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Nd:yag 1064nm for Broken Capillaries on Nose: WARNING - Can Cause Scarring! - London, UK

Some background: I am 30 years old and have been...

Some background: I am 30 years old and have been suffering from moderate Rosacea for a few years and have sought various treatments with varied result. I had a series of IPL treatments two years ago, which initially helped, but then gradually my skin changed in texture, became much less elastic, more sensitive and rough (enlarged pores, more lines, more melasma etc). After having read about others with similar experiences on this forum I understood that this was due to the IPL and have ruled this out as a treatment. I also tried Pulsed Dye Laser, with bruising, with little results. My dermatologist suggested that this is due to the fact that my rosacea is not very severe and that the laser does not respond so well to smaller vessels.

The treatment: Realising that there is little I can do to radically improve my Rosacea, apart from antibiotics and observing a good diet and life style, I decided to just take care of a few persistent red veins on the side of my nose. My dermatologist recommended Nd:yag 1064 nm (I believe the make is Fotona). I had the treatment on Monday, it is now Thursday. The treatment was unpleasant and afterwards I was left with two hard blisters, on each side of my nose. These blisters burst by themselves - I believe in the shower - on the Tuesday and I was left with two scabs AND (to my horror) these scabs were formed in small indentations - looking as if there are chickenpox marks to be formed. I called my dermatologist who asked me to come in and see her. She calmly explained that this is very common (!), something which I was not at all informed about beforehand (would I have known I would never have undergone the procedure). She suggested we wait, let the scabs heal and fall off, and then lift the skin to make it even. She claims that it will go back to normal after this - something which I am VERY sceptical about. I have now read about others who were left with holes after burns - irreversible damage. I am absolutely devastated. From a few broken capillaries I am now left with potential pitted scars, for life. My advice to you: DO NOT DO IT! My dermatologist is, supposedly, one of the best in London. I did a lot of research before seeing her and she has years of experience. I wish someone would have told me about the risks.

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This happened in June, I waited about 2 months to get fraxel and it was just on my burned nostril. Glad to hear yours is getting better!! It doesn't depend on lighting for me to be honest, you can always see it. The fraxel treatment is fully healed now and to be honest did not make a difference. I'm getting a series of 5 TCA chem peels from a dermatologist in my home town in 2 weeks. If that doesn't work then I'm under-going surgery in June. Hope I helped!
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Hi Kira. When did the scar happen? How long did you wait til you had fraxel? Did you have fraxel all over or just on the scar? The scar for me has lightened up. But Part of the scar doesnt match my skin tone and I don't know if it ever will. At times it seems better and others times it seems the same. I guess it depends on the lighting. I just which I could get rid of the color. I think my nose cast a shadow??
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Same thing happened to me! Absolute horrible, huggeee indented scar on the side of my nose. Doctor blamed it on me...uhm what? Because I was nervous. What an asshole! Anyway, has anyone attempted to hire a lawyer or has any advice on what legal action to take in this matter? I really wanna stick it to him hard, he burned and destroyed my face! The scar is in a place where I didn't even have veins!! Help please!
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Hi from Illinois! this happened to me with a cool glide laser. It blistered by nose and left me with a shallow discolored indented mark. In certain lights it looks like it is gone,but other lights it is still there. It has been 9 months and it has gotten a little better. I have been using retin a ,for about 3 months,every other night. I to get depressed at times, wonder if others can see it. I work under some harsh lights.
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Hi all, i too have had problems with laser treatments on the little veins by the side of my nose. I am now left with pitted scars and i feel really sad about them. They appeared after severakl treatments - the nurse just kept putting the setting higher and higher. I waited a year and then went to see someone else because the veins were worse and more prominent. The new nurse i saw said that she would use another type of laser and reassured me that it would not scar. I figured that i already have some scarring but if i could get rid of the red veins it would all look a bit better. I blistered and the areas she treated looked badly burned. The veins reappeared after a couple of days and two weeks later i have quite severe pitting. I am never going to a beautician or anyone ever again for any form of treatment. I shouldnt have been so vain. My nose looks far worse now than it did to start with and i feel miserable every time i look in the mirror :(
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Hi Sophie, I'm also sorry to hear about your experience but I can also related. Just one week ago I have VariLite laser done on the veins on my nostrils. On both sides i got blisters right after but as of now only one side concerns me. I am healing but seem to be forming scabs in these very small slashes/indentation with raised redness around it. I am so devastated I now have permanent scars on my nose. I don't know if you check this forum anymore but I would love to know how your scars have healed after so much time??

