Timolol capillary hemangioma

I have type 1 rosacea. I had a nightmare reaction to Soolantra and switched to 20% Azelaic Acid in cream format (Acmed if you are in EU).
My dermatologist is awesome and internationally recognized for work with lasers and a few other skin topics. Also a very no-BS guy which is rare in cosmetic dermatology!
Today I did my first session of VBeam PDL - which he said is truly the only actual weapon in his arsenal to eliminate veins and reduce redness - topicals can reduce appearance but won't solve permanently. We treated broken capillaries around nose and mouth (not bad but a little visible) and the whole cheek, chin and nose area broadly. The veins are gone!
Also now that I'm acclimated to azelaic, he also prescribed:

• Dioxmin serum (in EU, not sure elsewhere - ingredients diosmin 6% with arnica & witch hazel) - for additional redness treatment
• Timolol glaucoma eye drops! Apply drops to face (not eyes) to constrict blood vessels in rosacea hot spots. First I had heard of this.

My dermatologist is awesome and internationally recognized for work with lasers and a few other skin topics. Also a very no-BS guy which is rare in cosmetic dermatology!
Today I did my first session of VBeam PDL - which he said is truly the only actual weapon in his arsenal to eliminate veins and reduce redness - topicals can reduce appearance but won't solve permanently. We treated broken capillaries around nose and mouth (not bad but a little visible) and the whole cheek, chin and nose area broadly. The veins are gone! It was not painful but very weird - bright shock of light and a buzzing feeling, annoying but not the worst.
Some interesting tidbits from our visit today:

• He has stopped recommending Morpheus, Potenza, Ultraformer or Ultherapy due to the pain vs outcome ratio - he does not see enough impact to put people through it (to say nothing of the cost)
• Rosacea (I have type 1): I had a nightmare reaction to Soolantra and switched to 20% Azelaic Acid in cream format (Acmed if you are in EU). Today now that I'm acclimated to it, he also prescribed:
  • Dioxmin serum (in EU, not sure elsewhere - ingredients diosmin 6% with arnica & witch hazel)- for additional redness treatment
  • Timolol glaucoma eye drops! Apply drops to face (not eyes) to constrict blood vessels in rosacea hot spots. First I had heard of this.

1) WHAT IS CAVERNOUS MALFORMATION?

Cavernous malformations are also known as cavernous angioma, CCM, and cavernoma. They are made of abnormal blood vessels. They are not cancerous. Cavernous malformations are made of the smallest blood vessels, called capillaries. They resemble mulberries and have very thin walls compared with other blood vessels. Blood moves through them very slowly. The thin vessel walls can be leaky, allowing blood into the surrounding brain or spinal cord tissue. We believe about one in every 500 people has a cavernous malformation, but most people never have symptoms. Of the people who have a cavernous malformation, we believe many will never have a symptomatic hemorrhage.
The rarest place for a symptomatic cavernous malformation is in the spinal cord. A spinal cord cavernous malformation is not the same as a spinal hemangioma, which is located in the vertebra (bone). Cavernous malformations may also occur in the area of the brain called the brainstem. Spinal cord and brainstem cavernous malformations can cause more severe symptoms when they hemorrhage.

2) WHAT IS AN INCIDENTAL CAVERNOUS MALFORMATION?

Your doctor may have discov­ered your cavernous malformation (cavernous angioma, cavernoma) when you had brain or spinal imaging for a reason not related to your cavernous malformation. For example, you may have received a CT scan or an MRI after a car accident or concus­sion. In this case, doctors will call your cavernous malformation an incidental finding. Research has shown that incidental cavernous malformations that have not had a previous hemorrhage have a very small chance of ever becoming problematic. While you may want to follow the precautions listed in the Hemorrhage section of this book­let, you may not need repeat imaging unless instructed by your doctor or you develop symp­toms. However, many doctors and patients choose to have imaging, typically with MRI, to monitor the lesion. For example, your doctor may order imaging during pregnancy, after medication changes, if another illness is diagnosed, or at times of dramatic lifestyle change, which can include ex­treme or unusual exercise.

3) WHO MIGHT BE INVOLVED IN MY CARE?

• NEUROLOGIST – manages symptoms like seizure and pain
• NEUROSURGEON – evaluates for surgery
• REHABILITATION SPECIALISTS – improve functioning after brain event
• ORTHOPEDIST – monitors spine in CCM3 patients (see Genetics)
• NEURO-OPHTHALMOLOGIST – cares for brain-related vision problems
• GENETICIST – evaluates for the hereditary form of the illness
• DERMATOLOGIST – cares for vascular skin lesions in hereditary illness

4) WHAT CAUSES MULTIPLE CAVERNOUS MALFORMATIONS?

Some people have more than one cavernous malformation (cavernous angioma, cavernoma). This can happen for several reasons:

• Most commonly, people with more than one cavernous malformation have a hereditary form of the illness. People with the genetic form of the illness typically develop additional cavernous malformations over time.
• Some people may have a second kind of abnormal blood vessel called a developmental venous anomaly (DVA). Your doctor might also call this a venous malformation or venous angioma. This dilated blood vessel only rarely causes symptoms on its own. However, it may create conditions that make it more likely for cavernous malformations to form. This is not hereditary.
• Brain or spinal radiation for cancer treatment can cause cavernous malformations to form many years later. In people with the hereditary form, radiosurgery to treat a cavernous malformation may also cause more lesions to form. You can find more information about radiosurgery in the section on Other Treatments.

5) WHAT IS SPORADIC CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA)?

Sporadic cavernous malformation means that you are the only one in your family to have a cavernous malformation, and you do not have a genetic mutation that would cause your children to inherit the illness. Usually, individuals with the sporadic form of the illness have just one cavernous malformation with no other visible blood vessel abnormalities or medical history to explain the lesion.
Sometimes, individuals have a different kind of blood vessel abnormality called a developmental venous anomaly (DVA) or they have a history of brain radiation for cancer. A DVA or brain radiation can lead to the development of one or more cavernous malformations (see What Causes Multiple Cavernous Malformation? above). To be certain you have the sporadic form of the illness, you will need to have an MRI with some special images called susceptibility-weighted imaging or SWI. Ask your doctor if this was part of your original MRI. See Stacie and Vern’s Patient Stories to learn more about sporadic cavernous malformation with and without a DVA.

6) WHAT IS A BLEED OR HEMORRHAGE?

