VBeam Laser Treatment in Danville, CA
VBeam Laser Treatment in Danville, CA
VBeam is a pulsed-dye vascular laser, and it remains the reference treatment for visible blood vessels in the skin: the persistent redness and broken vessels of rosacea, telangiectasias, cherry angiomas, port-wine birthmarks and poikiloderma of the neck and chest. It works because its light is absorbed by the haemoglobin inside the vessel rather than by the skin around it. At Dermatology and Laser Centre every VBeam treatment is planned and performed by Dr. Gergana Gallacher herself. The settings are matched to the diagnosis, the size and depth of the vessels and your skin tone, and she will tell you before you start whether to expect a few hours of redness or several days of visible bruising.
VBeam is a laser built for blood vessels in the skin. It is still the first choice for the lasting redness and broken veins of rosacea, for fine thread veins, for the small bright red spots people collect with age, for port wine stain birthmarks, and for the mottled red colour on the neck and chest. It works because the light is soaked up by the blood inside the vessel, not by the skin around it. At Dermatology and Laser Centre, Dr. Gallacher plans and carries out every VBeam treatment herself. She sets it for what is being treated, for how big and how deep the vessels are, and for your skin tone. She will tell you before you start whether you should expect a few hours of redness or a bruise for several days.
VBeam Laser: the essentials
The short version
595 nm pulsed-dye laser (PDL), long regarded as the reference device for superficial vascular targets.
A 595 nm pulsed-dye laser. It has been the reference machine for blood vessels near the surface for a long time.
Facial redness, rosacea-associated redness, telangiectasias, angiomas, port-wine stains and other selected vascular lesions
Facial redness, the redness of rosacea, fine broken veins, small red spots, port wine stain birthmarks and other blood vessel marks.
An integrated Dynamic Cooling Device sprays a burst of cryogen mist onto the skin with each pulse, so the surface is chilled at the moment the light is delivered.
A built-in cooling device puffs a burst of cold cryogen mist onto your skin with every pulse, so the surface is chilled at the exact moment the light goes in.
Usually redness and mild swelling, which in most patients settles within a few hours. Some settings and some diagnoses deliberately produce purpura, a bruise that can stay visible for several days.
Usually redness and mild swelling, and for most people that settles within a few hours. Some settings, for some problems, are meant to leave a bruise, and that can show for several days.
Varies by diagnosis, vessel depth, treatment endpoint and response; a series may be recommended
Depends on what is being treated, how deep the vessels are, what we are aiming for, and how you respond. A course may be recommended.
Works very well on fair skin and moderately well on olive skin. On darker skin tones it is used in selected patients only, with adjusted settings, because melanin in the upper layer of the skin absorbs the same wavelength.
It works very well on fair skin and reasonably well on olive skin. On darker skin it is used for selected people only, with the settings adjusted, because the colour in the top layer of skin soaks up the same light.
Dr. Gergana Gallacher performs all laser treatments personally. They are not delegated.
Dr. Gallacher does every laser treatment herself. It is not handed to anyone else.
What is the VBeam laser?
What is the VBeam laser?
VBeam is a pulsed-dye laser designed primarily to target hemoglobin in superficial blood vessels, making it a leading option for vascular redness and selected vascular lesions.
It is a laser designed to aim at the blood inside vessels near the surface of the skin, which makes it one of the best options for redness and for visible blood vessels.
VBeam is a pulsed-dye laser. It is usually described simply as a vascular laser, because it is the gold standard for treating vessels of all kinds: the fine capillaries and flushing of rosacea, telangiectasias, cherry angiomas, port-wine birthmarks and poikiloderma. The 595 nm wavelength is preferentially absorbed by oxyhaemoglobin, the pigment inside red blood cells, which is what allows the laser to heat the contents of a vessel while leaving the surrounding skin comparatively untouched. That selectivity is the whole point of the device, and it is why a laser designed for vessels outperforms a general purpose light source on vascular targets.
Pigment in the upper layer of the skin absorbs some of the same light on the way through, so settings are never generic. They are chosen for the vessel, the depth, the diagnosis and the patient in front of her.
