar. If acne is still active, acne control should also be considered together.

 

In the end, what matters in vascular laser treatment is not “how strongly the laser is applied,” but whether the mark is truly centered on vascular reaction.

 

It is natural to want red marks to disappear quickly, but the skin can react more sensitively than expected.

 

So instead of pushing treatment too aggressively, it is better to identify the cause and depth of redness and reduce it safely over time :)

 

This was Director Won Dae-han.

 

Thank you for reading.

 

 

※ This article is intended to provide general medical information. Actual suitability for vascular laser treatment, the number and interval of treatments, laser type, and energy settings may vary depending on the cause of redness, skin type, whether acne is still active, and whether pigmentation is present. An accurate diagnosis and treatment plan should be determined through consultation.