All cavernous malformations (cavernous malformations, cavernomas) have some chronic oozing of blood in the area of the lesion. This is what gives their typical appearance on MRI. Oozing is different from the more significant hemorrhage or bleed. A hemorrhage is new bleeding in the cavernous malformation and is often associated with new symptoms. Symptomatic hemorrhage is the most serious complication of cavernous malformation and is the most common reason for surgery. The hemorrhage may cause new symptoms or an increase in symptoms. The specific symptoms a person experiences will depend on the location and size of the cavernous malformation and the amount of blood that has leaked outside the lesion. Eventually, the blood breaks down leaving behind an iron deposit called hemosiderin.
Most lesions never hemorrhage. However, once a cavernous malformation has had one hemorrhage, it is at a significantly greater risk of bleeding again. In the first five years after a hemorrhage, the risk of another hemorrhage in a cavernous malformation that is not in the brainstem is 17-20% (1 in 5 lesions will have a second hemorrhage). The risk of a second hemorrhage in brainstem cavernous malformations is greater at 30% (1 in 3 lesions will have a second hemorrhage). Most of these second hemorrhages will take place in the first two years after the original hemorrhage. Fortunately, five years after a hemorrhage, the risk of another hemorrhage gradually returns to a rate that is similar to the risk from a lesion that has never bled.

7) WHAT CAUSES HEMORRHAGE?

We do not know what causes hemorrhage. Without evidence, it is hard for doctors to recommend specific precautions.

• People with multiple cavernous malformations, usually caused by a familial form of the illness, are at higher risk.
• There is no evidence at this time that medications or supplements that thin blood, such as ibuprofen or aspirin, can cause hemorrhage. However, doctors may recommend limiting their use. It is also not clear whether hormonal birth control or estrogen supplements should be restricted, but some doctors advise this, especially if a patient had a prior bleed on such medications or while pregnant.
• Behaviors that can increase inflammation like smoking cigarettes may increase the risk of hemorrhage.
• There is no reason to avoid flying in airplanes.
• This is no reason to reduce aerobic exercise. We do not have enough data to determine whether weight-lifting may place one at higher risk.
• Researchers don’t know if head trauma, including that which you might experience with contact sports, can cause hemorrhage.

Things you can do:

• Animal studies have shown that MAINTAINING NORMAL VITAMIN D levels may be protective. Clinical research has indicated that patients who are Vitamin D deficient are more likely to have had active lesions. Your doctor can check your Vitamin D level with a blood test.
• PROTECT YOURSELF against preventable, contagious illnesses with hand washing, and vaccinations.
• FOLLOW YOUR DOCTOR’S ORDERS to manage other chronic illnesses, such as high blood pressure and diabetes.

8) WHAT SYMPTOMS CAN A CAVERNOUS MALFORMATION CAUSE?

• Seizures are one of the most common symptoms of cavernous malformation (cavernous angioma, cavernoma). Seizures fall into two general groups: focal seizures that are local to one area of the brain and generalized seizures that involve both sides of the brain. All cavernous malformation seizures begin as focal seizures but some progress to generalized seizures. Neurologists use anti-epilepsy medications to control seizures. However, neurosurgeons have had good results in eliminating seizures with brain surgery if they are able to pinpoint which cavernous malformation is causing the seizures. Surgery is most successful when it occurs within two years of a first seizure. Brainstem and spinal cavernous malformations do not cause seizures.
• We know people with cavernous malformation experience more frequent headaches than other people. A headache does not necessarily mean a new hemorrhage. For the most part, we can’t distinguish a cavernous malformation headache from any other kind of headache. A headache unlike one you have ever experienced or headaches, particularly on the same side or general location as your lesion, may be related to your lesion. A headache may be related to your cavernous malformation if it is unlike one you have ever experienced or if it is in the general location of your lesion.
• The symptoms of a cavernous malformation hemorrhage depend on its location and size. Cavernous malformations can cause attention, memory, social skills, mood, and learning problems, particularly if the lesions are in the frontal, parietal, or temporal lobes, or in the cerebellum, even without obvious bleeding. This is particularly true for individuals with many lesions throughout the brain.
• Cavernous malformations in many parts of the brain and spinal cord can cause weakness or numbness in the arms or legs. In some areas, such as the thalamus, they can also cause pain. A cavernous malformation in the brainstem can cause coordination problems called ataxia or can cause facial paralysis, usually on one side.
• Cavernous malformations can cause vision problems. There are two kinds of vision problems: those caused by lesions in the occipital lobe of the brain, which affect how visual information is processed, and those caused by lesions in the brainstem, which affect how the eyes work.
• A cavernous malformation can cause hearing problems, including loss of hearing and tinnitus, dizziness, or nausea, particularly if it is located in or near the cerebellum.
• A cavernous malformation in the medulla, the lowest part of the brainstem, can cause spasms of the diaphragm, which resemble hiccups that don’t go away. More rarely, these can cause swallowing or even breathing problems.
• Cavernous malformation hemorrhages in the brain can cause fatigue. Individuals may complain of fatigue for months to years after a major hemorrhage or brain surgery.
• Spinal cord cavernous malformations can cause numbness, weakness, paralysis, tingling, burning, or itching. The location and extent of the symptom depend on the level of the spine affected. Spinal cord lesions can also cause difficulty with bladder and bowel control.

9) HOW OFTEN DO I NEED AN MRI?

You and your doctor will decide how often to repeat your MRI. Some doctors advise their patients to obtain repeat MRIs on a specific schedule. Others suggest waiting until there are additional symptoms Experts suggest more frequent imaging for those who may not be able to report symptoms, like young children or those with intellectual or communication problems. These individuals may also need sedation for MRI. You and your doctor will weigh the risk of sedation against the benefit of imaging. CT scan is another kind of imaging that is sometimes used. CT scan is much faster than MRI, but the images are not as clear, and the CT scan involves exposing a patient to radiation. You may have a CT scan in an emergency when MRI is not available. People with multiple cavernous malformations should limit their exposure to CT scans as much as possible because it is not clear whether the radiation exposure can cause the development of more lesions. A doctor may suggest a cerebral angiogram also known as a cerebral arteriogram. This procedure allows the doctor to see the arteries and veins in your brain. A cavernous malformation is not visible on an angiogram, but the test is done when another type of blood vessel lesion, called an arteriovenous malformation, is suspected. If a cavernous malformation has a typical appearance on MRI, it does not require a cerebral angiogram as part of routine care.8) WHAT SYMPTOMS CAN A CAVERNOUS MALFORMATION CAUSE?

