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Cutera Xeo ND Yag For Leg Veins

I have to say I've been unimpressed with Cutera Xeo and its ND Yag laser for vein treatments.

Previous post: Cutera Xeo. Does it work?

We took possession of one of these Xeos about two months ago and have since treated a couple of patients, including some of our physicians and staff so that we could keep close tabs on both how well we thought it works as a treatment, the efficacy, time, etc. I have to say that we're somewhat unimpressed. My staff of physicians are really down on it, having used is on their own leg veins and seeing either such light results as to be nothing, or actually an increase in the visibility of the veins, which is exactly what we didn't want.

Another problem was found where, after a Yag treatment, one of my staff was injected with Sclerotherapy and had a previously unseen  and unwanted reaction in which the vein blanched black, something none of my physicians had ever seen before. One of our physicians was a big proponent of this Cutera, but as I said, we've so far been less than impressed. I would like to hear if anybody else has better results.

Laser treatment for veins, of course, are becoming increasingly popular and, to be honest, they're more profitable since they seem to be worth more to the patient and hence, you can charge more. At one of the seminars or symposiums I came away with the feeling that great reactions from a treatment with  lasers hovers around 5%, which I find abysmal.

Anybody with views, I'm happy to hear them because that's about a $130,000 piece of equipment and I would like to be able to get some use out of it rather than getting rid of it. I have to get multiple physicians to agree on it however.

Reader Comments (25)

Sclero is still the gold standard for vein treatments. Lasers still have a way to go before I'd buy one just for that. I'd also be interested to hear if there are any medspas that have had better results.
07.2 | Unregistered CommenterJabberMD
Hmmm... Skill, experience, and settings play the key role in vein removal. Laser anything is not a toy nor a "gun" you fire and say "its working or its not". You've got a pretty strong 1064 with the Xeo. We also have Palomar which also works well. More training recommended and checking your settings-- highly recommended Cutera USERS ONLY conference in Los Angeles this August. Hope to see you there! ( I will be happy to buy your Xeo for a good price! ) PS - if you have a
blanched black area setting may be too high if you heard a popping sound. Call the nurse at the Cutera's mainline -- she can help you out with clinical settings if you are a beginner with lasers, hopefully you have a warrenty or new contract with Cutera.
07.5 | Unregistered Commentermdman
Just another side comment which may or may not be related : when buying used lasers make sure you get all the clinical support needed. Preset settings and good price may not be enough.

1) Can I call other physicians who have Cutera with their clinical expertiese and settings?
2) Can I get a hold of someone immediately with clinical
concerns and problems?
3) How do I get updates on my system with advances in the technology with the Xeo if I buy used?

07.5 | Unregistered Commentermdman
Here are a couple of facts:

1. Sclerotherapy is the Gold Standard for vein treatment.

2. If you are treating spider veins you need to know if the patient has underlying venous disease. That should always be the first focus for treatment.

3. If you don't know what I mean by #2, you need to learn more about venous disease.

4. Threre was a mention of a black spot (the original post)that a patient had after sclerotherapy. That is called Necrosis (nectrotic tissue due to injection into an arteriole). It will heal on it's own and it may take several months. It may or may not leave a scar. Most likely not or so small that after several months it will not be noticable. It may also be that you injected the vein too soon after the laser treatment.


In my opinion Lasers are a poor substitute for leg vein treatment. I feel that they can be a good adjunct after sclerotherapy. sometimes the really small veins can't be injected and a laser can help in a situation like that.

07.19 | Unregistered CommenterMD
The Xeo does not work on veins.
11.4 | Unregistered CommenterCynicMD
CynicMD how can you throw out a comment with NO reason for belief? I have been in 4 different offices 3 of which had Cutera Xeo and the 1064nm wavelength is the better of any of the machines out on the market. have you read ANY of the clinicals on the Cutera? i think you are a sales rep. trying to throw crap against the wall to see if anyone will smell it.
05.8 | Unregistered Commentertruth

I would have to disagree with you. I have had my Cutera 1064 for 3 years and feel it is a good option for vein treatment. I have MANY happy vein patients treated with only the 1064. I have been able to get low pressure reticular veins up to 7mm with it. Sclero is a good choice as well. I have some patients that refuse to do sclero so the laser is their best option. My assumption is that you have not used the 1064 for any length of time. It does not do a good job on the very fine vascular netting but it di=oes a great job on spider veins.
05.8 | Unregistered CommenterLH

American Laser was not Rick Frisk he owned Advanced Laser and sold it to American. after a tragic family issue. He did work with American for two years due to a noncompete. He is back in the bussines I was just hired to work with him again. Who ever writes he is not ethical or honest you don't know him sit and watch the true storie will unfold.