VBeam is a pulsed-dye laser. Most people just call it a vascular laser, because it is the gold standard for treating blood vessels of every kind: the fine capillaries and flushing of rosacea, thread veins, small bright red spots, port wine stain birthmarks, and the mottled red colour some people get on the neck and chest. The light it uses is soaked up by the red pigment inside blood cells. That is how it can heat what is inside a vessel while leaving the skin around it largely alone. That is the whole point of the machine, and it is why a laser made for vessels beats a general purpose light on this job.
The colour in the top layer of your skin soaks up some of the same light on the way through, so the settings are never off the shelf. They are picked for the vessel, for how deep it is, for the diagnosis, and for you.
Who performs your VBeam treatment
Who does the treatment
At Dermatology and Laser Centre, laser treatment is not delegated. Dr. Gergana Gallacher performs every VBeam treatment herself, from the initial diagnosis through to the last pulse. That matters more with a vascular laser than with almost any other device, because the result depends on judgements made in real time: the endpoint being aimed for, how the vessel responds to the first pass, and when to stop. Those are clinical decisions, and she makes them at the handpiece rather than writing a protocol for someone else to follow.
Dr. Gallacher is a board-certified dermatologist, fellowship trained, and has held faculty appointments at Stanford University and the University of California, Davis. Only a small number of board-certified dermatologists in the United States hold both fellowship training and that teaching background.
At Dermatology and Laser Centre, laser work is not passed to anyone else. Dr. Gallacher does every VBeam treatment herself, from working out the diagnosis to the final pulse. With a vascular laser that matters more than with almost any other machine, because the result depends on judgements made as she goes: what she is aiming for, how the vessel reacts to the first pass, and when to stop. Those are medical decisions. She makes them with the handpiece in her hand, not by writing instructions for someone else.
Dr. Gallacher is a board-certified dermatologist with fellowship training, and she has taught on the faculty at Stanford University and at the University of California, Davis. Very few board-certified dermatologists in the United States have both.
Choosing the right device for the indication
Picking the right machine for the problem
VBeam is not the answer to everything, and it is not offered here as a catch-all. It is the right device when the target is haemoglobin in a vessel close to the surface. Where the vessel is deeper or larger, a longer wavelength vascular laser may reach it more reliably. Where the problem is brown pigment rather than red, a pigment-selective device is the correct tool. Where the concern is texture or scarring, resurfacing is the right conversation.
The practice keeps a range of current platforms specifically so that the device can be matched to the diagnosis rather than the diagnosis stretched to fit whatever machine is in the room. Dr. Gallacher will tell you when VBeam is the right laser for your concern, and she will tell you when it is not.
VBeam is not the answer to everything, and it is not sold that way here. It is the right machine when the target is blood in a vessel near the surface. If the vessel sits deeper, or is larger, a laser with a longer reach may do a better job. If the problem is brown colour rather than red, a laser built for pigment is the right one. If the problem is texture or scarring, resurfacing is the right conversation.
The practice keeps a range of up to date machines for one reason: so the machine can be matched to the problem, instead of the problem being bent to fit whatever machine is in the room. Dr. Gallacher will tell you when VBeam is the right laser for you, and she will tell you when it is not.
How does VBeam work?
How does it work?
The 595 nm pulsed-dye wavelength is preferentially absorbed by hemoglobin, converting light into controlled heat that damages selected vessels so the body can gradually clear them.
The light it uses is soaked up strongly by the blood inside the vessel. That turns into controlled heat, which damages the vessel wall, and your body then clears the vessel away over the following weeks.
Because pigment in the epidermis can also absorb light, the treatment must be adjusted for skin tone, vessel size and depth, and the condition being treated.
The colour in the top layer of your skin soaks up some of the same light on the way through, so the treatment has to be adjusted for your skin tone, for the size and depth of the vessels, and for the condition being treated.
Diagram showing VBeam pulsed-dye laser energy targeting hemoglobin in a superficial blood vessel
A diagram showing the laser light being soaked up by the blood inside a vessel near the surface.
What can VBeam treat?
What can it treat?
VBeam is most useful when redness, or a visible vessel, is what is actually driving the concern.
VBeam is most useful when redness, or a visible blood vessel, is what is actually bothering you.
- Rosacea-associated facial redness, flushing and the fine vessels that come with it.
- Facial telangiectasias and other small visible vessels.
- Cherry angiomas and selected haemangiomas, including in infants.
- Port-wine stains and other selected vascular birthmarks. These can be treated in infancy: VBeam is gentle enough for vascular abnormalities in babies.