• Seizures are one of the most common symptoms of cavernous malformation (cavernous angioma, cavernoma). Seizures fall into two general groups: focal seizures that are local to one area of the brain and generalized seizures that involve both sides of the brain. All cavernous malformation seizures begin as focal seizures but some progress to generalized seizures. Neurologists use anti-epilepsy medications to control seizures. However, neurosurgeons have had good results in eliminating seizures with brain surgery if they are able to pinpoint which cavernous malformation is causing the seizures. Surgery is most successful when it occurs within two years of a first seizure. Brainstem and spinal cavernous malformations do not cause seizures.
• We know people with cavernous malformation experience more frequent headaches than other people. A headache does not necessarily mean a new hemorrhage. For the most part, we can’t distinguish a cavernous malformation headache from any other kind of headache. A headache unlike one you have ever experienced or headaches, particularly on the same side or general location as your lesion, may be related to your lesion. A headache may be related to your cavernous malformation if it is unlike one you have ever experienced or if it is in the general location of your lesion.
• The symptoms of a cavernous malformation hemorrhage depend on its location and size. Cavernous malformations can cause attention, memory, social skills, mood, and learning problems, particularly if the lesions are in the frontal, parietal, or temporal lobes, or in the cerebellum, even without obvious bleeding. This is particularly true for individuals with many lesions throughout the brain.
• Cavernous malformations in many parts of the brain and spinal cord can cause weakness or numbness in the arms or legs. In some areas, such as the thalamus, they can also cause pain. A cavernous malformation in the brainstem can cause coordination problems called ataxia or can cause facial paralysis, usually on one side.
• Cavernous malformations can cause vision problems. There are two kinds of vision problems: those caused by lesions in the occipital lobe of the brain, which affect how visual information is processed, and those caused by lesions in the brainstem, which affect how the eyes work.
• A cavernous malformation can cause hearing problems, including loss of hearing and tinnitus, dizziness, or nausea, particularly if it is located in or near the cerebellum.
• A cavernous malformation in the medulla, the lowest part of the brainstem, can cause spasms of the diaphragm, which resemble hiccups that don’t go away. More rarely, these can cause swallowing or even breathing problems.
• Cavernous malformation hemorrhages in the brain can cause fatigue. Individuals may complain of fatigue for months to years after a major hemorrhage or brain surgery.
• Spinal cord cavernous malformations can cause numbness, weakness, paralysis, tingling, burning, or itching. The location and extent of the symptom depend on the level of the spine affected. Spinal cord lesions can also cause difficulty with bladder and bowel control.

10) DO I NEED SURGERY?

If your cavernous malformation (cavernous angioma, cavernoma) is causing symptoms, you should have a very detailed discussion about surgical options with your neurosurgeon. The decision to have surgery always involves weighing risks and benefits. In general, experts recommend surgery if three criteria are met. First, the individual must have symptoms. Second, the cavernous malformation must have had at least two hemorrhages. Finally, removing the cavernous malformation will cause fewer deficits than another hemorrhage would. Sometimes, experts recommend surgery after just one hemorrhage. For example, surgery may be a good option for someone with epilepsy caused by a cavernous malformation even if they have only had one hemorrhage.
There are neurosurgeons who specialize in cerebrovascular (brain blood vessel) and skull base (brainstem) surgery. The experience level of a surgeon is the best predictor of a good surgical outcome. The American Academy of Neurological Surgeons offers a searchable directory of neurosurgeons by specialty. It is helpful to interview a number of surgeons, including asking them about their experience, and to consult with other patients through Alliance to Cure Cavernous Malformation before making decisions.

11) ARE OTHER TREATMENTS FOR CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA) AVAILABLE?

Doctors have treated cavernous malformation with stereotactic radiosurgery, also known as gamma knife, linear accelerator, X Knife, Brainlab, or cyberknife, for many years, but its effectiveness is not clear. In stereotactic radiosurgery, focused radiation is directed at the cavernous malformation without opening the skull. Experts now recommend that radiosurgery be considered only with individuals who have a single symptomatic lesion that is in an area of the brain where the risks of traditional surgery would be too high. Radiosurgery should not be used for treating cavernous malformations that do not cause symptoms or for cavernous malformation in people with the hereditary form of the illness, as the radiation itself might trigger new cavernous malformations to form. Other minimally invasive surgical techniques are being used more widely.
Researchers are working to find medications to treat cavernous malformations. It may take more than one medication to treat every situation. Medications could be useful to:

• Stabilize the cavernous malformation so it does not hemorrhage. Patients could use medications even before a first hemorrhage. This is particularly true for people with hereditary forms of the illness.
• Stabilize the cavernous malformation after a hemorrhage to reduce the risk of the lesion bleeding again. Remember, there is a high-risk time in the first years after a hemorrhage. During this time, it might make sense to use a stronger temporary medication.
• Slow or stop the development of more lesions in people who have multiple cavernous malformations.
• Shrink or destroy existing cavernous malformations. This is the ultimate goal.

12) DO I NEED GENETIC TESTING?

Most people with a cavernous malformation do not need genetic testing. We believe only 20-25% of individuals with a cavernous malformation have a hereditary form of the illness. If you have just one cavernous malformation, you need an MRI with special imaging called susceptibility-weighted imaging (SWI) to rule out the hereditary form. If you have multiple cavernous malformations but you also have a developmental venous anomaly (DVA), SWI will show whether your lesions cluster near the DVA or whether they are in other areas of your brain. If the cavernous malformations are only around the DVA, you do not need testing. Having multiple cavernous malformations clustered around a DVA is typical of the sporadic form of cavernous malformation. You can’t inherit or pass down the sporadic form of the illness. People who have multiple cavernous malformations that are not associated with a developmental venous anomaly should request genetic testing. Sometimes people are the first in their family with a hereditary form. You do not need other affected family members to justify testing.

13) WHICH GENES WILL THE LABORATORY TEST?

There are three known genes that, when mutated, can cause a hereditary form of the illness. Researchers have named them CCM1, CCM2, and CCM3. In the United States, individuals who trace their ancestry to the original settlers of New Mexico and Chihuahua, Mexico have passed a specific mutation of the CCM1 gene down from generation to generation since at least the early 1600s. Researchers call this the common Hispanic mutation. However, you do not need to be Hispanic to have the hereditary form of the illness. Hereditary forms of cavernous malformation exist in every ethnic group everywhere in the world.
Each child of a person with the hereditary form has a 50/50 chance of inheriting the illness. It does not skip generations. However, up to half of the people with a hereditary form may have lesions but have no symptoms. Individuals with a mutation of the CCM1 or CCM2 gene develop multiple cavernous malformations and some develop cavernous malformations under the skin.
Individuals with a mutation on the CCM3 gene may have additional features. About half of individuals with a mutation on the CCM3 gene have their first hemorrhage as children. They hemorrhage more often and develop new lesions more quickly, at a rate of 2-3 new lesions per year (compared to an average of one lesion every two years for those with CCM1 or CCM2 mutations). They may have other physical issues such as scoliosis and benign brain tumors, most commonly meningioma. They are also likely to be the first in their family with the illness. Patients with a CCM3 mutation need additional monitoring and should contact Alliance to Cure Cavernous Malformation to learn more about our special programs.

14) HOW DO I GET GENETIC TESTING?

A medical professional such as a neurologist, neurosurgeon, geneticist, or genetic counselor must order genetic testing. Only a few labs in the United States perform testing, and many insurance companies do not cover the expense. Our website contains a list of testing laboratories and information about our free genetic testing program for individuals who qualify. Depending on the laboratory, you will submit either a blood or a saliva sample for testing. It may take up to six weeks to receive results. After you have received your result, your doctor or genetic counselor can talk with you about genetic testing for other family members. This can be a difficult topic for extended families, and it is important to have the support of a health professional. Family members who are not experiencing symptoms may choose not to be tested or have their asymptomatic children tested. Genetic testing is a very personal decision.