If you are not getting results with the laser (assuming it is properly calibrated) then it's not the laser. It's you. What settings are you using and what type of vessels are you going after? Maybe we can help.

01.27 | Unregistered Commenterdexter

+1 on the Cutera 1064. This really does work well for veins, provided you are using effective settings.

Recently, Cutera had a webinar on this topic - I'm sure you can access that on their reviews venous disease and its treatment in a reasonably comprehensive way. The settings given in that seminar are higher than the ones that Cutera publishes as its typical "beginner" settings.

01.27 | Unregistered CommenterTF

Vascular treatments with the laser probably take more time to master than many other laser treatments. There are more options for targeting vascular issues with Xeo or Coolglide 1064 than with any other laser on the market. The Xeo has the greatest number of spot sizes and fluences available to treat various vascular conditions. Education here is key. Understanding vascular conditions, what should and should not be treated with a laser, and ideal parameter settings are all good places to start. There are many vascular webinars online at Don't give up before you've gotten going!

02.28 | Unregistered CommenterGoLaser

Is the cutera 1064 good for arne scars, e.g. atrophic scars & some ice pick scars on face. I am looking for a treatment to get rid of my scars on face, as i know on the market, cutera and fraxel lasers probably the best laser treatment on this. Is anyone has experienced on it? thanks

06.24 | Unregistered Commenterneed help

In addition to my message above, I am a 24 years old male with fair skin. after finished taking prescribed roaccutance for a month, i have not got any acnes again. With atrophic/icepick/boxcar acne scarring on my face, which treatment is THE BEST to get rid of this? Thank you for all advise

06.24 | Unregistered Commenterneed help

need help,

Do not waste your money on using Cutera 1064 for acne scars. The fraxel is OK.

06.24 | Unregistered CommenterLH

Thanks LH. Any other treatment better than fraxel? is fraxel the best? which type of fraxel treatment? repair? restore? thank you

06.24 | Unregistered Commenterneed help

I do not have experience with the fractionated CO2's but some form of fractionated laser treatments seem to be what most physicians are leaning to.

06.24 | Unregistered CommenterLH

why did u say that cutera xeo is not good at all on acne scarring? did u experience this treatment before? Any idea which treatment should i go for in order to get the best result ",) thanks

06.24 | Unregistered Commenterneed help

need help,

I am a physician. I have offered the 1064 in the past as laser genesis. I no longer offer it as I do not feel it is worth the time or money.

06.24 | Unregistered CommenterLH

Any Suggestion or Advise on which treatment is the best for acne scarring?

LH, could you please tell me more of your experiences regarding this, if you dont mind. thanks............

06.24 | Unregistered Commenterneed help

need help,

You needs some form of resurfacing. I like fractionated resurfacing as the risks are lower than full resurfacing or dermabrasion.

06.24 | Unregistered CommenterLH

With atrophic/icepick/boxcar acne scarring on my face, could fractionated resurfacing really work on it? In your opinion, which kind of fraxel laser work well to my situation? fraxel restore? fraxel repair? or other... Thanks

06.24 | Unregistered Commenterneed help

I have tried and eliminated all type of veins, from fine telangiectasias until varicose thick veins with Nd Yag 1064 of cutera. To achieve this success, it is needed training and ability in the use of the technology cutera.

02.11 | Unregistered CommenterLazaro

For example to treat reticular veins of 5 mm to 10 mm of diameter you can use fluencias of 100, 120, 135, 150, 160, 180 j / cm, pulses of 20, 35, 45, 55, 60 ms, and spots of 7 mm, 10 mm.

02.11 | Unregistered CommenterLazaro

the setting announced in the previous post, you also can try and eliminate varicose veins.

02.11 | Unregistered CommenterLazaro

Lazaro: I have read every published study I can find with regard to leg vein treatments with long pulsed Nd:YAG lasers and I have NEVER seen any clinician suggest that 1064 nm laser treatment is efficacious for coagulating a vessel larger than 4 mm diameter. It seems to be unanimous amongst the highly recognized experts in the field that vessels larger than 4 mm diameter require either sclerotherapy or endovenous laser therapy.

Several clinicians that participate in this blog regularly are forming a group to discuss this subject matter and you might want to joint he group and communicate with them about this. We have the benefit of sharing (unbiased) information with experienced practitioners all over the world who are not being paid by anyone else for their expertise.

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