- Poikiloderma of Civatte, the mixed red and brown discolouration of the neck and chest, where appropriate.
- Redness within a scar, where the vascular component is what is visible.
- Bruising after cosmetic injections or surgery, where VBeam can be used to speed clearance.
- Selected superficial pigmentation, such as some freckles and sun spots, although a pigment-selective device is usually the better first choice for brown marks.
- The lasting redness, flushing and fine broken veins of rosacea.
- Thread veins and other small visible vessels on the face.
- The small bright red spots people collect with age, and some blood vessel growths, including in babies.
- Port wine stain birthmarks and certain other birthmarks made of blood vessels. These can be treated in babies. VBeam is gentle enough for that.
- The mottled red and brown colour on the neck and chest, where it is suitable.
- Redness inside a scar, where the red is what shows.
- Bruising after cosmetic injections or surgery. VBeam can help a bruise clear faster.
- Some surface brown marks, such as certain freckles and sun spots, although a laser built for pigment is usually the better first choice for brown.
Does VBeam treat brown spots, scars, or other problems?
Does it treat brown spots or scars?
VBeam has a few uses that are not vascular, but it should not be presented as the first answer for every pigment, scar, wart, stretch mark or wrinkle concern.
It has a few uses that are not about blood vessels, but it is not the first answer for every brown spot, scar, wart, stretch mark or wrinkle.
VBeam may be considered for several vascular concerns, but suitability depends on the diagnosis, vessel depth, skin type, treatment area and the exact device settings.
It can be considered for a number of blood vessel problems, but whether it suits depends on the diagnosis, how deep the vessels are, your skin type, the area, and the exact settings.
Vascular birthmarks in infants and children
Birthmarks in babies and children
VBeam is safe and gentle enough to treat vascular abnormalities in infants. Port-wine stains and infantile haemangiomas are among the oldest and best-established indications for pulsed-dye laser, and for port-wine stains in particular, treatment started early in life is generally more effective than treatment started in adulthood, because the vessels are still fine and superficial.
Treatment of a baby or a young child is a paediatric dermatology decision, not a cosmetic one. It begins with a diagnosis, because not every red mark on a newborn is the same thing and some require imaging or paediatric input before any laser is considered. Sessions are short, the built-in cooling makes each pulse tolerable, and eye protection is fitted for the child. Dr. Gallacher performs these treatments herself and will set out honestly what a course is likely to achieve, over how many sessions, and what it will look like in between.
This is not a treatment most medical spas can offer. It requires a physician who can make the diagnosis first.
VBeam is safe and gentle enough to treat blood vessel birthmarks in babies. Port wine stains and the raised red growths babies can develop are two of the oldest and best proven uses for this laser. With port wine stains in particular, starting early in life usually works better than starting in adulthood, because the vessels are still fine and close to the surface.
Treating a baby or a young child is a medical decision, not a cosmetic one. It starts with a diagnosis, because not every red mark on a newborn is the same thing, and some need a scan or a paediatric opinion before any laser is used. The sessions are short. The built-in cooling makes each pulse bearable. The child is given eye protection. Dr. Gallacher does these treatments herself, and she will tell you plainly what a course is likely to achieve, how many visits it is likely to take, and what it will look like along the way.
This is not something most medical spas can offer. It needs a doctor who can make the diagnosis first.
Clearing bruising after injections and surgery
Clearing bruises after injections and surgery
VBeam can also be used to speed up the clearance of bruising left by other cosmetic or surgical procedures. A bruise is trapped haemoglobin, which is exactly what a pulsed-dye laser is built to target, so a brief low-energy pass over the area can shorten how long the discolouration remains visible.
At Dermatology and Laser Centre this is offered as a practical service rather than a footnote. If you bruise after a filler treatment, after a biopsy or after surgery, Dr. Gallacher can usually treat it, and in her experience the sooner it is done once the bleeding has settled, the better it works. It is short, it needs no anaesthetic, and it is the sort of thing that matters when there is an event in the diary.
VBeam can also be used to make bruising from other cosmetic or surgical treatments clear up faster. A bruise is blood pigment trapped under the skin, and that is exactly what this laser is built to aim at. A quick pass at a low setting can shorten how long the mark shows.