15) SHOULD I HAVE CONCERNS ABOUT PREGNANCY WITH A CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA)?

At this time, experts believe women are no more at risk for hemorrhage during pregnancy than at any other time. But, a bleed during pregnancy can present challenges. Brain surgery to remove a cavernous malformation (cavernous angioma, cavernoma) during pregnancy is very rare but is undertaken in cases where a second hemorrhage would be life-threatening. Women with cavernous malformations can have a vaginal delivery if they have not had a recent hemorrhage. If your doctor suggests an MRI during your pregnancy, your MRI should not include gadolinium contrast. Women who have epilepsy and are on anti-epilepsy medications should talk with their doctors about the choice of medication and folate supplementation. Ideally, you should have this conversation before you become pregnant to prevent harm because some antiepilepsy medication can increase the risk of birth defects when taken in the first weeks of pregnancy. However, having a seizure during pregnancy can cause harm that is far more serious to the fetus. It’s important to continue antiepilepsy medication during pregnancy if you have had seizures and are pregnant.

16) ARE THERE SPECIAL ISSUES FOR CHILDREN WITH A CAVERNOUS MALFORMATION?

There is the potential for many special issues with children, depending on their age at diagnosis and their symptoms. Young children may not be able to tell you about symptoms, so it becomes important to schedule imaging regularly. On the other hand, it is also important to avoid overreacting so that children aren’t exposed to unnecessary medical procedures, radiation from CT scans, MRI contrast medication, and sedation. It is not always possible to strike a balance, and every parent will err in both directions at one point or another. As a child grows older and parents become more experienced, managing this illness becomes easier. Telling your child about his or her diagnosis can be emotional and can require a period of adjustment for your child. Try to explain in simple terms that are age-appropriate. Having a pediatric mental health professional ready to help can make this easier. A mental health professional can also help if a child with hemorrhage or surgery-related deficits struggles with peer relationships, restrictions on activities, or academics. You will need to explain your child’s illness many times to many professionals including school staff, as well as friends and other caregivers. Good support from other parents in the Alliance to Cure Cavernous Malformation community or your local special needs community can be helpful for you.

17) WHAT SHOULD I ASK MY DOCTOR?

If you don’t already know the answers to these questions, you may want to ask these at your next appointment and write the answers here.

• WHAT SIZE IS THE CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA)?
• HOW MANY CAVERNOUS MALFORMATIONS DO I HAVE?
• WHAT IS THE EXACT LOCATION OF THE CAVERNOUS MALFORMATION?
• WHAT FUNCTIONS DOES THIS AREA OF THE BRAIN CONTROL?
• DO THERE APPEAR TO BE ANY VENOUS OR OTHER MALFORMATIONS NEAR THE CAVERNOUS MALFORMATION?
• DOES IT APPEAR TO HAVE BLED PREVIOUSLY?
• IN YOUR OPINION, WHAT ARE THE CONDITIONS UNDER WHICH YOU RECOMMEND SURGERY TO REMOVE THIS CAVERNOUS MALFORMATION?
• IF I HAVE ANOTHER BLEED, WHAT SYMPTOMS WOULD YOU EXPECT?

Please also consult our additional questions to ask your doctor about specific situations, like surgery.

18) HOW DO I COPE?

Receiving a diagnosis of cavernous malformation (cavernous angioma, cavernoma) in the brain or spinal cord for you or a loved one can be difficult and upsetting. No matter your level of medical involvement, you will require a period of adjustment to a “new normal” which will include a time of grieving for what has changed. A counselor or other mental health professional can help if you experience emotional difficulty that interferes with your ability to get through your days. Close friends and family may have difficulty understanding, particularly if you don’t appear ill. The Alliance to Cure Cavernous Malformation online community or one-on-one peer support can be helpful as you look for others who share your issues.

19) ARE THERE OTHER WAYS I CAN BE SAFER?

Request a CD with your most recent MRI and a printed copy of the radiology report. This is good to have with you when you travel and in case of an emergency. You may also want to wear a medical alert bracelet indicating you have a condition that can cause a brain hemorrhage. Finally, you can have your medical information in more detail on your cellphone. Some cellphones offer apps that emergency personnel can access even when your phone is locked.

20) WHAT DOES ANGIOMA ALLIANCE OFFER PATIENTS AND FAMILIES?

Our mission is to inform, support, and empower those affected by cavernous malformation (cavernous angioma, cavernoma) and drive research for better treatments and a cure.
PATIENT INFORMATION: Alliance to Cure Cavernous Malformation provides extensive information on our website and in our newsletter. We announce new research findings as they are published. We host patient conferences with presentations by disease experts. You can view these at any time on our YouTube channel.
PATIENT SUPPORT: Alliance to Cure Cavernous Malformation offers patient support through Facebook, facilitated video conferences, and through our local Community Alliances. At our patient conferences, we offer time for attendees to share their stories.
GENETIC TESTING: Alliance to Cure Cavernous Malformation offers free genetic testing to individuals with multiple cavernous malformations who can’t get coverage through their insurance.
OPPORTUNITIES TO PARTICIPATE IN RESEARCH: Alliance to Cure Cavernous Malformation has a patient registry where you can sign up to be notified about research studies, including clinical drug trials, that are recruiting. We also are collaborators in multiple projects that are exploring the impact of the illness on patient’s quality of life.
CLINICAL CENTERS: Alliance to Cure Cavernous Malformation has a growing network of recognized Clinical Centers that provide expert multi-disciplinary care.
AWARENESS EVENTS: We sponsor volunteer-organized awareness opportunities around the country including community walks. In addition to these patient and family activities, Alliance to Cure Cavernous Malformation sponsors the annual International CCM Scientific Meeting, which brings together researchers from around the world. We provide consultations to assist with their clinical drug trial planning.

