A Plastic Surgeon Breaks Down What You Need To Know About Excel V

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Vascular skin concerns like rosacea, port wine stains, varicose veins, and broken capillaries are notoriously hard to treat without dermatologist intervention. Take it from me—well, I personally don’t have any vascular skin concerns, but my partner of 15 years has a port wine stain birthmark that covers the left side of his face. Every two years or so, he has to get laser treatments to help treat pigmentation and keep it from causing further damage to his face. And every two years, he has to take at least a week off work to recover from his typical V-Beam pulse dye laser treatments. His face gets heavily bruised and swollen, and honestly, it’s just a lot of downtime for a relatively common procedure.

V-Beam lasers have been around for over 30 years, but there’s a new treatment on the block—Excel V. Excel V takes laser technology for vascular treatments to the next level, providing a more comfortable, effective procedure with less downtime. Want to know more? Keep reading to learn more about the procedure, and find out just what the Excel V treatment costs, below.

What Is Excel V?

Excel V is a laser treatment system that primarily treats vascular skin concerns like broken capillaries, spider and varicose veins, rosacea, port wine stain birthmarks, and cherry angiomas

According to Alexis Parcells, MD, board-certified plastic surgeon, owner of Parcells Plastic Surgery, and founder of SUNNIE Wrinkle Reducing Studio, “The Excel V Laser system is a high-powered green laser designed to target abnormal blood vessels and pigmented skin lesions. Excel V treats nearly twenty unique aesthetic and dermatologic skin concerns. The most common treatments include rosacea, facial and leg veins, age/brown spots, and acne scars.” It can also help reduce acne scarring, fine lines and wrinkles, smooth out skin texture and in some cases, can even be used for laser hair removal, wart removal, and nail fungus removal. In other words, Excel V can do it all.

How does it work? And why is it so effective? Well, instead of traditional vascular laser treatments that use just one laser, Excel V uses a dual laser system: a 532 nm laser that targets blood vessels closer to the skin and people with lighter pigmentation, and a 1064 nm Nd: YAG laser that targets deep blood vessels and darker pigmentation. These two lasers are incredibly precise and can be used interchangeably to create a customized treatment. For example—if you have a port wine stain, some areas are darker, deeper and more pigmented than others. Excel V can tackle these areas, plus the less pigmented ones in one fell swoop. Iconic, tbh.

Meet the Expert

  • Alexis Parcells, MD is a board-certified plastic surgeon, owner of Parcells Plastic Surgery, and founder of SUNNIE Wrinkle Reducing Studio.
  • Anna Guanche, MD is a board-certified dermatologist and celebrity skincare expert.

Benefits of Excel V

Excel V has a host of benefits, including:

  • Can treat a range of skin tones, from very light to dark
  • Offers incredibly precise treatment
  • No long term downtime
  • Sessions are quick, ranging anywhere from 10 to 15 minutes
  • Non-invasive
  • Discomfort is minimal—people report it feels like a soft rubber band snap against the skin
  • No local anesthetic needed

Compared to other laser treatments, Excel V has relatively minimal downtime and is pretty quick. According to Dr. Parcells, “Each treatment takes approximately 10-15 minutes. Most patients require only 1-2 treatment sessions.” Anna Guanche, MD, board-certified dermatologist and celebrity skincare expert adds, “Benefits include quick and effective treatment with a great safety profile. There is limited downtime and adverse side effects.”

“Excel V can be altered to be compatible with each patient’s skin condition," says Dr. Parcells. "It also has an adjustable spot size which allows for precise and effective treatment from both superficial and deeper problems. And to ensure patient comfort, this laser uses new cooling technologies which produce continuous cooling before, during, and after the laser pulse."

How To Prepare For Excel V

If you’re planning on getting an Excel V treatment, there are a number of activities and products that you should avoid before your procedure:

  • You’ll need to completely stop the use of all self-tanners and avoid excessive sun exposure at least two weeks before your treatment. You should not be tan at all before your procedure, so load up on the SPF daily and make reapplication a priority.
  • If necessary, you should shave your face the day of the treatment to avoid stubble and ingrown hair.
  • You should not wax, get a facial or a peel, or use any depilatory products like Nair for about one to two weeks before your procedure.
  • If you have a history of cold sores, herpes, or fever blisters, please let your provider know. They will prescribe you an antiviral treatment to take before your procedure. Excel V can cause these issues to flare up.
  • You should also avoid the use of pain medications like aspirin and ibuprofen, iron supplements, blood thinning medication, vitamin E (topical and oral), and gingko, garlic, or ginseng for two weeks before your treatment, unless you are prescribed them by your primary care doctor.
  • Three days before your treatment, you should stop taking antibiotics like tetracycline.
  • If possible, do not wear makeup to your appointment.

What To Expect During An Excel V Treatment

If you’re getting an Excel V treatment on your face, you’ll be given a pair of protective goggles to shield your eyes from the laser. Your doctor will take a look at your face to determine laser intensity and get started.

As I mentioned earlier, the Excel V treatment is relatively pain free—you don’t even need numbing cream or anesthetic. Dr. Parcells adds, “Patients describe the treatment as feeling like a stinging sensation as the pulses of energy are delivered. To minimize discomfort, the Excel V uses a proprietary cooling mechanism. Following the treatment, pain is minimal to non-existent.”

You can expect to feel small, rubber band-like pops (or some people describe it as warm water running down your face) as your dermatologist glides the laser against your skin. 

After your treatment, you will probably notice slight redness and swelling—no need to ring the alarm bells, as this is completely normal.

Potential Side Effects

While the side effects of Excel V are minimal, Dr. Parcells explains you might experience swelling and redness around the treatment area. "Most people recover over 48 hours," she says. "Most patients show significant improvement within two to six weeks of treatment.  However, final results might not be apparent for several months.”

The Cost

The cost of Excel V has a ton of variables and the cost varies widely—it’s a pretty personalized laser. You’ll have to consider your location and the dermatologist providing your treatment, as well as the area and type of skin concern you have. The cost can range anywhere from $100 to $800 per session, with most people needing at least three sessions to see long lasting results. 


There are a number of aftercare procedures that you should make sure to follow strictly after your treatment for the best results. Your face might feel a little hot from the laser, so you can use a cool compress or ice pack. According to our experts, sun exposure is critical—you’ll want to completely avoid the sun for up to two weeks after your treatment so you don’t get any post-inflammatory hyperpigmentation. Dr. Guanche adds, “If using Excel V for leg veins, it is recommended to wear compression stockings for 48 hours after spider vein treatment and/or refraining from activities that pump blood to the lower legs.”

If you know you have a treatment coming up, invest in a sun hat or visor, some sunglasses and slather at least SPF 30 every day. If you have any pain, you can take a pain reliever like Tylenol.

You should also avoid heat, hot tubs, saunas, and exercise for a few days after your treatment. After two weeks, you’re free to resume using topical acne treatments like tretinoin, AHAs/BHAs, and benzoyl peroxides. 

The Final Takeaway

The Excel V treatment is a great way to combat vascular skin concerns with minimal to no-down time at all. The procedure is pain free and you should be able to resume normal activities within 48 hours to a week. Yea, it is a bit on the pricey side, but you should always check with your dermatologist office to see if they offer discounts for bulk purchases.

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