Treatment options for persistent, diffuse rosacea for 43 yo, northern european male with type III/IV skin?

Rosacea progressing since age 30. Always use sunscreen, no sun damage, freckles or wrinkles. Worst trigger is cold, windy weather which leads to burning and stinging. Used Tazorac and Fraxel in past for acne scarring. Fraxel made Rosacea somewhat worse. On Oracea for 3 months with no change. 2 IPL sessions 5 weeks apart and only result is brown patches on forehead that are fading. Scheduled for 1 more IPL. Should I wait longer or seek out topicals such as Metrogel?

Doctor Answers 1

Treatments for Rosacea

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Hi DB.  Metrogel is certainly an option and we recommend exhausting all medication options before turning to lasers.

Unfortunately, you have not been well informed about the most effective laser technology for Rosacea.  IPL is not a laser and is generally not very effective for Rosacea.  Fraxel is great for texture changes like fine lines and acne scars but is not indicated for Rosacea.  This is why you have not achieved good results with light based treatments.

Seek out an experienced laser practitioner in your area that uses a pulsed dye laser.  The Cynosure V-Star or Candela V-Beam are leading pulsed dye lasers.  Both will be much more effective for your condition that IPL or Fraxel as long as the practitioner is experienced.  Also, you should familiarize yourself with "bruising" treatments as these are sometimes required for best results.  Good luck.

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