Hello, I'm hoping for more detailed feedback on the results of my recent MRIs. Specifically, how and why certain things were ruled in or out, and how to prioritize various pathways of care.
MRI results (with and without contrast, Clariscan 20cc). Standard, multiplanar, multiple sequence orbital protocol: Extraconal structures: "There is a small extraconal mass just lateral to the lateral rectus muscle measuring 8.3 mm in height 6.2 mm in width and 10 mm in length. As the signal intensity of muscle on T1 that brightens on T2 is not fat suppressed and does not enhance. It has fluid attenuation on T2." OPINION: "Small extraconal mass lateral to the lateral rectus muscle on the left. This appears to be a uniocular cystic lesions, but type is indeterminate from this study."
Everything else was reported as normal.
I go to the opthalmologist to get my contact lens rx renewed annually. I have my eyes dilated annually because I have hEDS and I know the eye issues that can go along with having a connective tissue disorder. This year, my opthalmologist saw fuzzy optical nerve borders. I started wearing glasses at age 8. Nobody, in over 30 years of eye exams, has seen this issue. She immediately referred me to the neuro-opthalmologist I'd seen after my head injury in 2015, so he could make comparisons to prior imaging. He looked at my eyes, looked at my records, agreed with her findings, also thought it might be intracranial hypertension (not uncommon with Ehlers-Danlos patients), and ordered the MRIs.
I had my follow-up with that neuro-ophthalmologist this morning. The visit was less than informative, at best. He couldn't find my prior records from 2016 to compare things with because they had "changed to a new system" - last month, he told me that my optical nerve borders did *not* look like that when I saw him in 2016. He looked visibly frustrated with his computer, and a little flustered. I get it. I hate when my university switches to a new system, too. But, telling me during this visit, "Maybe they've always been that way," wasn't helpful, or accurate. His advice was to "watch and wait" and follow up in six months.
My neurologist, who I've seen since 2015, immediately referred me to a different neuro-opthamologist so we can get more specific answers, but that appointment won't be for a few weeks. I'm following up with my regular opthalmologist next Saturday. If someone could provide additional feedback between now and then, I would be very grateful. I need to be grading Research Methods final papers and knowing more would help me focus on that.
I have noticed mildly descreased visual acuity over the past several years, but at 45 I attributed it to aging. My contact rx is currently 475/20. It used to be 550/20 when I was in my 20s. I've also noticed dry eyes, but since I have a dysautonomia dx, I attributed it to that. The steady pressure/discomfort in my left temple, upper cheekbone, eye, and surrounding scalp area I attributed to a flare-up of the occipital neuralgia issues I dealt with off and on since a minor head injury in 2015. That caused primarily left-sided pain, so I assumed it was back. I have hEDS, so I have pain most days. I manage it with Celebrex, a tens unit, and short periods of gabapentin when necessary. I mention this to emphasize that it hurts, but also that lots of me frequently hurts, and I tend to tune it out unless it's over a 5/10, or is sharp, nerve-type pain. Now I'm wondering if that pressure/discomfort is due to pressure from the extraconal cyst.
Questions:
1) What is the "uniocular cystic lesion" likely to be, and how do you know? The neuro-ophthamologist just kept saying "It's probably a cyst" and when I asked if it could be a capillary hemangioma or cavernous hemangioma (found those options here: https://www.ajronline.org/doi/pdfplus/10.2214/AJR.07.3117), he said, "Yes, yes, that's the most likely thing." He seemed relieved to have a thing to tell me. He didn't say how he knew that, and based on this response being at the end of 10 min of me asking what it was, I found it odd that only after *I* brought up those options did he mention it. Tell me it's because the MRI report says "It was fluid attenuation on T2" so that narrows the options down. I *think* I've figured out what that means, but I'm not a professional!! I would like a professional to explain this part to me.
My undergraduate degree is in nursing, I've finished my PhD coursework in Sociology and am working on my dissertation while teaching Research Methods. I have also taught Research Statistics. I do not have the background to answer these questions, but I do have the capacity to read a journal article. I want more information and more details, please. This is stressful. Reading about it is distracting and relaxing. Blame being a graduate student, but it is relaxing.
2) What should next steps be regarding determining the cause of the optic nerve inflammation? My ocular nerve borders are "fuzzy" bilaterally according to my opthamologist, and "I can see they're inflamed" according to my neurologist, and I have positive auto-antibody titers associated with Sjogren's [but also associated with POTS, and that's the reason I had that bloodwork done in the first place], and mild dry eye [dx by my opthamologist]. I've read that finding a Sjogren's focused rheumatologist is worth the effort if that's the most likely issue.
3) Two family members (niece and nephew) have been dx with hyperreflexia and are in the process of being evaluated for Chiari. My sister is on Topomax as of this summer; it has relieved her constant headache, present since age 11. My NP at my neuro mentioned topomax as a treatment option for intracranial hypertension, if that was the cause of my optical nerve border fuzzing. She mentioned that a lumbar puncture with opening pressure measurement would be something to assess to make sure I wasn't one of the small % of people who have intracranial hypertension but negative MRI findings. With our family issues (she sees all of us), she thinks that it's worth completely ruling out. Should I have that done before the rheumatologist consult? I don't know if that would be helpful information to have going into that appointment.
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Relevant history: 45yr old cis woman, 5'7", 175 lbs, dx of hypermobile Ehlers-Danlos Syndrome [two siblings, one cousin, two neices, and one nephew also dx with hEDS so far, with 5 family members suspected. We thought our symptoms were "normal" growing up.)
Extended history, if you want to read this far:
POTS, with a 32pt rise in HR and a 10mmHG rise in BP on TTT.
Iliac Vein stenosis, 28.9% on left common and 21.2% on right common [sister has over 50% and neice has over 75%].
"Blood coagulation disorder with prolonged bleeding time" [managed with tranexamic acid]. "Whole-mount PTEM study demonstrates low normal dense granules (1.55 dense granules/platelet. Occasional platelets with abnormally large or fused alpha granules and slightly increased canalicular network. Some platelets lack alpha granules."
Cervico-occipital neuralgia [post-head injury in 2015]
"white matter gliosis adjacent to the frontal horn of the left lateral ventricle which is unchanged. There is also a punctate area of gliosis within the left posterior frontal subcortical white matter adjacent to the motor strip which is unchanged. Possible etiologies include post-traumatic lesions, remote post-ischemic lesions, and migraine angiopathies/vasculitis. Less likely possibilities would include infectious/inflammatory and demyelinating processes." {dti MRI performed after head injury; 2015}
Myelomelacia at C2-C3; stable since 2015 [also post head injury, seems to be from the impact and is stable on repeat imaging]
Hx of iron deficiency anemia [well managed by my wonderful hemetologist].
Vascular oddities: Small hemangioma in liver seen on CT [vascular surgeon was concerned about what kind of EDS I might have and wanted to be cautious]. Small area of angiodysplasia seen during GI pill capsule procedure. Chronic Venous Insufficiency [enlarged veins in my legs seen on ultrasound, but without visible external varicosities]. Thoracic Outlet Syndrome, vascular [well managed with PT] **during an abdominal ultrasound, it was found that my aorta did not split where expected but instead split higher up than usual. This may explain why other family members have more severe iliac vein compression. Left pelvic venogram: "reflux into the internal iliac veins with flow arrest with exhalation which resolves on inhalation" Right pelvic venogram: "reflux into internal iliac vein and collaterals which subsides with inhalation" Refluxed pelvic veins found during venogram in March 2023 are being sclerosed this month.

I have a capillary hemangioma on my face and this is the makeup that covers it best. I am also interviewing for new jobs and only have a bit left. Any ideas on how to get some fast in Ireland?

Hello, I was diagnosed with conjunctival hemangioma in my left eye. Doctor says it’s not effecting my vision, it is not cancerous, and no clue how it formed. I seem to have it for a while, it was light pink ( not noticeable ) and became red ( noticeable ). I was prescribed timolol drops as research show it may help even thought I don’t have glucoma or eye disease. What other treatments are available out there ? Are there any holistic treatment ? Any advice is much appreciated.