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Hi everyone. I have just had a laser procedure done to treat a cluster of veins under my eye. I was doing it in stages with each month with a well qualified doctor. The first few times everything was fine, my skin would swell a little for a day or two and then go down and the vein cluster was fading little by little. Then the most recent time he used it on a higher setting without saying a thing to me. Needless to say it scabbed and now I have a very prominent 6mm pitted scar under my eye. It doesn't seem to healing very well despite me using vitamin E and hydrocolloid patches. It is hugely distressing. When I smile and my skin wrinkles under my eye except the scar just making it all the more noticable. To top it off inside the pit the veins are still there. I have no idea what to do. I think I have ruined my face forever, as a 25-year-old girl that seems to be all society wants to judge me on too.
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Suz-goose- I have scarring from rosacea nodules that I picked at. I have been working on them and using everything imaginable including vitaman e which I never found did a thing. Lately, i have been breaking open a capsule of Coenzme Q-10 and mixing it with something that helps it absorb. I think emu oil will do this. I actually used an estriol cream i have from the internet.This has something to pull the estriol into your skin which also pulled the Co enzyme Q-10 in with it. Totally alone it will no absorb to help the scar. Anyway- Coenzyme Q10 is bright yellow so just leave it on for an hour or and rinse off. I must have done it twice a day using a capsule each time and the scarring is down. A new scar will do well with this. Try it-it works better that all the things at the drugstore I have tried (onion extract, etc).
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Hi everyone. I have just had a laser procedure done to treat a cluster of veins under my eye. I was doing it in stages with each month with a well qualified doctor. The first few times everything was fine, my skin would swell a little for a day or two and then go down and the vein cluster was fading little by little. Then the most recent time he used it on a higher setting without saying a thing to me. Needless to say it scabbed and now I have a very prominent 6mm pitted scar under my eye. It doesn't seem to healing very well despite me using vitamin E and hydrocolloid patches. It is hugely distressing. When I smile and my skin wrinkles under my eye except the scar just making it all the more noticable. To top it off inside the pit the veins are still there. I have no idea what to do. I think I have ruined my face forever, as a 25-year-old girl that seems to be all society wants to judge me on too.
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Hi, I am very sorry to hear about your experience. I know exactly how distressing it is. How long ago did you have the procedure done? Which type of laser was used? I wish I could give you some advice on what to do, but so far nothing has really helped, apart from letting the skin heal by itself. I've had subcision, dermafiller and dermapen treatments, with little or no improvement. I have decided to let the scars be for a couple of months and then see an expert on scarring. I have tried using dermaflage to temporarily cover the pits. It is tricky to use, but works fairly well as a temporary solution. The first weeks and months after I had the scarring were extremely distressing. It has now been six months and the scarring is less visible, or even if it isn't you slowly get used to it. It is so very upsetting that people keep having these experiences, with practitioners downplaying the risks and even denying there has been any damage, when it is clearly visible. I have thought about taking legal action, not only to be properly refunded but also to raise awareness about this issue. But don't know how to go about it, or if I have the strength to do so. Again, I am really sorry about your experience. S
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Thank you for your reply Sophie. I had the procedure done October 29th. The laser was called Cosjet CR or something like that, I have no idea which setting was used. I have been using all night eye patches these days and given up on hydrocolloid. It hasn't made much difference though. Bright side I am now like a makeup ninja and can make it almost disappear. It is a pain constantly touching it up though. My doctor said the treatment is not finished and I should continue it and it will look better. I am pretty sceptical but it is not expensive and I am praying anything will make it look better. My next appointment would be next week as I am supposd to wait 6 weeks between them. Should I go ahead with it do you think? Argh I am so confused. Please help someone!
