What would be a good treatment for co-occurrence of Melasma and Telangiectasia (Rosacea)

Question

I am 30/F/Indian/Fair skin. Skin is sensitive, oily & blemishes easily. Had acne until my early 20's (resolved on its own). I suffer from rosacea (visible capillaries on my cheeks, nose & above upper lip). I also have melasma on the same facial regions. What would be the ideal way to treat co-occurrence of melasma and telangiectasia? I was told IPL for telagiectasia could potentially worsen melasma but that IPL is also treatment for melasma (!) Confused.

Jason Emer, MD · Answer

i suggest posting photos and getting a formal consultation, it sounds like you will need a combination approach to treatment. I would avoid IPL in melasma.  Best, Dr. Emer.

Matthew Elias, DO, FAAD · Answer

Thank you for your question.  Due to you being Indian albeit with fair skin, it is probably best to start with a bleaching regiment with TriLuma for approximately 8 weeks after which you may still require combination therapy.  I would use the Excel V set for Red/Brown Dyschromia after first eliminating the visible capillaries with the Excel V in the first pass.  If at that point, the reds are gone and you still have some melasma you will require adding a second laser such as the Fraxel Dual 1927 or Clear and Brilliant Permea 1927.  Regards, Dr. Matt Elias

Davin Lim, MBBS, FACD - Account Suspended · Answer

Rosacea is
very complex and a tailored treatment program give the best results. This is
because there are many types of 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. In your case you also have melasma in darker skin type.

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, and unsafe in your skin type. Vascular lasers can also treat the vascular component of melasma. For melsama I like the Picosure with the FOCUS lens, I use anti-inflammatory ointments straight after to decrease rosacea flare ups.

2. Creams -
anti inflammatory, have to be super careful as HQ creams for melasma can irritate your rosacea.

3. Tablets
-anti - inflammatory and sometimes low dose Vitamin A cream- once again titrated to your skin type based upon melasma and rosacea.

4. For
females- Mineral make up is recommend, over make up that contains parabens. Sunscreen helps both melasma and rosacea.

For the best
results, consult a dermatologist for both medical and laser treatment
options.

Kind regards

Dr Davin S.
Lim

Laser
Dermatologist

Brisbane,
Australia.

What would be a good treatment for co-occurrence of Melasma and Telangiectasia (Rosacea)

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What would be a good treatment for co-occurrence of Melasma and Telangiectasia (Rosacea)

Answers (3)

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