30 years old, female. I went to an eye doctor with an issue in my eye that I have noticed for awhile. I did a few tests and doctor mentioned it seems like conjunctival hemangioma. She said it’s nothing that bothering my vision and more of an esthetic issue as it is noticeable in close up to the eye. She read a research article that timolol drops ( for glucoma ) may reduce it but no guarantee and not enough research available. She doesn’t want to refer me to a e specialist as it’s not emergency issue. Did anyone experience similar situation? Is there any other treatment available ? I am willing to find a private service if needed. Thank you!

Hi there! My 12 week old daughter has a medium sized raised hemangioma on her neck. We saw a pediatric dermatologist yesterday to discuss options. We decided on topical timolol since the dermatologist was not concerned about the location of the hemangioma. However, I am terrified about giving her medicine - even topical - and that it may affect her ability to breathe, sudden blood sugar drop, etc. I was just wondering other's experiences if they used Timolol for solely cosmetic reasons, or better to wait it out for the hemangioma to hopefully shrink? It seems an impossible decision - if we wait and the hemangioma doesn't shrink very much we may regret beginning Timolol. Or, if the effectiveness of Timolol is low and not worth the risks therefore better to just wait for the natural involution?
Thank you in advance from one very nervous mom!

This afternoon I noticed that my four year old daughter’s neck vein or artery is pulsating. Here is a video:
Her standing: https://youtube.com/shorts/2Z42DW31t5U?feature=shared
Her laying (harder to see in the video): https://youtube.com/shorts/eDkEreXfNwI?feature=shared
She was standing and reading when I initially noticed it… not physically exerting herself. I have never seen this before and it seems abnormal. I’m concerned that it could be a sign of a bigger issue.
Her medical history: -A few weeks after birth she developed a large segmental hemangioma near her left eye. She was put on topical timolol drops for a little over a year. It has involuted and she no longer takes medication for it. -Part of her work up at that time included a cardiac work up. They discovered that she had a hypoplastic aortic arch. She had monthly echos for a few months and then the pediatric cardiologist said that she grew out of it. He specifically said that she never needs to come back to see him again bc her echo was now normal. -Now at 4 years old she is a very active/seemingly healthy girl on no medicine with no known medical issues.
I am wondering if anyone could offer insight into what it looks like is happening. Is this common? Normal? Serious? Feeling very worried that something might have been missed when they did the work up a few years ago.
Thank you so much for your time!!

Looking for some advice/guidance/reassurance.
My son has an a hemangioma on his scalp so we were unsure about treating. Our pediatrician said to let it run its course but a specialist we brought him to recommended that we treat with topical timolol maleate 0.5% gel. We don’t really care about how it looks but we did worry about ulcerating or possible complications. When we asked the specialist about side effects or long term concerns of using a topical beta blocker, she said the systemic absorption was very limited and is very well tolerated in infants. Because of this, we decided to start the treatment at two months. We are still using it now at five months. Feeling anxious this week, I decided to look for more studies and I found one that really scared me. The link is below. I am aware that the study is for propranolol not timolol and is very small (only 20 boys in the whole study) but their post hoc analysis is terrifying. Here is a summary:
“Males treated with beta-blockers had substantially lower IQ scores than treated females and males from the general population, which is a matter of concern and should be considered when evaluating the risk/benefit ratio in less severe forms of infantile hemangioma.”
Link to full study: https://link.springer.com/article/10.1007/s00431-022-04674-7
Has anyone here read this? What are your thoughts?

Hi. I am uber sensitive. In fact even petroleum is setting me off. Now w a damaged barrier (I did not touch near area) its healing textured, weird different patters w a red line around where bandaid was (2 weeks ago, yeah allergic that too).
I ordered some medical grade dimethicone for my other healing spot from a hemangioma (well adult nake, acquired), which is also healing a little too red for my liking. That is about 3 weeks post.
It turns out the biopsy showed it was rosacea. Any ideas for helping these along on a budget?
Mature skin.
I have some TO buffet but was not sure ok. Would a cica ceramide serum help? I also ordered avene cicalfate dt wanting something suitable for my reactive skin. But it is supposed to help barrier and has copper peptides. Is it ok to use timolol gel or maybe not bc healing?
I plan on calling dem but thought maybe you might have some good ideas nc it was them after-all that told me to use Vaseline.
Thanks

Hi! I’m looking for research about how common bald spots are following infant hemangioma and any case studies people have heard about regarding the risks of beta blockers? We’re trying to make an informed decision about treating our 2 month old’s hemangioma. I flaired this the way I did because I’d also love to hear from anyone whose infant has had a hemangioma on their scalp - did you treat it or not? Were there issues with hair loss if untreated? If treated, did you notice any problems with sleep, etc?
Background: our 2 month old has a small (a little smaller than a dime) hemangioma on her scalp. Her pediatrician referred us to a dermatologist just to make sure and they recommended a beta blocker cream to treat it. Our stance has largely been “if it’s just an aesthetic issue that’s going to go away, why mess with it?” But they told us it could cause a bald spot later in life. In looking into this I see that it is a concern but I’m struggling to find how common of an issue it actually is? I don’t want her to struggle with a weird bald spot later on but also I’m seeing somewhat limited studies on the topical creams. It looks like Timolol (which I believe is what my derm wants us to put on it) hasn’t shown negative effects across across 279 infants who were studied (one had trouble sleeping but that was it) but that doesn’t seem like a HUGE sample size, especially given that the substance has been found in infant urine following topical administration and systemic absorption of it has been linked in adults to a host of heart and lung issues.
(Source: https://www.nice.org.uk/advice/esuom47/chaptefull-evidence-summary)
I guess I’m just struggling to choose a treatment that MIGHT have a health impact, however slim the chances, for a problem that’s ultimately cosmetic. Am I overthinking it?

What is glaucoma and how can you avoid it?

January is National Glaucoma Awareness month, and we’re sharing all the information you need to know about the eye disease, plus steps you can take to prevent and treat it.
Glaucoma affects roughly 400,000 Canadians and 67 million people worldwide, and is one of the leading causes of blindness. Educating yourself about glaucoma and understanding the many risks associated with it is an important step to help protect and preserve your eye health.

What is glaucoma?

Simply put, Glaucoma is a group of eye diseases that progressively degenerate the optic nerve, leading to loss of nerve tissue and potential blindness. The cause of these diseases is not entirely known, though some theories point to inadequate blood supply or poor perfusion, which is the passage of fluid through the circulatory system.
Typically, glaucoma arises when the eye is no longer draining fluid properly. This is due to an inefficient draining system slowing down the rate at which fluid leaves the eye, resulting in fluid buildup and increased intraocular pressure (IOP) in the eyes.
The pressure damages the eye’s optic nerve function, which can result in visual field loss or blurry vision. The vision loss will usually first appear in the peripheral vision, a warning sign that glaucoma may be present or on the horizon. The good news is, routine eye exams can usually determine if glaucoma Glaucoma was replaced with “this eye disease” as a result of excessive use of KW is present long before any vision loss is noticed by the patient.

