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Treat Dermatitis first, then V beam reduces rosacea flares

Rosacea is only apparent on my left cheek and a...

Rosacea is only apparent on my left cheek and a tiny bit on my nose. Both appear to be caused by sun damage because I've had bad sunburns in those locations because I didn't reapply sunscreen enough.

I also slept on my left side for 7 years.  Once the rosacea started flaring up in 2010 due to stress, hot coffee and red wine, sleeping on that side made it worse.  So I now sleep on the other side and only drink iced coffee.

I've tried taking doxycycline (20mg twice a daily) and Metrogel and Finacea, and it controlled the acne portion of rosacea but the redness was always there and flares still happened too easily.  I'm hoping that V Beam will reduce the redness and the flares.

The treatment itself was a lot like lower power version of hair removal.  (Dr. R used 7.5 joules versus the 25+ joules for past Laser Hair Removal sessions.)  It's less painful than hair removal, and the strangest part is seeing green flashes with my eyes closed and the metal goggles on. 

A few hours after treatment, I look like I got in a fist fight.  I'll post an updated photo with the same camera as the before in a few days.

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My whole cheek was swollen and bruised for 5 days....

My whole cheek was swollen and bruised for 5 days. After 1 week, the bruising is completely gone and my cheek no longer seems to flare. I feel normal again for the first time in a year. I still plan on going in for another treatment in a month to treat the remaining redness.


Thanks for the post, Eric.
In fact I scheduled an appt for vbeam with the same doctor. :)

How many total treatments have you received so far? And does the rosacea come back at all?
  • Reply
hey again eric,
i just wanted to share with you that after some experimentation i've found that coffee ( i most always drink iced ) is a huge contributor to my rosacea.. i don't know whether its the caffeine or what but i'm much better on days when i don't have any. i miss the energy but my face certainly feels better for it.. have you had a similar reaction? hope all is well.

  • Reply

Yes!  My rosacea first appeared when I was drinking a lot of coffee and under a lot of stress when we switched the software that runs RealSelf.com from Drupal to the Yii PHP framework.  That was when I first noticed a burning feeling on my cheek and started having acne there.

I've found that matcha green tea doesn't produce the same reaction, even when I have it warm as a green tea latte at Starbucks.  (I do wait for a green tea lattee to cool, and typical make matcha green tea with lukewarm tap water.)  Matcha green tea is powdered tea leaves, so it has more caffeine than typical bags of green tea, yet only 25% as much caffeine as coffee. And there's another chemical, L-Theanine, that has a calming influence.  Green tea also tends to cause the body to prune excess blood vessels, although it's not as strong an effect as garlic or barries.  Watch this TED talk about foods that moderate blood vessel creation for more info.

Read my story about switching from coffee to matcha green tea and let me know if matcha gives you the energy to get through winter days while helping your face.

If you have persistent dandruff, one factor in...

If you have persistent dandruff, one factor in your rosacea is probably Seborrheic Dermatitis.  After the redness got worse after a rainy 4 day hike in Hawaii (perfect conditions for a fungus), I was researching dandruff treatments and learned people with Rosacea often also have Seborrheic Dermatitis, which is caused my a fungus.  I bought some Nizoral shampoo and some Lotramin Ultra cream, and those two have cleared up the persistent redness that remained even after 5 V Beam treatments.  So please, make certain you have your Dermatologist check for any signs of Seborrheic Dermatitis before you start V Beam.  V beam did fix the rosacea flare ups but not the persistent redness, since that was a rash.  I probably could have only had 3 V beam treatments if I had been treating the Seborrheic Dermatitis from the beginning.

Products I recommend for Seborrheic Dermatitis:

Nizoral 1% Ketoconazole shampoo (use daily for 2 weeks, then once per week)

Neutrogenia T/Sal - 3% Salicylic acid shampoo (alternate with Nizoral)

Lotramin Ultra - use on worst areas of redness



Do NOT go and see Kelly the PA at Jennifer Reichel's office for a Vbeam. I am a very experienced vbeamer and she used the wrong settings (way too strong) and it's been two weeks and my skin still looks red and burned. Absolutely horrible experience. I've been to many of the best rosacea doctors and this was by far the worst treatment I have ever received.
  • Reply
Nizoral is in my Amazon cart now! I have had SebDer since I was a kid. It is so embarrassing, but just one Rx practically cured it. I'll try the Niz on my face for a while. How long did it take you to see results with the Niz?
  • Reply
It would be better to get an Rx for Ketoconazole cream (2%) since the shampoo has some foaming agents that can irritate sensitive skin. In retrospect, the redness on my face was exacerbated by a face cleanser that was marketed for people with sensitive skin (SebaMed) but has Sodium Laureth Sulfate as its primary ingredient. After rereading "Skin Type Solutions" by Leslie Baumann MD, I follow her advice to avoid using any shampoo on my face (it's too irritating for reactive skin) and use only La Roche Posay Toleraine Dermo-Cleanser.
Seattle Dermatologic Surgeon

Dr. R is an expert Dermatologist with just the right amount of humor to make having your face lasered a less stressful experience.

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