Couperose and pigmentation spots

Do you suffer from red discolorations and broken veins (couperose) or dark spots (pigmentation spots) in your face or on your hands? Unfortunately, these usually harmless conditions do not go away on their own. Fortunately, there is something that can be done about it. Cosmetic doctor Shai Rambaran and skin therapist Silvia Scheurwater of the Van Rosmalen clinic tell you all about it in the article below.

What is couperosis?

Silvia: Couperose are red discolorations and burst veins in your skin, especially on the side of the nose, on your cheeks, forehead or chin. These are caused, among other things, by excessive exposure to the sun: superficial veins in the skin become weaker and expand. Couperosis usually develops after the age of 30 and is more common in people with fair skin. Women suffer from it more often than men. Couperose is aggravated by high temperatures such as a sauna or hot shower. But also because of alcohol, stress or spicy food. Light-skinned people are more likely to develop rosacea and hereditary predisposition also plays a role (thickness of the arterial walls). Couperose is similar to rosacea, but the symptoms are different (in rosacea: red bumps, pus heads and swellings).

What can you do about it?

Silvia: Unfortunately Couperose does not disappear by itself, but fortunately it is treatable. In the Van Rosmalen clinic we treat rosacea with a vascular laser and IPL. This combination allows us to achieve the best results. The vascular laser targets the deeper large vessels and IPL can reduce small vessels and diffuse redness. You will feel small pricks in your skin during the treatment. After the pulse, the feeling immediately disappeared. Hemoglobin (red color in the blood) absorbs the energy and converts it into heat. The heat destroys the vessel and also provides enormous collagen stimulation. After a few treatments, the vessels are less visible, your skin feels tighter and the pores are sometimes less visible. The skin may be a bit red and swollen, but this disappears after a few days. For a good result you need several treatments (3-5) with an interval of at least 1 month.

This gentleman suffers considerably less from couperose after treatment (right)

Pigment spots

Shai: pigment colors our eyes, skin and hair and protects our skin against UV radiation. If we expose our skin to the sun for too long, the cells that make pigment get confused, causing build-ups of pigment: these are the dark spots on your skin. There are different types of pigmentation spots. The best known are: age spots, pregnancy mask, also called melasma.

Age spots (Lentigo)

Age or sun spots are common in people over the age of 50. They are brown spots on the skin that has been (too) exposed to sunlight, such as hands and face. These spots are almost always benign. Almost everyone suffers from pigmentation spots with age, both men and women. These brown spots are most common on your face, décolletage, or arms and hands. The spots can also be caused by medication.

If you are pregnant, the spots can become much more intense. It is then called a pregnancy mask aka melasma (it is caused by pregnancy hormones). The spots are harmless, but can cause a restless image. In some cases they disappear after pregnancy, but unfortunately we also see that the spots remain visible. Melasma and age spots can be treated in different ways. But the very best advice I can give is: prevention through treatments and the right skincare.

How do you prevent pigmentation spots?

Shai: By good education: from an early age do not expose the skin excessively to harmful sunlight and apply a sunscreen with a high SPF (30 or higher) every day. Skin damage caused by the sun is stored in the DNA and can develop into skin cancer at an older age.


on the right you see fewer pigment spots after the treatment

The treatment

Shai: All pigmentation spots are generally treatable. Whether they will disappear completely depends on a number of factors such as size, color and skin type.

We treat pigmentation spots with the laser, a peeling, microneedling (enterpen) or cryopen. And because beautiful skin starts at home, I advise our clients to invest in good skin care products that really do something for your skin: cosmeceuticals. These products have a high concentration of active ingredients that lighten the pigment spots. This is 30% of the result. In a first consultation without any obligation, we give our clients tailor-made advice about which treatment is most suitable for his or her skin.


The cryopen can freeze the spot with high pressure to the nearest millimeter so that the surrounding tissue remains undamaged. After the treatment, the skin around the spot may turn a little red. This disappears after a few days, just like the scab on the treated area. For a good result, this treatment must be repeated at least 3 to 4 times. The cryopen does not cause scarring.


The laser treatment aims to remove the excessive and unwanted pigment in the skin and is only suitable for dark spots. The doctor or skin therapist treats the affected areas locally. If there are multiple spots scattered in the face, the entire face is treated. This energy is absorbed by the pigment in the skin, so that it breaks down and the pigment is reduced. You will see that the pigment spots then temporarily darken slightly, after which the pigment comes out of the skin speckled and you are/become much more even. The laser flash feels like a pinprick, after the pulse it disappears immediately and you can only feel some heat.

When determining the strength, the depth of the pigmentation spot, the thickness of the skin and the skin type are taken into account. For superficial pigmentation spots, 1 to 2 treatments are required. For deeper pigment spots, several treatments (4-6) are required to achieve a good result.


Pigmentation spots can also be reduced with a chemical peel to remove the top skin cells and pigment granules from the epidermis. The result is an improved and fresher skin structure. Several treatments are required for good results. The effectiveness of a peel depends on the strength of the acid used. Before the peels, you should prepare your skin at home with some cosmeceuticals. This contains the same ingredients as in some peels, only less concentrated. As a result, we achieve faster results, you have less downtime after the treatments and you retain the result longer. The skin therapist will tell you exactly which product is suitable for your skin.


Do you no longer want to hide your couperose or pigment spots under a layer of make-up after reading this story? And do you want to preventively prevent that you get more and more pigment spots and couperose every year? Then let us advise you about a tailor-made treatment. Choose a clinic that is certified by the NVCG. This way you know for sure that your skin is in good hands.

Do you suffer from a different kind of spots or imperfections in your face? Then read the previous skin specials that appeared at Anti-Aging Secret. See, for example, the articles by Silvia Scheurwater on melasma or rosacea.

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