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Suz-goose- I forgot to mention. I would not go back to get more laser. This doc is too heavy handed to leave that kind of mark. Leave your face alone and try another doc in a year or so but you are so young and lasers make your face look old after a while.
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You are not alone. I too have found what a pitfall the lasers can be. I too have pits on my nose from the laser. I have been having the laser done on my cheeks, nose and legs off and on for 5 years. No problems.The aestherican always called the tool The Laser. I had a red spot under my nose that would not go away. The aesthetican offered to use what she called the Cauterizer to treat the spot. I agreed.The spot returned, so she tried again at a higher setting. This worked and I did not have any bad effects. This lady retired. I went back to have some more veins on my nose done. When the new lady pulled out the Cauterizer, I told her "We don't use that on my face" she replied"Yes, you just don't notice it because you have the goggles on". I said a second time."No, that was for one spot under my nose". She insisted that it was in my paperwork and was done all the time. Well, you can guess what I did...I got on the table and had the treatment.The next morning I awoke to 7 red sores on my nose. With bubbles and seeping clear fluid. I called the clinic immediately and was told "This is normal". I let her know this never happened before. She said all is well, put some triple ointment on it and come in to see her in a few days. I did as she told me to. When I went in to see her she looked at the scabs on my nose and told me I had hyperpigmentation HUH?? I have scabs and sores, you can't even tell what color the skin is beneath. She said not to worry they will go away, give it a few weeks. Two weeks later I called to tell her of the 7 sores I had 4 had healed but 3 left pits. She replied" You only had one spot". I let her know she had seen the 7 sores when I visited 2 weeks prior. She only insisted that I only had one. She just denied it. I am to go back in a day or two but I am heartbroken. I don't know if the new lady read the information in my chart wrong or if the lady who retired did not make clear notes. All I know is I have pits on my nose.
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Hi, I am so sorry to hear about your experience and completely understand how distressing this is, not only because of the damage to your skin and the psychological stress this causes, but also because of the insistent denial of the practitioner that something is wrong. My dermatologist has never admitted that she burned me with the laser and that she made a mistake with the settings, she maintains that it is "normal" to get blisters, scabbing and pits, that it "happens all the time" and is easy to fix. If this was normal, why was I not warned? Why would anyone undergo a treatment when it is "normal" to get scars (that, by the way, are not easy to fix)? The pits do get more shallow with time and the redness fades. I think it is very individual, mine are still very noticeable and they are still in the healing process. Some people's skin heal better than others. My dermatologist has now done subcisions, injected dermal filler (made it look much worse as the filler ended up surrounding the indentation, making it appear deeper) and used dermapen to reverse the damage. I don't see much improvement - I sometimes wonder if it would just have been better to let it be and if all of these additional treatments might have made things worse... I am going to see another dermatologist in January (long waiting list), specialising in scarring. Until then I think I will just let it be. I am currently using tretinoin every other night, hoping it might help a little. The dermapen might help also, but the scars look much worse before they look better. I know of another person with the same damage who tried Fraxel repair, but saw little improvement. I have tried Dermaflage, to temporarily fill in the pits, for social occasions. It works pretty well (it takes practice to get it right), but I wouldn't recommend it for every day use as I think it slows down/prevents the healing process. I wish I could say something to cheer you up. All I can say is try to be patient, it will get better. Try to stay away from mirrors and looking too much at the scars (will only make you upset and make the scars look worse than they really are). Stay in touch and I will keep you updated on any progress. Warmest regards, S
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Dear Jay,

