PR+ or VL+ : a choice of applicators

Which applicator to choose?

One of the most frequent questions asked  – in training or at exhibitions – is which applicator to use to treat certain conditions. Hair is simple – lighter skin types can be treated with the HR+ applicator, darker skin types get better and safer results with the HR-D+ applicator.
It is for rejuvenation and treatment of vascular lesions that guidance is needed.
MicroLight Pro and Ellipse Light SPT+ systems only work with the VL+ applicator so no choice to make here.

The users who have to make the choice are those with Ellipse I2PL+ and MultiFlex+ systems which allow a choice of using the VL+ or PR+ to perform rejuvenation, vascular lesions and rosacea treatments.


The poem is simple enough to remember, but needs to be looked at in a little more detail for the subtleties to emerge. Some examples will clarify this:

A light skinned patient with no suntan but with a red port wine stain (PR+) or blue port wine stain (VL+) needs treatment. The client’s skin colour is not an issue, and which applicator to use is determined by the colour of the port wine stain. If the same patient is brown from suntan, or if a patient has brown skin (Skin Type IV) the VL+ is chosen for safety.

A light skinned untanned patient with rosacea, also gives an easy choice – PR+ is chosen because the rosacea is pink or red. If the same patient has suntan, think brown and use the VL+. Rosacea is most common in skin types I and II but is found in darker skin, and for darker patients, the VL+ should again be chosen.

But imagine a typical rejuvenation patient – light skinned (Fitzpatrick Skin type I, II or untanned III) – who has both pigment damage (brown) and some red vessels. The best option is to treat the brown pigmentation first using the VL+; pigment acts like a mask over the underlying vessels. By first removing the pigment, the red vessels or diffuse redness become more apparent and therefore easier to treat at a second session, one month later with the PR+ applicator.

If a patient has a darker skin type (tanned III or IV), then it is the patient who is brown – and for brown skin the VL+ gives a safer treatment.  Even a Type II patient with a greater degree of suntan can also be said to be brown, and is more safely treated with the VL+. Of course, if the suntan is too recent, the user should always postpone the treatment.

Blue vessels are generally larger and located more deeply in the skin, and the higher wavelengths of the VL+ applicator penetrates more deeply – meaning that with Intense Pulsed Light, the VL+ is the applicator of choice for all blue vessels.

So at the risk of ruining a perfectly good poem, remember that with the PR+, think pink:

For brown (lesions, suntan or skin type) and blue

VL+, do!

For Pink and Red

PR+ instead

About ellipseblogger

Ellipseblogger is the collective name for the various service staff of Ellipse A/S; manufacturers of laser and Intense Pulsed Light (I2PL) solutions for aesthetic dermatology since 1997. Please note that this blog reflects our worldwide applications of Ellipse systems of which some may not be currently cleared for sale in the US.

Posted on April 5, 2013, in Basics, Treatments and tagged , , , , , , , . Bookmark the permalink. Leave a comment.

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