Four types of glaucoma

There are “4 common types of glaucoma” you should know about out of the several forms that exist.

1. Primary open-angle glaucoma:

The most common form of glaucoma, primary open-angle glaucoma is when pressure is placed on the optic nerve. Aqueous fluid is produced inside the walls of the eye, but if too much of it is being produced within the eye or is not draining properly, it can create unwanted pressure. One theory behind why this happens is that when the eye’s drainage system becomes inefficient over time, resulting in optic nerve damage to the capillaries, which in turn damages the optic nerve as a whole and decreases the amount and quality of information sent to the brain.In people with open-angle glaucoma, this results in a loss of vision. Peripheral vision is affected first, followed by central.

2. Angle-closure glaucoma:

Also known as closed-angle or narrow-angle glaucoma. Chronic or acute, angle-closure glaucoma is a faster moving ailment that can cause vision loss within one day. Angle-closure glaucoma is caused when the drainage angle in the eye formed by the cornea and the iris closes or becomes completely blocked.Age-related glaucoma occurs when the drainage angle between the cornea and the iris are shut off or blocked. As one gets older, usually after 40, the eye lens enlarges, pushing the iris forward and shrinking the gap between it and the cornea. The aqueous fluid is then prevented from exiting your eye’s drainage system, creating the buildup of eye pressure and fluid. A family history of glaucoma is a cause of closed-angle glaucoma.

3. Secondary glaucoma:

This type of glaucoma can occur as the result of an injury, eye surgery, infection, or tumour growth in or around the eye, causing pressure to rise. It has also been linked to a variety of medical conditions, medications, and eye abnormalities.

4. Normal-tension glaucoma:

(Originality/Plagiarism) - In normal-tension glaucoma, optic nerve damage occurs despite normal eye pressure.

Risk Factors

While glaucoma can happen to anyone, the Mayo Clinic outlines some key risk factors that can contribute to the diagnosis, including: ● being over 60 years old ● a family history of glaucoma ● medical conditions, such as diabetes, heart disease, high blood pressure, or sickle cell anemia ● corneas that are thin in the centre ● eye injuries ● being extremely nearsighted or farsighted ● taking corticosteroid medications (like eye drops) for a prolonged period
Having any of these factors certainly does not mean you are guaranteed to develop glaucoma, but it’s always a good idea to be aware of your medical history and risk factors, and let your optometrist know if you have any questions or concerns. As we mentioned above, scheduling yearly eye exams is an excellent preventative measure to ensure your eyes are being monitored for the first signs of disease.

Diagnosing glaucoma

Optometrists have many tools when it comes to testing and diagnosing a patient with this eye disease (excessive use of KW). Depending on the specific case, they may use scanning, eye drops or simple diagnostic measures to determine if someone is suffering from the disease. The most common diagnostic tools include:
● Ophthalmoscopy: Eye drops are used to dilate the pupil. The doctor is then able to examine the optic nerve more clearly to determine if there is damage. ● Retinal Imaging: Similar to ophthalmoscopy, the goal is to view the optic nerve. In this case, laser scanning is utilized to form a fuller picture of the back of the eye. At FYidoctors, we use the Optomap Retinal Scanner during eye exams, for comprehensive digital imaging. ● Tonometry: This is a pressure test of the eye. Drops are used to numb the eye and a tool is carefully placed on the outside of the eye, which gives a pressure reading. Average pressure is 16 mm Hg, and although anything higher is not necessarily an indication of glaucoma, it is a possible sign, which optometrists will analyze. Non-contact tonometry (an air puff test) is also an option. ● Perimetry: A computerized visual field test in which the patient stares straight ahead and must identify lights that appear in their periphery. ● Gonioscopy: This test directly looks at the drainage system of the eye. Doctors will numb the eye and place a special lens on the exterior to examine the frontal area closely. ● Optical Coherence Tomography (OCT): A special type of imaging of the optic nerve and macula. OCT gives doctors precise information about potential damage to the nerve fibre layer of the retina that concerns glaucoma.
You may recognize some of these tests, as optometrists conduct similar exams during regular eye check-ups.

How to treat glaucoma

Once a doctor diagnoses a patient with glaucoma, the next step is looking at treatment options. Treatment typically is offered in one of two ways—medication or surgery. Although there is no cure for glaucoma, treatment and prevention protocols do exist to prevent further damage and vision loss.
According to the Glaucoma Research Society of Canada, “the primary effect of most glaucoma medications is lowering Intra-Ocular Pressure (IOP). This has been proven over the years to be an effective way to prevent or slow down the progression of the disease.”
Medications that lower IOP are a positive development in limiting the effects of glaucoma, and some common treatment protocols include:
● Beta Blockers: The most common beta blocker used is timolol. These drugs reduce production of aqueous humor (fluid in the eye), which will lower pressure. ● Alpha Agonists: Those who use alpha agonists will apply it to the eye to decrease aqueous humor productions and increase the outflow of liquid from the eye. Both activities lower IOP. An example of an alpha agonist is brimonidine. ● Carbonic Anhydrase Inhibitors: Common CAIs are brinzolamide or dorzolamide. They are applied to the eye and will also decrease the production of aqueous humor. ● Miotics: A common miotic is pilocarpine. This particular medication increases outflow of liquid and decreases IOP.
If medication is unsuccessful, doctors may recommend that a patient should consider having surgery. Glaucoma patients can either have laser surgery or filtering microsurgery. Laser treatment is conducted with a light beam, which makes multiple scars on the eye’s draining system, increasing the outflow of fluid in the eye.
In the case when laser surgery does not work, filtering microsurgery may be recommended. This is slightly more invasive—a drainage hole is created with a surgical tool to drain liquid. Your optometrist will know best which option to take in your unique case.

New glaucoma treatments

Diagnostics and treatment are evolving all the time. As research continues and scientists better understand glaucoma, more options for patients are coming to light. Glaucoma Today, a publication that explores new advancements in glaucoma care, has published several studies on new and promising diagnostic endeavours.
A 2019 study explores anterior segment OCT, otherwise known as AS-OCT. This precision angle imaging device offers an alternative to gonioscopy; it doesn’t require any contact with the eye and can be done in darkness under standard lighting conditions.
Teleophthalmology, or telemedicine, is the ability to conduct tests in the patient’s home without having to go to a doctor’s office, which is an especially useful tool amid the COVID-19 pandemic.
In Glaucoma Today’s 2019 article, portable IOP-monitoring devices are discussed, including the Icare tonometer (Icare USA), which allows for at-home pressure readings that can be shared with a provider remotely. This type of diagnostic tool could limit the time a patient spends in the doctor’s office and potentially help save health care resources.

