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IPL vs. V-Beam for Rosacea

I was recently diagnosed with Rosacea but I also have Melasma. My Melasma is mixed epidermal and dermal and not very noticeable, in fact I don't think my dermatologist would have identified it if I hadn't pointed it out. Which is the best modality for treatment of my vascular Rosacea and carries the least risk of triggering hyperpigmentation? I realize there is always a risk but I'm hoping one is less risky than the other.. I just don't know which.

Doctor Answers (7)

V beam pulse dye laser, conservative settings PLUS HQ and Lytera

+1
This is a common condition that Im faced with on a weekly basis- melasma and rosacea. The ABSOLUTE first step is control of your melasma, as laser or IPL can make this worse. 
This is how I manage these two conditions in the one patient.

1. Treat melasma first- this means SPF+++. I like Lytera as it is less irritating on your skin and hence won't flare up your rosacea. 

2. Add HQ in a steroid base - short term. Percentage depends on how sensitive your skin is, as you have rosacea. 

3. Treat your rosacea like walking on egg shells- namely medical treatments before laser. Your medical dermatologist may use creams or compounded solutions. 

4. If the above fails, then I would use V Beam PDL - settings are different from my normal rosacea patient without melasma. I would be conservative, and most importantly you should be on melasma management 2-4 days after the laser (this decreases the chances of flaring up your melasma)

hope this helps you understand our thought processes in treating two conditions in the one patient. 

All the best
Dr Davin Lim 

Laser Dermatologist
BRISBANE, Australia


Brisbane Dermatologist
5.0 out of 5 stars 1 review

Use Melarase AM and Melarase PM with PDL and IPL treatments

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I have both laser and IPL in my practice and would use a combination modality treatment with both systems in the setting of pre and post treatment with skin lighteners.  I prefer the Melarase AM and Melarase PM line of products as pretreatment before IPL and pulsed dye laser. 

Raffy Karamanoukian MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Go With Vbeam for Rosacea

+1

The Vbeam laser is highly specialized for treating Rosacea. The general idea behind lasers is that they use a single wavelength to accomplish a specific objective. The Vbeam uses the 595nm wavelength because this form of light is easily absorbed by oxygenated hemoglobin carried by your blood cells.  This serves as the target point of entry for the laser to enter your skin. Once it is in your blood vessels, it heats the walls which causes them to seal off and become non-functional tissue that is disposed by the body. 

Since Rosacea is basically a condition of unwanted blood vessels, the Vbeam is an ideal tool for clearing this condition.

IPL is not able to accomplish this because it uses many different wavelengths. Although positive benefits have been reported, the outcomes are not predictable. 

Watch the video below to see the Vbeam in action on a real patient.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 23 reviews

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V-Beam for rosacea

+1

V-beam is a targeted therapy for rosacea. It helps with overall redness as well as dilated blood vessels on the face. You may need multiple treatments to achieve the results you want.

Gary Goldenberg, MD
New York Dermatologist

V-beam vs IPL for rosacea

+1

      V-beam is a pulse dye laser that attacks red pigment in your skin, in other words small dilated blood vessels and red spots that are a hallmark of rosacea. The nice thing abot V-beam is that it targets just the red stuff, while sparing the rest of the skin. It does not work as well for the purple vessels though. Usually you may need multiple treatments to improve skin color. This therapy is good in conjunction with topical therapy or medical therapy non-responders. 

Joseph Shvidler, MD
Tacoma Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Go with the V-beam

+1

The v-beam is a more specific and safer treatment for your blood vessels than any IPL and will usually require far fewer treatments than IPL.  If you are trying to get improvement for the melasma, you might be a good candidate for the Fraxel Dual laser.  Definitely wear sunscreen after your v-beam treatment given your set of issues.   

Laurie Jacobson, MD
Seattle Dermatologist
4.5 out of 5 stars 11 reviews

IPL vs. Vbeam

+1

In general, almost any laser can worsen melasma; however, this risk can be decreased by using a prescription bleaching cream prior to the procedure, such as hydroquinone.  In general, the Vbeam is a more targeted therapy for blood vessels, rosacea, and facial redness.  This is because the Vbeam is single wavelength of light, whereas the IPL is a broad spectrum of light and is much riskier to  use when treating patients with melasma.  

Timothy G. Rodgers, MD
Frisco Dermatologist
4.5 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.