Again, I am really sorry that you are in this situation. Don't blame yourself, I do that a lot too, but in the end this is not our fault - it is the responsibility of the practitioner to inform us of potential risks and to care for our safety. Also, some responsibility lies with the manufacturers of these machines and the bodies that approve them, but in the end money seems to, as so often, surpass ethics...

I had V beam too, without any problems and I so wish I would have stayed with that. The only reason I tried this is because my capillaries kept coming back after the V-beam, quite rapidly as well, and I was hoping this would make them stay away. Well, now they are still there and I have two dents.

IPL seems to be, despite all its promises, a quite risky treatment. It seems to be like a Russian roulette, sometimes all goes perfectly well, sometimes horrendously wrong, and the practitioner is not always to blame when things go bad - they can use the same settings as on a previous occasion on the same patient and all of a sudden there are irreversible side effects.

To be honest, I think these machines are approved too easily and then they use people as guinea pigs trying to learn how to use these machines properly. There are so many different models, working at different wave lengths, everything to make people think that this machine is the very "latest", when the very latest might be the option with most risks since it hasn't been tried out for a longer time.

The problem with IPL is that it offers treatment to Rosacea patients, like you and me, who are often lacking effective treatments and are desperate for improvement and so we take the chance and hope for the best, comforted by doctors saying how safe it is, not being a laser and all.

Regarding scar revision, I will keep you updated on how the subcision turns out. In the meanwhile I think the best all of us can do is to try to let time pass and the scars settle - even if it is disheartening and not fall into any "quick-fixes". Maybe retin-A might help a little, I have also read about people using Bio-oil/Emu-oil and/or copper peptides and needling for the same type of damage but I think it might be too early to try this out.

Thank you for sharing your experience. It is indeed sad we are here, but at least we can offer some support and hopefully make other people stay away from this procedure, and other similar ones.

All the best,
S
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WOW! Thank you both for your quick replies. I'm definitely going to cancel the Fraxel appointment and seek a second opinion -- that is, if other dermatologists will see me. If not, I will try the plastic surgeon route. At any rate, it wasn't like I had perfect skin to begin with so I can wait a little longer to seek out other solutions. It's just so disheartening because I waited so long and saved so much to get the IPL procedure done, and now I possibly have to spend more time and more money fixing their damage. Ugh! I'm not sure what kind of legal recourse I could take given all the waivers I signed. I can only hope that they will admit to their fault and refund all or some of what I spent -- I won't hold my breath.

The odd thing is that I had a laser treatment (V-beam I think) done about four years ago on my nose just to get rid of the blood vessels, and everything went just fine. Some light bruising, but the end result was very positive. So I thought with the IPL being "so much better and safer" there would be no reason to be concerned. Boy, was I wrong! I do feel foolish buying into this procedure and wish now that I would have done more research on what could go wrong rather than how *fantastic* my skin was going to be afterwards.

Thank you again for sharing your experiences with me. It's sad that we're here, but at least we do have a forum in which to come together and talk (type) about what we're going through. As soon as I have more information I'll send and update.
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I am thinking about making an FDA report on the machine and post about it on an ipl and laser damage forum that I have found online. Have been feeling quite upset ever since the procedure and now I am trying to keep my mind off it, letting time heal (hopefully), but eventually I would like to make some sort of complaint so as to prevent others from having the same negative experience as we have.
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Hi Denise and Sophie8,

I, too, am a victim of a laser treatment gone awry.

I recently had an IPL treatment performed to reduce some facial redness caused by rosacea, as well as razor burn on my neck. While I had good results with reducing the redness in my cheeks and neck areas, my nose wasn't so lucky and I now have three sizable "dents" in the area where my nose meets my cheeks (one dent on the right and two on the left). Sound familiar?

I'm pretty convinced that the physician assistant performing the procedure turned up the power on the laser to get rid of some rather large capillaries on my nose and this in turn caused the dents. It was very painful and I could smell my own skin burning. I didn't say anything right then and there because I didn't really see the damage until about three weeks after the procedure due to the fact that the areas kept getting scabs/white heads on them.

So I went back to the clinic and this time saw the actual dermatologist. He said this was very rare and that it happened in maybe every "1 in 1,000" patients. I was a bit peeved by this because, of course, I wasn't made aware of this potential issue during the initial consultation. Nonetheless, I wanted to focus on how to fix the problem and his recommendation is to perform Fraxel treatment (free of charge, of course) on me. The goal with Fraxel is to get the collagen in the area stirred up so that it plumps the skin up and gets rid of the dents.