At Dermatology and Laser Centre this is a real service, not a footnote. If you bruise after filler, after a biopsy or after surgery, Dr. Gallacher can usually treat it. In her experience, the sooner it is done once the bleeding has settled, the better it works. It is quick, it needs no anaesthetic, and it matters when you have something in the diary.
What happens during a VBeam treatment?
What happens during treatment?
After the skin is assessed and eye protection is placed, laser pulses are delivered over the target while integrated cooling helps protect the epidermis and reduce discomfort.
Your skin is assessed, you are given eye protection, and pulses are delivered over the area. Cooling built into the handpiece protects the surface of your skin and takes the edge off.
Most patients report mild discomfort or none at all. The VBeam has a built-in Integrated Dynamic Cooling Device, which sprays a cold cryogen mist across the skin a fraction of a second before each laser pulse. This is a genuine cryogen spray rather than chilled air or a contact plate, and it does two things: it protects the surface of the skin, and it keeps the sensation for most people within the range of warmth and tingling as the handpiece is glided across the treated area.
Protective eyewear is worn by both you and Dr. Gallacher throughout. Numbing cream is not usually required, and if you have found other lasers difficult in the past, say so before you start so the plan can be adjusted.
Most people find this mild, or feel almost nothing. The VBeam has a built-in cooling device that puffs a cold cryogen mist onto the skin a split second before each pulse. It is a real cold spray, not chilled air and not a cold plate. It does two jobs: it protects the surface of your skin, and it keeps the feeling, for most people, to warmth and tingling as the handpiece is moved across the area.
Both you and Dr. Gallacher wear eye protection the whole time. Numbing cream is not usually needed. If you have found other lasers hard going before, say so before you start, so the plan can be changed.
What is VBeam downtime?
What is the recovery like?
Some patients notice redness or mild swelling in the treated area immediately after treatment. This usually goes away within a few hours, and most people go back to normal activity the same day. Makeup can generally be worn once the skin is comfortable.
Some people get redness or mild swelling in the treated area straight afterwards. It usually goes within a few hours, and most people carry on with their day. You can normally wear makeup once the skin feels comfortable.
| After treatment | What patients may notice |
|---|---|
| First hours | Redness, warmth, mild swelling |
| Several days | If purpura-producing settings are used, purple discoloration/bruising may be visible; treated vessels can look darker before clearing |
| Ongoing | Sun protection is important while the skin settles and to reduce avoidable pigment change |
The first few hours Redness, warmth, mild swelling.
The next few days If the settings were meant to bruise, you will have purple discolouration. Treated vessels can look darker before they clear.
From then on Keep the sun off it while it settles. That reduces the chance of the skin healing a different colour.
For some problems, and with some settings, a bruise is the aim. That is not something going wrong. It is a deliberate choice, because it clears certain vessels more reliably, and it can show for several days. Dr. Gallacher will tell you which of the two to expect before she starts, so you can plan around it. Keep the sun off it while it settles, for comfort and to lower the chance of the skin healing a different colour.
Some diagnoses and some settings deliberately aim for purpura, a purple bruise. This is not a complication. It is a chosen endpoint that clears certain vessels more reliably, and it can stay visible for several days. Dr. Gallacher will tell you which of the two to expect before treatment begins, so you can plan around it. Sun protection matters while the skin is settling, both for comfort and to reduce the chance of avoidable pigment change.
Who is a good candidate for VBeam, and when might another laser be better?
Who is it for, and when is another laser better?
VBeam works very well on fair skin and moderately well on olive skin. The reason is straightforward: melanin in the upper layer of the skin absorbs some of the same wavelength that is meant to reach the vessel, so the more pigment there is, the more carefully the treatment has to be planned, and the narrower the margin becomes.
You are likely to be a good candidate if the concern really is vascular, if the vessels sit close to the surface, and if you can keep the area out of strong sun around your treatment. Treatment is postponed if there is active infection, broken skin or significant inflammation unrelated to the target. Infants and children with vascular birthmarks are treated here, after diagnosis.
VBeam works very well on fair skin and reasonably well on olive skin. The reason is simple: the colour in the top layer of your skin soaks up some of the same light that is meant to reach the vessel. The more colour there is, the more carefully the treatment has to be planned, and the smaller the margin gets.
