Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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Pages comparing lasers for cherry angiomas tend to quote efficacy percentages for each wavelength. Those numbers are almost never sourced. What can be said honestly is narrower and more useful: which wavelengths target blood, what the trade-off between them actually is, and why for a 2 mm red dot the choice of device is rarely the thing that decides your result.
What a Laser Is Actually Aiming At
Every vascular laser works on the same principle. Light at a particular wavelength is absorbed preferentially by one target in the skin — here, the haemoglobin inside the vessels. The absorbed energy heats those vessels enough to close them, while the surrounding skin, which absorbs that wavelength poorly, is left comparatively alone.
So the question “which laser” is really two questions: is this wavelength well absorbed by blood, and does it reach the depth this particular lesion sits at. Those two pull in opposite directions, which is the entire trade-off.
The Wavelengths That Target Blood
| Wavelength | Absorption by haemoglobin | Depth reached | Consequence |
|---|---|---|---|
| 532 nm (green) | Very strong | Shallow | Efficient on small, superficial lesions; less suited to anything sitting deeper |
| 595 nm (pulsed dye) | Strong | Moderate | Long-established for vascular lesions; characteristically causes temporary bruising |
| 1064 nm (Nd:YAG) | Weaker | Deepest | Reaches larger and deeper vessels, but needs more energy to do the same job |
That is the honest physics, and it is where most comparison pages stop being honest — because the next step is usually a table of clearance percentages per device. Those figures circulate widely without a source attached. We are not going to add to them.
IPL Is Not a Laser
Worth separating out, because the two are routinely discussed as though they were competing lasers.
A laser emits a single wavelength. IPL emits a broad band of wavelengths and uses filters to cut out the ones that are not wanted. That makes it flexible across several targets at once, and correspondingly less precise on any one of them.
For a small, well-defined red lesion, precision is the property you want. That does not make IPL useless — it makes it a different sort of tool, better suited to diffuse redness spread across an area than to a single 2 mm dot.
What This Clinic Actually Has
Most pages on this topic never say. Ours does, because comparing devices a clinic does not own is not useful to anyone deciding where to go.
The vascular platform at London Skin Clinic is the DermaV Nd:YAG (Lutronic), a dual-wavelength system combining 532 nm and 1064 nm. On the clinic’s own description, the 532 nm wavelength is used for superficial redness, thread veins and small capillaries, and the 1064 nm wavelength penetrates deeper for larger veins and vascular lesions. It is non-ablative, so it does not remove the skin surface, and it runs a cooling system alongside the beam.
Separately, the clinic uses the DEKA SmartXide CO2 for lesion removal. That is a different job: a CO2 laser targets water rather than haemoglobin, so it removes tissue rather than closing vessels.
There is no pulsed dye laser on the equipment list. We mention that deliberately — PDL is a well-established vascular laser and plenty of clinics use it, and a page that quietly omitted the wavelength it did not have would be a sales page rather than an informative one.
The clinic’s own published before-and-after record for cherry angioma removal is a DermaV treatment, so this is the platform used for these lesions rather than a general-purpose laser listed for other conditions. Which of the two methods suits a particular cherry angioma is still decided at assessment rather than in advance from a web page.
Why the Device Is Not the Main Variable
This is the part the comparison-shopping framing gets wrong.
A cherry angioma is typically 1 to 5 mm across and sits near the surface. It is, in laser terms, an easy target — which is why more than one method works on it. Two are used here: electrocautery, the usual choice, and vascular laser for selected lesions. Either of them, done completely, ends that lesion.
What actually varies between good and poor outcomes:
- Whether the lesion was assessed before it was destroyed. Both methods used here leave nothing to examine. A pyogenic granuloma, an angiokeratoma or, uncommonly, an amelanotic skin cancer can present as a red bump — which is why a lesion in any doubt is shaved so the tissue can be examined, rather than treated. Between two and five in every hundred lesions presented here as cherry angiomas turn out to be something else.