Obviously, I’m very apprehensive about doing anything involving a laser again and was wondering how your treatments (subcision and Retin-A) were coming along? I’m considering getting a second opinion but want to learn more so I know what to ask this time around. This whole process has been very distressing as I’m sure you both understand.
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Dear Jay,

First of all, I am very sorry to hear about your experience. I feel for you, knowing how distressing this situation can be. I blame myself a lot, thinking that I should have checked the procedure more carefully instead of blindly trusting my dermatologist. You go in for improvement and then you get this...

It is, as you say, very upsetting that none of us were properly informed about the risks - when clearly there are risks (I think often heavily understated by the technicians who perform these procedures...) Had I known that I could potentially end up with red/purple dents I would never have done this for something, which in the light of all this, very minor.

I would strongly advice you AGAINST any Fraxel treatment. I have read so many negative reviews about this procedure (and other lasers working with a pixel technique) with serious side effects that are irreversible. Even if you would not get side effects I really doubt that it would help with the dents on the side of your nose. It is just not worth the risk in my opinion.

The dermatologist who performed the nd:yag on my nose is now treating the scarring, which she still refuses to refer to as "scarring" or "damage" but rather she tries to frame it so that this is actually some sort of after care, just dealing with a rather normal outcome... This is particularly upsetting since I feel she is treating me as if I am overreacting to something that is in fact "normal", when clearly scarring is not normal. She has not reimbursed me for the procedure, but is doing the scar revision treatments for free.

I have had one subcision treatment with a very small amount of filler, hyaluronic acid (Stylage). Directly after the procedure I could see improvement, the scar seemed a bit raised and more at level with the surrounding skin, but that went down after a couple of days. I think it was the swelling from the needle that caused this.

My dermatologist told me that I need 4 subcision and filler treatments and that it will be a gradual improvement. Subcision works in the way that the needle cuts off the scar "fibres" to release the scar and let blood flow in so as to stimulate new collagen production. This process can take a couple of months. She claims the skin will go back to normal, which I know is certainly not true (once you have scarring it will never go away entirely), but I am hoping for improvement.

Retin-A might help in terms of mildly peeling the top layer of the skin and stimulating collagen, but I don't think it can entirely reverse the damage.

I have also read about TCA cross, performed on pitted acne scars. After what happened I feel nervous about any type of advanced procedure - and will certainly never go near a laser again - and I will wait and see if the subcision helps, if it doesn't I might try TCA.

Regarding seeing another dermatologist for a second opinion, I would strongly advice you to do so. I have not been able to do so because the dermatologists I have contacted (all with very good reputation) do not wish to treat another doctor's mistake, also they would of course charge me a lot if they would do so. But if you can find someone I would advice that you do so.

Please feel free to email me if you would like to discuss this further. Again, I am very sorry that this has happened to you.

Kind regards,
S
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I am sorry that this happened to you too. 1 in 1000- I don't believe that at all! I am only using the Retin-A for now and will wait about one year to pursue anything else- enough time to allow the scar to heal (was advised by a plastic surgeon to wait this long). I have been proposed other laser-related treatments such as resurfacing but am hesitant at this point, to put it mildly. Right now my scar is not large (3 mm) and is skin coloured so while the indent makes it difficult to conceal, it is not that bad. I am afraid that if I try to make the appearance better, I may just end up making things worse. That is the risk. Good luck and let us know how things go for you. It is ridiculous that we are not warned of this beforehand, given the costs of these little procedures.
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Hey! I had literally the same exact thing minus the fact that my doctor is an absolute prick and blamed the intents on ME! Oh it was MY fault because I was nervous?? WTF!!! But anyways I had three fraxel treatments done and I did see the scar improve, however, I see my nostril changing, like becoming smaller/different shaped. I haven't waited the full 6 months to see results so maybe I'm just jumping the gun but it REALLY bothers me. I actually think I might be getting a rhinoplasty this summer if things don't improve (which sucks because I really like my nose.) I'm only 19 and my doctor has messed up my face forever and won't admit it. He burned me in a place where I didn't even have veins actually. It sucks because it has completely ruined my life and I'm so young :( I actually was in route to going to medical school (future allopathic doctor) but I didn't sign up for classes next semester because I'm too depressed to focus on anything else. The scar is huge too...If anyone has any advice for me or on how to HIRE A LAWYER then please let me know!! My facebook is Kira Wiedemann and my email is wiedemannkira@yahoo.com. Thank you!
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Dear Denise,

