Grant L. Carter, MD and Gayle M. Carter, MD are board-certified in obstetrics and gynecology and are proud to announce the opening of Southern Utah Laser Aesthetics. Both physicians are laser certified and have extensive backgrounds in gynecologic laser treatment of endometriosis, ovarian cysts, and infertility. Southern Utah Laser Aesthetics allows our physicians to build on their backgrounds to provide professional laser aesthetic skin treatments for both women and men.

Grant L. Carter, MD attended medical school at the University of Utah, where he was recognized by the AOA Medical Honor Society and Chief Resident. He is board certified by the American Board of Obstetrics and Gynecology, and has been practicing in Southern Utah since 1982 when he founded Southern Utah Womens Health Center. He is currently director of Women’s and Children’s Services at Dixie Regional Medical Center. Dr. Carter is well known for his practice of comprehensive women’s health care, including laser surgery, which he pioneered in the Southern Utah area. He was laser certified using Laserscope laser in 1989 and since then has had experience treating multiple conditions. Dr. Carter is licensed in Utah and Nevada and has privileges at both Dixie Regional Medical Center in St. George, Utah and Kane County Hospital in Kanab, Utah.

Gayle M. Carter, MD joined Grant Carter, MD at Southern Utah Womens Health Center in 1984. He attended medical school at the University of Utah, where he was Chief Resident. Dr. Carter was the first recipient of the Michael Worley Award, presented to the outstanding resident in Obstetrics and Gynecology in 1980. He has been board certified by the American Board of Obstetrics and Gynecology since 1986. He was laser certified using the Laserscope laser in 1989, and has had extensive experience with laser surgery and treatment of various medical conditions, encompassing all facets of women’s health care. Dr. Gayle Carter is currently serving as Chairman of the Department of OB/GYN, as well as serving on the Medical Executive Committee, at Dixie Regional Medical Center in St. George, Utah. He is licensed in both Utah and Nevada.

Laser technology has made revolutionary advances in the treatment of cosmetics blemishes that are caused by vascular changes and/or abnormalities. The lasers used at Southern Utah Laser Aesthetics can significantly fade, if not completely erase everything from port-wine stains, cherry Angioma, spider angioma and Telangiectasia. With the remarkable laser instruments available today there is now little risk of scaring, bruising, and loss of pigmentation that lasers and other technologies may have caused in the past. At Southern Utah Laser Aesthetics, our physicians will design the best and most effective treatment plan for your particular problem and skin type. Below are some of the vascular lesions or blemishes that can be treated at S.U.L.A.

Port-Wine Stains

A Port-Wine Stain is a pink to purple birthmark composed of an abnormal collection or network of dilated blood vessels present beneath the skin. The Port Wine Stain was given this name because the skin appears to have a red, pink, or purple liquid, such as port wine, poured over it. These lesions are present at birth and usually occur on the face or neck. If untreated, port wine stains (birthmarks) can deepen in color and increase in size and depth as you age. They can become raised, thus increasing their susceptibility to abrasion, ulceration, chronic infections and circulatory problems. Therefore, port wine stains are best treated as early as possible.

What causes Port-Wine Stains?

While the cause of the Port-Wine Stain is unknown, the dense network of vessels is a remainder of extra blood vessel tissue that may become present in the first month of life. There is no significant genetic or inherited tendency and there is no factor during pregnancy that is known to cause or predispose a Port-Wine stain to develop.

What treatments are available for Port-Wine Stains?

In the past, many forms of therapy have been used to treat Port-Wine Stains. Most of the treatments that have been used in the past such as surgery radiation, X-ray, dry ice and tattooing have been abandoned because these treatments often leave deformities as undesirable as the Port-Wine Stain itself. The current most effective treatment for Port-Wine Stains is Laser Therapy.

When is the best time to treat a Port-Wine Stain with Laser Therapy?

