Thomas Adrian, MD

Rosacea is a genetic predisposition to develop extraneous superficial blood vessels in which results in a spectrum of manifestations including background facial redness, flushing and blushing, and inflammatory rosacea consisting of papules and pustules. This does not appear to be post inflammatory erythema of acne as that fades with time once acne is treated and typically would not be associated with flushing and blushing.

Your subtype of rosacea is likely erythemato-telangiectatic. The most effective treatment for ET Rosacea is with vascular lasers such as the Pulsed Dye Laser.

I would recommend consulting with a Fellowship Trained Dermatologist who has experience treating Rosacea with Vascular Lasers to develop a treatment plan to address your concerns.

Sincerely,

Thomas Adrian, MD, FAAD
Board Certified Dermatologist
Fellowship Trained Cosmetic & Laser Dermatologist

Hi SpiritSearch,

I would recommend consulting with a Dermatologist to give you an honest assessment of your scars. While it is difficult to tell if those were present or not prior to your procedures atrophic scarring can be a result of KTP laser treatment with inadequate cooling. It is highly unlikely the pulsed dye laser caused these scars in my opinion.

While Fraxel can be used to improve nearly all types of scars there are several procedures (Phenol CROSS, Subcision, etc) that are specifically tailored to certain types of scars. I would find a Fellowship Trained Dermatologist who specializes in scars to provide you with an appropriate treatment plan to best address your specific concerns.

Sincerely,

Thomas Adrian, MD, FAAD
Board Certified Dermatologist
Fellowship Trained Cosmetic Dermatologist

I would always recommend against excision of a tattoo regardless of location as the sheer volume of skin that needs to be removed generally results in an incredibly unsightly scar.

I do not see any reason why someone would not use a 532nm Nanosecond or Picosecond laser on the red area of your tattoo as this wavelength is highly effective at removing red ink and you do not appear to be at risk of hypopigmentation given your skin type. I would find a Board Certified and Fellowship Trained Dermatologist who performs tattoo removal to examine your tattoo and give you their opinions on removal options with laser.

Hope This Helps!

Thomas Adrian, MD, FAAD
Board Certified Dermatologist
Fellowship Trained Cosmetic/Laser Dermatologist

While surgical correction is a method for treating hair loss, 'hair transplant surgery' is not a diagnosis of the root cause of your hair thinning. Dermatologists are trained experts in the various causes of hair loss, including hormone imbalances, autoimmune conditions, and other 'organic' causes of hair loss, many of which can be corrected far easier than hair transplant surgery or simply injecting PRP into the scalp, which seems to be the new, expensive, and favorite treatment performed by non-dermatologists for the blanket diagnosis of 'hair loss'. 

From your pictures alone it is difficult to definitively diagnose your condition however given the papules associated with centrofacial and nasal redness I would tend to lean towards your condition being on the rosacea spectrum. I would recommend seeing a board certified dermatologist for treatment options.