Kavita Mariwalla, MD

Pregnancy causes skin alteration in unpredicted ways. IPL has not been tested in pregnant women and as such we cannot say with certainty that it would affect you adversely. However, I urge you to wait after pregnancy as your skin is likely to react to the laser in a way it may not normally do if you were at your baseline hormone levels. If it is performed on your face there is unlikely to be harm to the fetus though OBs advise against it.

Acne can leave post-inflammatory hyperpigmentation and redness, but usually, this redness fades.  It is best to give it about 4 weeks before resorting to IPL to take the redness away. Another option is VBeam.

Radiesse is too thick of a product to place in the lips. Juvederm or other hyaluronic acid product is a better choice.

VBeam targets blood in blood vessels. Unfortunately, it can cause severe hypopigmentation in skin of color. For this reason, we do not use VBeam in darker skin types. You can try the long pulse Nd:YAG for your vessels set with a long millisecond pulse width to try to decrease the risk of pigment alteration.

VBeam does work for redness and is more effective than the IPL however you will need several treatments.  If your redness is diffuse, you will need to figure out a way to trigger it so that it is maximally red at the time of the treatment. This way the laser has the best chance of targeting the blood in the dilated capillaries that is behind the red coloration.

Bruising is not required to treat the redness associated with rosacea with a VBeam however typically areas that bruise respond more quickly and efficiently. 

What you are experiencing is actually the result of the VBeam working in that spot. It knocked out all the redness and the blood vessels in that area. Unfortunately, now it looks very white compared to the rest of your skin which has a more ruddy/pink undertone.  The only thing to do is to try IPL to the remainder of your forehead or using the VBeam to eliminate the ruddy tone on your forehead or at least feather out the white area to pink.

PDT is not an ideal choice for treating large pores. It is not long lasting even though it does work for acne. If you are very concerned about your pore size you may want to consider laser resurfacing treatments or deep chemical peels.

It is not surprising that you had a decreased reaction on the third treatment. If the incubation periods were the same, it is likely that you have less pre-cancerous areas on the face.  These were probably treated after the first two treatments (typically it takes 2 for good effect) and that is why you had a decreased reaction on the third time.

Photodynamic therapy is a treatment that uses a light source that is filtered for a specific color (usually red or blue) to activate a chemical that is painted on the skin.  Some physicians activate the chemical with an IPL (also a light source) or a PDL (a laser).