Your thoughts on LED therapy vs. IPL for rosacea?

Question

I purchased a red LED light to treat inflammation and redness from Rosacea and it helped calm my burning and stinging but it hasn’t done much for the blotchy redness on my cheeks and chin. I am scheduled for my first IPL but am nervous about side effects after reading bad reviews on this website. I’m wondering if LED is a less invasive/risky way to combat the symptoms of Rosacea over time? How does LED compare to IPL for redness/flushing? LED seems to have no risks whereas IPL does.

Jack G. Bertolino, MD · Answer

This is always a challenge, and like the others who have commented here, I agree that IPL IS MORE DEFINITIVE. Using LED red light just after an IPL treatment will speed up your results, but that depends on how bad your condition is. Get a proper evaluation with photos and proceed. Hope this is helpful. JB

Raffy Karamanoukian, MD, FACS · Answer

Vbeam laser is an excellent modality for patients who have rosacea, blushing of the skin, facial and body telangiectasia, spider veins, redness, post surgical redness, and skin flushing. It is a safe procedure that can be used at varying depths to help treat micro blood vessels in the skin. We also use it in our office for facial skin inflammation, keloids, and hypertrophic scarring. It is an important part of scar therapy. Vbeam can be combined with chemical peels and other lasers, but experience with the treatment is essential. The Vbeam laser does not affect deeper tissue. Schedule a consultation with an expert in Vbeam and you will find it to be an excellent modality for many skin types. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

LED may provide some improvement, but Rosacea needs a combination approach. I recommend getting a formal evaluation with a cosmetic dermatologist. For rosacea, I like a combination using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V, Clear + Brilliant), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

Shalini Gupta, MD · Answer

Hi.  Good question.  Rosacea involves surface vessels which dilate and cause redness and flushing triggered by warmth, spicy foods, wine, nerves, and cheese.  Over time, the vessels close to the skin surface continue to multiply, which leads to the flushing.  The only way to effectively treat this problem is with lasers that can eliminate these surface vessels.  You may need some ongoing maintenance as the vessels may want to reestablish over time.  For this reason, IPL will work best.  We like to use our red light to reduce overall inflammation in the skin and this works well for skin rashes and redness but does not over time destroy the underlying cause of the flushing which is the vessels. However, it is very useful in calming down the chronic inflammatory problem of rosacea.  When combined with levulan, this treatment is called photodynamic therapy and can be even further beneficial as it may also help reduce the demodex mite overgrowth in the skin.  We have also found great results treating rosacea skin with the fraxel laser, which also helps to reduce overall redness and vasculature.

Lisa Jenks, MD · Answer

First of all, it is important to understand that Rosacea is an inflammatory disorder that can be controlled, but not made to go away.  You should try and identify your triggers and stay away from those as much as possible.  Sunlight, spicy foods and alcohol are all common triggers.  You should also be on medical grade skin care products that are designed to reduce inflammation, protect the skin and minimize redness.  I like "All Calm", which is made by ColorScience.I recommend a combination of ongoing red light treatments along with a series of 4 IPL treatments.  You are correct in that the IPL is more aggressive, but it does do a better job of clearing the underlying red blotchiness.  Usually patients will do the series of 3 (about a month apart) and then do 1-2 every 12-24 months, depending upon how quickly their blotchiness returns.  It is normal to look "beat up", with some swelling and possible bruising, for about 5 days after each IPL treatment.  Doing a red light treatment immediately afterwards will help speed up the healing process.Ongoing red light treatments will decrease the chronic inflammation in a gently, no down-time, way.As long as you go to a facility that has physician oversight and they determine that you are a good candidate for the IPL, you should have good results.  Having said that, it is true that there are risks associated with any laser treatment.  Best of luck to you.

Davin Lim, MBBS, FACD - Account Suspended · Answer

LED is certainly less painful than IPL, and in some situations it can calm down inflammatory rosacea. Best combined with medical therapy by a medical dermatologist. The real trick with rosacea is to find the best combination for your skin type, including your own unique triggers. Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)
To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. 
  
A detailed history, together with a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -
  
1. Lasers ( to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 
  
2. Creams - anti inflammatory
  
3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. 
  
4. For females- Mineral make up is recommend, over make up that contains parabens. 
  
For the best results, consult a dermatologist for both medical and laser treatment options. 
  
Kind regards.
  
Dr Davin S. Lim.
  
Laser Dermatologist.
  
Brisbane, Australia.

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