I am sorry to hear that you've had the same experience. I still have the veins too... Is it on the side of your nose? I went to the dermatologist today and she used a needle and went under the skin, to "lift the scar". I will need to do this again once a month for four months. I believe the procedure is called subcision. The idea is that by breaking the tissue that holds the skin down and letting blood flow under the scar the scar will raise itself.

I am VERY sceptical that this will help, as the surface of the skin is - naturally - also affected by the laser burn. I am very disheartened by this entire process. The dermatologist response to my expression of concern was to try to wave it off by saying "oh this happens all the time and it will be perfectly fine". If this happens "all the time" why did she not warn me before?! If I would have known I would NEVER have done this, as I am now left with red indented scars that are much more visible than a few broken capillaries, which by the way, are still there.

I have been tempted to ask for my money back and go to someone else, but it turns out many dermatologists are very resistant towards dealing with another doctor's "mishap" (as the receptionist of the renewed Dr Nick Lowe told me)

The strange thing in all of this is that my dermatologist is very nice and helpful, but she refuses to admit that she has damaged my skin and keeps up an act of "this is all normal", when clearly it is not.

I was told to stay away from IPLs, and thought this was the "safe" option, that it would just be a minor procedure with no downtime or risk of scarring. I was very very wrong.

Denise, if you don't mind, let's stay in touch and we can let each other know if we have any good treatments trying to heal and repair the scars.
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Hi- yes, the veins are fine lines on the side of my nose as is now, the indented scar! It isn't a huge scar (maybe 3 mm) but of course I am mad also because I was not told of this potential risk and would have never done the treatment had I had known. Anyhow, I did go back to the original doctor who said that it will fill in which it hasn't yet. They did refund my money for some laser genesis treatments that I had purchased in advance. Then, I saw a plastic surgeon who suggested waiting one year before looking at doing anything because he said that the scar would change over the year. A second dermatologist told me that she could try laser resurfacing. She also gave me a strong peeling retin-A cream to try to get a peeling effect. So far, I am using the cream only (just started last week). I will let you know how things go. Feel free to private message me if you want. The second dermatologist also suggested pulsed dye laser for the veins but as you can understand, I am really reluctant to try any more lasers!!
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Hi Sophie- how are things going with your scar? Did you manage to resolve it? I am still hesitant to try to remedy mine although I am doing 4 BBL treatments from a different salon to attack the overall redness (mild rosacea) on my face. Please update me with how you are doing. Thanks
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Hi Denise, Thank you for getting in touch. I hope you are doing well. I did I few treatments with dermaroller, subsicion and fillers, with some minor improvement of the indents (not sure if the procedures actually did any difference, if the scars improved naturally or if I am just getting used to having them there...) I try to cover them up (the uneven colour), but other than this I have given up on finding a method to remove them. One thing that this treatment has taught me, which I think is a good lesson to have, is to be very careful with any type of laser treatment, aesthetic/dermatological treatments all together. There are so many "promises" out there, but the risks are just far greater than the chances of seeing any real long term improvement. I am now using a combination of tretinoin and obagi nu derm products to improve the general appearance of my skin, tretinoin is harsh on sensitive rosacea prone skin so I am being very careful. I am seeing some overall improvement in my tone and texture after two months of use. Nothing dramatic, but I realise it will take time and it takes patience. I don't want to sound too pessimistic but if I were you I would stay away from BBL treatments, seek advice from a good dermatologist and try to resolve your issues with rosacea this way. I wish you all the best. S
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