In general, the earlier a Port-Wine Stain is treated, the better the results will be. Lesions that are pink, flat and blanchable respond to the laser treatment the best. Lesions on the head, neck and proximal extremities tend to respond better than lesions near the hands and feet. Because the lesion is usually flat and superficial in infancy, they are ideally suited for this treatment. In addition, since these lesions tend to expand in proportion to the child's growth, the smaller the lesion, the fewer the laser pulses to complete the treatment.

How long will my complete treatment take?

Though Laser therapy is safe and effective it will not remove the entire Port-Wine Stain in one session. Lesions that are dark and thick usually respond slower and require more treatments. Lesions over the temple and forehead respond better than a lesion on the cheek or around the lips. Lesions on the arms and legs respond the slowest and sometimes incompletely. In most cases the Port-Wine Stain may require anywhere from four to seven (or more) repeat treatments to each area with two to three month intervals between each treatment. Large Port-Wine Stains may take several years for complete removal. To archieve the best results, patience is essential.

Is the laser treatment painful?

Most adults and children are able to tolerate the discomfort caused from the treatment. However, we recommend that a topical anesthetic be applied to the treatment area 30-45 minutes prior to treatment to help with any discomfort. A topical anesthetic may be given to the patient after their consultation. Our physicians may recommend a mild sedative be taken prior to the treatment. If this is the case our physician will provide you with a written prescription and instructions.

Are there possible complications after treatment?

It is impossible to predict what long term undesirable or unknown side effect could occur as a result of this relatively new modality of Laser Therapy since it has been in use since the mid 1980's. We are also not certain as to whether or not the treated lesion will return many years after the treatment.

What precautions should be taken after the treatment?

As with all Laser therapy treatments a sunscreen (SPF 30 or higher) should be applied to the treatment area both before and after the treatments. You should avoid rubbing or creating any friction at the treatment site. The treated area should be cleaned with a gentle soap and water and a healing ointment such as Aquaphor® should be applied 2-3 times daily for the first 7-10 days post therapy.

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Cherry Angioma

A Cherry Angioma is a benign skin growth that appears as a small, smooth, cherry-red bump. Cherry Angiomas are fairly common skin growths that vary in size. They can occur almost anywhere on the body but usually develop on the trunk. These growths are most common after the age of 40 and the cause is unknown. Although painless and harmless, Cherry Angiomas may bleed profusely if injured. Removal of these skin growths usually does not cause scaring.

Symptoms may include:

• A skin lesion or growth the size of a small pinhead size to about 1/4 inch in diameter.
• A bright red skin lesion or growth.
• A smooth skin lesion or growth.

What kind of diagnostic testing is recommended?

Your physician will probably diagnose a Cherry Angioma based on its appearance and growth. No further tests are usually necessary, though a skin biopsy may be used to confirm the diagnosis.

What treatments are available?

Cherry Angiomas generally do not need to be treated. They tend to be cosmetically displeasing and sometimes prone to bleeding. Angiomas may be removed by surgery, cryotherapy (freezing), electrosurgery/cautery (burning), or laser therapy.

Are there any complications?

Complications, if any, are as follows:

• Changes in appearance
• Psychological distress
• Bleeding

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Spider Angioma

Spider Angioma, also known as nevus araneus, is an abnormal collection of blood vessels near the surface of the skin. The appearance is often similar to that of a small spider web. A spider angioma lesion typically has a red dot in the center with reddish extensions radiating out for some distance around it. Spider angiomas can occur anywhere but are most commonly found on the face and the trunk. Spider angiomas are very common and are especially prevalent during pregnancy and in patients with liver disease.

What kind of diagnostic testing is recommended?

Although no testing is usually necessary, in some cases a skin biopsy may be needed to confirm the diagnosis.

What treatments are available?

Generally, treatment is not necessary. However, some spider angiomas can be bothersome. Therefore, the lesion can be obliterated with laser treatments.

What can I expect after treatment?