You are probably a good candidate if the problem really is blood vessels, if they sit close to the surface, and if you can keep the area out of strong sun around your treatment. Treatment waits if there is an infection, broken skin, or significant inflammation that is nothing to do with what is being treated. Babies and children with blood vessel birthmarks are treated here, once the diagnosis is clear.
- Patients with superficial vascular redness often have a strong treatment rationale for VBeam
- Darker skin tones are treated in selected patients only, with adjusted settings, because epidermal melanin can absorb laser energy
- Treatment should be postponed over active infection, open skin, or significant inflammation unrelated to the target condition
- If your redness is coming from vessels near the surface, this is a strong match.
- Darker skin is treated in selected people only, with the settings adjusted, because the colour in your skin soaks up laser energy too.
- Treatment should wait if there is an infection, broken skin, or significant inflammation unrelated to what is being treated.
VBeam treatment at Dermatology and Laser Centre: Dr. Gallacher performs every laser treatment herself.
A VBeam treatment here. Dr. Gallacher does every laser treatment herself.
What are the benefits and risks of VBeam?
What are the benefits and risks?
The main benefit is selective treatment of vascular redness with a device designed for that target; risks include temporary swelling and bruising as well as less common burns, pigment change, infection, or scarring.
The benefit is a laser built specifically for redness and vessels. The risks are swelling and bruising, which are temporary, and less commonly burns, changes in skin colour, infection, or scarring.
| Potential benefits | Possible risks / limitations |
|---|---|
| Targets vascular redness without removing the skin surface | Redness, swelling, purpura/bruising, temporary discomfort |
| Useful for multiple superficial vascular diagnoses | Temporary or persistent pigment change, blistering/burn, infection, scarring, incomplete response, recurrence |
What you can gain
Treatment aimed straight at redness, without taking the surface of the skin off.
Useful across several different blood vessel problems near the surface.
What you are accepting
Redness, swelling, bruising and discomfort for a while.
Changes in skin colour, which can be temporary or lasting, blisters or a burn, infection, scarring, an incomplete result, or the vessels coming back.
What are alternatives to VBeam?
What else could I do instead?
Alternatives depend on the vessel type, depth, skin tone and diagnosis and may include 1064 nm Nd:YAG vascular laser treatment, IPL in selected patients, topical or oral rosacea therapy, electrosurgery for selected lesions, or no treatment.
It depends on the type of vessel, how deep it is, your skin tone and the diagnosis. Options include a deeper reaching vascular laser, IPL for some people, creams or tablets for rosacea, an electric current for certain marks, or leaving it alone.
For rosacea, laser treats the vascular component but does not replace medical management of inflammatory bumps, triggers, or other disease features when those are present.
With rosacea, a laser treats the redness and the vessels. It does not replace medical treatment for the inflamed bumps, for your triggers, or for other parts of the condition, when those are present too.
Illustrative result
What a result can look like
The images below show what treatment of vascular redness and visible vessels can look like. They are shown to illustrate the kind of change a course of pulsed-dye laser treatment is aimed at, not to predict your own outcome. The number of sessions varies with the diagnosis, the depth and calibre of the vessels, and how you respond. Individual results vary.
The pictures below show what treating redness and visible vessels can look like. They are here to show the kind of change this laser is aimed at. They are not a prediction of your own result. How many sessions it takes depends on the diagnosis, on how deep and how large the vessels are, and on how you respond. Results vary from person to person.
Getting in touch
Getting in touch
If you are interested in treating redness, visible vessels or a vascular birthmark with a laser chosen for that specific job, and performed by the physician herself, contact Dermatology and Laser Centre. Our office is in Danville, California, and we welcome patients from Walnut Creek, Alamo, Blackhawk, Pleasanton, San Ramon, Lafayette and nearby communities.
If you want redness, visible vessels or a blood vessel birthmark treated with a laser picked for that exact job, and carried out by the doctor herself, get in touch with Dermatology and Laser Centre. Our office is in Danville, California. We see patients from Walnut Creek, Alamo, Blackhawk, Pleasanton, San Ramon, Lafayette and nearby communities.
> Builder note: "Blackhawk" is currently missing from the site-wide footer service-area line, which reads "Danville, San Ramon, Walnut Creek, Alamo, Pleasanton, Lafayette". Dr. Gallacher named Blackhawk explicitly. Add it.
Questions patients ask
Is VBeam painful?