In conclusion

Glaucoma can be confusing to navigate, which is why it’s always best to talk to your optometrist about treatment options. Scheduling yearly eye exams can help prevent glaucoma by detecting the disease at an early stage and stopping it in its tracks. Visit an FYidoctors clinic near you today to book your next appointment.
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Eyeglasses

My four week old daughter has a large infantile hemangioma on the side of her face, ear, chin and inside bottom lip. I just spoke with the doctor, and they started her on Timolol today, and will start oral medication when she’s 45 days old. Also, ordering her an MRI to rule out PHACES. Has anyone has good results with these medications? Hoping it won’t leave a large scar on her face :( Feeling overwhelmed to say the least!

To stop the visible symptoms of aging from appearing on your face, there are a variety of therapies that may be tried. But in most cases, these treatments will make it difficult for you to go about your everyday life.
Nevertheless, there is one approach that doesn't call for any downtime at all. This process is known as Photorejuvenation Treatment Machine. This face therapy procedure uses Deep Penetrating Light (DPL). It helps to penetrate the deeper layers of the skin to encourage collagen production.
The following are a few advantages associated with photo rejuvenation:
Benefits of Photorejuvenation
Remove all wrinkles
It is essential to maintain your face as youthful as possible. Medical spas use cutting-edge technology to eradicate all signs of wrinkles and replace them with smoother and softer skin.
Stimulating the formation of a DPL Photorejuvenation Device is the most effective method for reducing the appearance of deep wrinkles. In addition, to it works as a structural component and a promoter of cellular health. It also plays the role of a thickening agent throughout the body.
This naturally occurring protein declines with age, contributing to the appearance of deeper wrinkles. They remove wrinkles and renew the skin using photorejuvenation, which results in the skin having a more toned and youthful appearance.
Improve blood vessels
Photorejuvenation is a beautiful treatment choice for individuals who have damaged blood vessels and removes undesirable pigmentation and wrinkles from the skin. This treatment quickly fixes spider veins, port wine stains, capillary hemangiomas, etc. JOVS Skin Care Devices is an effective treatment for damaged blood vessels. However, operating on every patient who suffers from this condition is not necessary.
The laser is set to a specific wavelength and treats the tiny vessels' walls directly. The surrounding tissue can heal while any future bleeding is stopped due to this treatment.
Fix all pigmentation
Dark spots are another age-related issue that often affects individuals as they age. These are particularly common in people who have spent much time in the sun. These patches develop with time and give the impression of a dark brown color. Due to dark pigmentation, individuals may lose their beauty.
Photorejuvenation, which works as Anti-Aging, Skin Tightening and Lifting, may eliminate these imperfections and reveal the inherent beauty of the skin's surface. It improves the body's capacity to create collagen while assisting in restoring sections of the pigment that have been damaged by the sun. Consequently, newer, brighter skin has begun to surface underneath the previously present darker areas.
Helps in overcome Rosacea diseases
Rosacea is a disorder that causes the skin to become flushed and red. Tiny bumps and pimples often accompany it. It can lead more a more dangerous disease known as pustular rosacea. Many patients who suffer from rosacea discovered that photorejuvenation therapies effectively alleviate their symptoms.
The light energy released at Home DPL For Hyperpigmentation may reach several millimeters under the skin's surface and can even go through the top layer of the skin to reach its target. The therapy alleviates the inflammation and discomfort linked with rosacea since it targets the deeper levels. It decreases edema and redness while also improving circulation throughout the body.
Long term impact
When you use JOVS Skin Care Devices, your skin becomes more transparent and more evident as time goes on. Many individuals need repeated treatments, with a gap of one month between each treatment.
Even though everyone's skin responds differently. There is a possibility that each treatment may result in an improvement. It may take 5-6 sittings for each person. Through Photorejuvenation devices, one can make easily brighten skin.
Work for all types of skin.
The DPL treatments are more effective on those with light to medium skin tones. photofacials may be performed on patients of any skin type without the risk of infection. This is because persons with lighter skin have lower melanin levels, which makes it simpler for IPL energy to target areas of unwanted pigmentation without causing damage to the skin's surface.
DPL photorejuvenation therapies is safer options to individuals of all skin types. However, extreme darker skin should choose less severe photorejuvenation treatments to prevent pigmentation concerns.
Help Tighten Skin
DPL devices penetrate the skin and improve cells. It can cure other cosmetic problems by initiating boosted collagen production and cell regeneration. This is quickly done through applying DPL on surface of skins
Conclusion
JOVS Skin Care Devices is a good alternative for people wishing to enhance their complexion without downtime. Photo-rejuvenation is a non-invasive therapy for photodamage and other superficial skin. While it costs more than other treatments, it has minimal side effects. The Jovs devices come in different varieties. All the appliances worked for various purposes.

Male
28 years old
139 lbs
5’3
Current medications:
• Timolol Maleate Opthalmic Solution USP (eye drops to regulate eye pressure)
• Merronidazole (topical, for acne)
• Clyndamycin Phosphate (topical, for acne)
• Ciclopirox (topical shampoo for acne)
• Ketoconazole Shampoo (also for acne)
• A 2-in-1 capsule of Vitamin D3 (125mcg) + K2 (100mcg) if it counts.
I had an MRI done to get a look at my optic nerve & incidentally, they found a hyperintensity on the left side of my brain, which is believed to be either focal cortical dysplasia, gliosis or lipid-poor hemangioma, amongst the few possibilities. I took my MRI to a neurologist & was repeatedly asked if I had any history of head trauma or epilepsy, which I denied. I did mention that I was born prematurely by about a month & the neurologist seemed almost sure that I have focal cortical dysplasia. He ordered an electroencephalogram which appeared abnormal as it revealed high potential for epileptic activity on the left frontal side of my brain. I was once again asked about any history of convulsions, brain fog, involuntary movements, loss of consciousness, confusion, staring spells, none of which I’ve ever experienced. At most, I’ve rarely experienced a mild eye twitch, possibly linked to being tired. I did share the following memory with the neurologist:
I woke up to have breakfast sometime around 2004-2006 & felt a bit sick. I remember feeling tired & closing my eyes on the breakfast table, only to be awoken by my mom freaking out because I had knocked over my milk. I don’t know if I was shaking or if I literally just knocked over my breakfast in the process of falling asleep at the table, though this had never happened before. I think I threw up afterwards. I was taken to the doctor to be told that I had low blood-sugar & that was that. I carried on with my life as normal. The neurologist insisted that this was possibly an epileptic seizure. He also mentioned that if I haven’t experienced any symptoms in the past 5-10 years, that he wouldn’t administer any further treatment & that I shouldn’t worry. Though he did continue questioning if I had a history of epilepsy. I know this is good news but it left me feeling a bit worried for some reason. I was wondering if someone could take a look at my EEG & share your thoughts, since it has so much language that I don’t understand. Also, I don’t take any benzodiazepines as speculated by the report.