Spider angiomas often disappear in children but tend to be persistent in adults. Therefore, the number of laser treatments needed is unknown. You should notify your physician if you develop any new spider angiomas, to rule out associated medical conditions

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Telangiectasia

Telangiectasias, also known as vascular ectasias, are abnormally dilated blood vessels associated with a number of diseases. Telangiectasias may develop anywhere on the body but can be easily seen in the skin, mucous membranes, and whites of the eyes. Though most are asymptomatic, some telangiectasias bleed readily and cause significant problems. Telangiectasias may also occur in the brain and cause significant problems from bleeding.

What are the common causes of Telangiectasia?

The most common causes of Telangiectasia are as follows:

• Facial Telangiectasia associated with age, sun exposure, and alcohol use.
• Hereditary hemorrhagic Telangiectasia (Osler-Weber-Rendu syndrome): an inherited disorder of the blood vessels, which can cause excessive bleeding.
• Ataxia - Telangiectasia: an inherited disorder that affects many tissues and systems in the body. Multiple symptoms may include telangiectasias (dilation of capillaries), ataxic (uncoordinated) gait, proneness to infection, defective humoral and cellular immunity and increased risk malignancies.
• Spider angioma: an abnormal collection of blood vessels near the surface of the skin that resembles a spider web.
• Curtis marmorata Telangiectasia congenita (an inherited disorder)
• Bloom syndrome
• Klippel-Trenaunay-Weber syndrome
• Sturge-Weber disease: a rare disorder present at birth. It is characterized by a birthmark, usually on the face, known as a port-wine stain (from too many blood vessels just beneath the skin) and neurologic problems.
• Xeroderma pigmentosa: an inherited inability to repair DNA damage caused from ultraviolet light.
• Nevus Flammeus such as Port-Wine stain: vascular (blood vessel) skin markings (birthmarks) that develop before or shortly after birth.

* If you notice enlarged vessels in the skin, mucous membranes, or eyes of your child or yourself you should contact your physician or health care provider.

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Rosacea

Rosacea is a chronic skin condition, usually localized to the middle of the face, (nose, cheeks, forehead, around the eyes, on the chin). This condition can cause red patches, prominent blood vessels, lines and small pimples on the face, as well as burning and irritation in the eyes and eye lids. The most common symptoms are redness of the face or cheeks, increased tendency to blush or flush easily, increased broken capillaries of the face, and acne-like skin eruptions.

Flare ups of rosacea are caused by triggers that cause facial flushing, which is due to dilation of facial blood vessels. Common triggers include sun, exercise, hot weather, nicotine, caffeine, and alcohol. While the exact cause of rosacea is unknown, many people with this skin condition have been found to have a family history of rosacea. One theory is that rosacea may be a result of highly reactive blood vessels combined with inflammation and infection.

How does the treatment work?

While topical creams may help control some of the symptoms of rosacea, laser treatments are the best way to treat the condition and improve your appearance. Laser treatment uses brief pulses of high-energy light that is absorbed into the skin. The light is changed into heat energy and the heat then destroys thin sections of skin, layer by layer. As the treated area heals, new skin grows to replace the damaged skin that was removed during the laser treatment.

What results can be expected?

Effects are cumulative. After the first treatment, you may see improvements in broken capillaries, small facial veins, and some pigmented areas within a few days. Other improvements may be more subtle and take one to three months. With each subsequent treatment, subtle changes will accumulate until you have achieved the improvement you desire.

Is the treatment painful?

Most patients experience little discomfort. The pulses from the laser may sting or burn slightly, or you may feel a snapping sensation against your skin. A topical anesthetic may be applied to sensitive skin. To further reduce discomfort, our laser utilizes a special cooling system that lowers the temperature of the skin at the treatment site before, during and after laser exposure.

What should be expected after treatment?

Immediately after treatment you may experience some redness and slight swelling and/or slight darkening of pigmented areas. The redness and swelling usually dissipate within one to three days; however, darkened pigmentation may persist, and peel lightly for up to one week. It is extremely important to apply a moisturizer with SPF30 sunblock and avoid sun exposure on a daily basis to prevent additional sun damage.

How long does the treatment take?

The treatment takes approximately 30-60 minutes, depending on the area to be treated. Prescribed topical anesthetic should be applied 30-60 minutes prior to the treatment time if needed.

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