- Whether the settings suited your skin. In darker skin, treatments that are too aggressive risk post-inflammatory pigment change — which occurs in around 2% of treatments here. This is a matter of the operator’s judgement, not the badge on the machine, and it is sometimes the reason vascular laser is chosen over electrocautery rather than the other way round. In one case, a patient with darker skin and several small facial angiomas was treated with laser specifically to limit pigment change, with a good cosmetic outcome. Where there is a particular risk, a prescription treatment can be arranged at the consultation.
- Whether the depth was matched. A deeper lesion treated only at the surface can refill within weeks, which patients reasonably describe as it having grown back. We cover that in do cherry angiomas grow back.
- Whether you were told new ones will appear. No laser changes that, and a clinic implying otherwise is overselling.
Put plainly: for this particular lesion, who is holding the device matters considerably more than which device it is. That is an unglamorous conclusion and it is the accurate one.
Better Questions Than “Which Laser?”
- Will this lesion be looked at properly before anything destroys it?
- Is there any reason this one should be shaved and examined rather than treated?
- How will the method be adjusted for my skin type?
- If it does not fully clear, what happens then, and is a second session charged?
- How many can be treated in one appointment, and what will the total be?
Those change the outcome. The wavelength, for a lesion this size, largely does not.
Cost
| Consultation | £100 |
|---|---|
| First cherry angioma | £200 |
| Each additional lesion at the same appointment | £100 |
The price is per lesion rather than per session, and it does not vary by method — so the choice between laser and the alternatives is a clinical one rather than a commercial one: cherry angioma removal.
Common Questions
- Which laser is best for cherry angiomas?
- There is no single best wavelength for a lesion this small. 532 nm is strongly absorbed by blood but shallow, 1064 nm reaches deeper but is absorbed less strongly, and 595 nm pulsed dye sits between them. For a 1 to 5 mm superficial lesion all are capable, and the assessment and the operator matter more than the choice between them.
- Which laser does London Skin Clinic use?
- The vascular platform is the DermaV Nd:YAG by Lutronic, a dual-wavelength 532 nm and 1064 nm system, and it is the laser used for cherry angiomas — the clinic’s own before-and-after record for this treatment is a DermaV case. A DEKA SmartXide CO2 laser is used separately for lesion removal, targeting water rather than blood. Which of the two methods suits a particular lesion is decided at assessment.
- Do you have a pulsed dye laser?
- No. PDL is a well-established vascular laser used in many clinics, and it is not on the equipment list here. Cherry angiomas are treated with the methods that are available, all of which are capable for a lesion of this size.
- Is IPL as good as a laser for red spots?
- They are different technologies. A laser emits one wavelength; IPL emits a filtered broad band, which makes it more flexible across several targets and less precise on any one. For diffuse facial redness that flexibility helps; for a single well-defined red dot, precision is what you want.
- How many laser sessions will I need?
- Many cherry angiomas are dealt with in one, and some — typically larger or deeper ones — need a second. Judge the result once the area has healed rather than in the first few days.
- What clearance rate should I expect?
- About 97% of cherry angiomas treated here clear completely after one treatment, and around 3% need a second session, which is not charged. Roughly 1% return at the same site. Those are this clinic’s own figures across 300 to 500 lesions a year. We do not publish clearance rates broken down by laser type, because the figures that circulate for those are rarely traceable to a source.
- Is laser treatment suitable for darker skin?
- It can be, with the settings adjusted. The relevant risk in darker skin is post-inflammatory pigment change, which is why the method and the settings are matched to skin type at assessment. It occurs in around 2% of treatments, and where there is a particular risk a prescription treatment can be arranged at the consultation.
- Does laser removal scar?
- Marking is usually minimal for a lesion of this size, but it cannot be ruled out, and it varies with the lesion, the method and your skin. Anyone promising no mark at all is promising something they cannot know in advance.
The best treatment is the one that gives the safest result with the least visible mark for that particular lesion and skin type.
Mr Onur Gilleard, Consultant Plastic Surgeon
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