Does it hurt?
Most patients report brief warmth, snapping, or tingling. Dynamic cooling is delivered with the laser to protect the skin and improve comfort.
Most people describe brief warmth, a snap, or tingling. Cold spray goes on with the laser, which protects your skin and makes it much easier.
Will VBeam make me bruise?
Will I bruise?
It can. Some settings are designed to avoid purpura, while other clinical situations may use a purpuric endpoint. Your physician should explain the expected appearance before treatment.
You might. Some settings are chosen specifically to avoid it. Others deliberately aim for it, because it works better for certain marks. Your doctor should tell you which to expect before you start.
How many VBeam treatments are needed?
How many treatments will I need?
There is no universal number. The diagnosis, size and depth of the vessels, treatment endpoint, and response determine whether a series is recommended.
There is no standard number. It depends on the diagnosis, on the size and depth of the vessels, on what we are aiming for, and on how you respond.
Can VBeam treat rosacea?
Can it treat rosacea?
VBeam can reduce the vascular component of rosacea, including persistent redness and visible vessels. It does not cure rosacea, and medical therapy may still be needed for other symptoms.
It can reduce the redness and the visible vessels of rosacea. It does not cure rosacea, and you may still need medical treatment for the other parts of it.
Can VBeam be used on darker skin?
Can it be used on darker skin?
In this practice VBeam is used on darker skin in selected patients only, with adjusted settings, because the risk-benefit balance changes as epidermal melanin increases. Dr. Gallacher assesses each patient herself and decides whether VBeam with adjusted settings is appropriate.
For selected people, yes, with the settings adjusted. The balance of risk and benefit shifts as skin gets darker, because the colour in your skin soaks up the same light, so Dr. Gallacher assesses each person herself and decides whether VBeam with adjusted settings is right for them.
Can VBeam be used on babies?
Can it be used on babies?
Yes. VBeam is safe and gentle enough to treat vascular abnormalities in infants, and port-wine stains and infantile haemangiomas are long-established indications for pulsed-dye laser. Early treatment of a port-wine stain is generally more effective than treatment started later. Any infant is assessed and diagnosed first, and Dr. Gallacher performs the treatment herself.
Yes. VBeam is safe and gentle enough for blood vessel problems in babies. Port wine stains and the raised red growths babies get are two of the longest established uses for this laser. Starting a port wine stain early usually works better than starting later. Every baby is examined and diagnosed first, and Dr. Gallacher does the treatment herself.
Can VBeam help a bruise clear faster?
Can it help a bruise clear faster?
Yes. Bruising is trapped haemoglobin, the same target the laser is designed for, so VBeam can be used to speed the clearance of bruising after cosmetic injections, biopsies or surgery. It is a short treatment and it works best when done early, once any bleeding has settled.
Yes. A bruise is trapped blood pigment, which is exactly what this laser aims at. VBeam can be used to help bruising clear faster after cosmetic injections, a biopsy or surgery. It is quick, and it works best done early, once any bleeding has stopped.
Does Dr. Gallacher perform the laser treatment herself?
Does the doctor do the treatment herself?
Yes. All laser treatments at Dermatology and Laser Centre are performed by Dr. Gallacher personally. They are not delegated to a technician or an assistant.
Yes. Every laser treatment at Dermatology and Laser Centre is done by Dr. Gallacher herself. It is not handed to a technician or an assistant.
Does VBeam work on brown spots and freckles?
Does it work on brown spots and freckles?
It can lighten some superficial brown marks, and a small number of non-vascular uses are recognised. But it is not the first answer for pigment, and it should not be presented that way. If brown discolouration is the main concern, a pigment-selective device is usually the better tool, and Dr. Gallacher will say so.
It can lighten some surface brown marks, and there are a few uses for it that are not about blood vessels. But it is not the first answer for brown marks, and it should not be sold as one. If brown colour is your main concern, a laser built for pigment is usually the better tool, and Dr. Gallacher will tell you so.
Talk it through with a physician first.
Every plan starts with an assessment of your skin, your anatomy and what you actually want to change.
This page is general health information, not medical advice. It cannot tell you whether a treatment is right for you. Approved uses, risks and results differ from person to person, and product labelling changes. Ask us at Dermatology and Laser Centre about your own situation, or make an appointment, and seek urgent care for any serious symptom.
