Alice Pien, MD

Laser treatment for Rosacea is by the far the most effective medical treatment for this condition.  Performed properly, it can remove any visible signs of vasculature in the skin such as broken capillaries and spider veins, and significantly reduce the blushing you are referring to. 
What is important for patients to understand, is that Rosacea is not just a problem in the most surface layers of the skin (epithelium), but often is caused by weakness in the deeper collagen layers of the dermis as well. Thus, for a truly effective treatment, lasers to strengthen the deeper collage as well as lasers to treat the vasculature are needed.  Without treating the underlying collagen, the rosacea has a tendency to return more quickly.

A white birthmark describes skin that has less natural pigment (melanin) than the surrounding skin.  It is caused by a patch of skin that either has fewer cells that make melanin (called Melanocytes) than in the surrounding skin,  or by a group of melanocytes who are programmed to make less melanin than the surrounding skin. Very similar to a person with dark hair that has a patch of white hair. 

Either way, successful treatment is focused on getting your light patch of skin to naturally produce more melanin so that it blends with the surrounding skin.  Unfortunately, there is no sure-fire method of making this happen.  But... there are some treatments that work about 50% of the time.  The 'hi-tech' method uses the Excimer laser, and a low-tech method utilizes micro-needling with tiny acupuncture needles.

It is also important to assess the skin very carefully in order to distinguish a genuine white birthmark from a case of Vitiligo, where seemingly normal skin looses its pigment. (not from birth).   Michael Jackson suffered from Vitiligo and opted to bleach the rest of his skin to match the patches that were turning white.

Yes, pigmented birthmarks can absolutely be removed.  The cost depends on the time required to treat it, which of course depends on its size.


Also, different types of birthmarks may have different amounts of pigment (melanin) and at different depths in the skin.  These variations often results in a range of
needed treatment sessions.  A more shallow and lighter colored birthmark usually requires fewer treatment sessions than a darker and deeper birthmark.


The type of laser used is also dependent on the density and depth of the pigment as well as the type of skin the patient has.  In fact, we often use a combination of lasers 
to ensure the most effective treatment possible.


Therefore, be sure that the clinic that you choose to treat your birthmark has a selection of lasers from which they can customize the most effective treatment for you!

The CO2 fractional laser is particularly effective for interacting with the collagen matrix of your skin.  It tightens and tones skin, shrinks pores, diminishes wrinkles, stimulates generation of new collagen, and lifts sagging skin.  We also use it frequently in our protocols for treating scarred skin.   A series of CO2 treatments can achieve fabulous results without the risks, pain, and downtime. 

There are three prevalent methods of removing moles.


1.  Freezing them off.
2.  Surgically cutting them out.
3.  Lasers.

All 3 of the above methods, when done correctly can be very effective in permanently removing a mole.  However, ... the challenge is avoiding scarring in the aftermath of the treatment.
This is especially important if the mole is in a prominent and visible location, such as your face.
During the past 20 years, we have removed thousands of moles, and have found that lasers are far-and-away, the modality that provides the best results of the 3 methods.  

Let me explain:
Lasers are by far the most precise of all 3 methods.  Additionally, it is the only method which offers the possibility of removing the mole delicately in stages.  When you use a scalpel to cut them out, or liquid nitrogen to freeze them off, the procedure is basically an all-or-nothing treatment.... meaning that the entire mole will come off in a single procedure.  The challenge with this, is that that removing it all in a single treatment tends to leave you with a scar.  On the other hand, lasers are so precise, that you can take a little bit of the mole off at a time, (ablation) in this way minimizing any trauma that causes scarring. Basically, we "sneak up" on the skin, so that it barely knows anything is going on, and heals without leaving a scar.  The downside of course, is that you need to come to the office more than once.  

Finally, different types of lasers can be used to target all sorts of tissue at any depth in the skin.  Thus, only a tiny percent of patients whose moles have been removed with lasers, every need to come back because the mole has returned.