What is the treatment for shrinking large pores and smoothing rough rosacea skin? Is CO2 too aggressive for rosacea skin?

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

 This is a great question, and much more important than which laser is being used is who is going to be operating that laser. A CO2 laser with appropriate settings and parameter choices can be an excellent option for textural changes in rosacea, and even some vascular focused lasers can deliver excessive amounts of energy and damage when inappropriate settings are used. Basically, choose your provider not your laser to get the best results.  Make sure that provider has numerous options available to them, so you were not just getting the one or two laser options that they have, but truly what is best for you. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.Cameron Chesnut #realself100 Physician 

I would not recommend using an ablative laser on inflamed, sensitive skin. If vascular lasers we're not successful, IPL or red LED may be helpful. The primary treatment for rosacea is not with a device. I suggest you consult with your dermatologist and try to combine medical and topical therapy with non invasive procedures. This produces the best results. Good luck.

Hello and thank you for your question.  If your skin is sensitive, I don't suggest doing any aggressive lasers that can increase the flushing to your skin. It is hard to say what would be a good treatment without at least a photo, however, a good next step for you may be to try an IPL (or photofacial) treatment.  This treatment targets the hemoglobin in our red blood cells and essentially ablates the extra vasculature that is seen in cases such as rosacea. This treatment also helps reduce pore size and other pigmentation in the skin with little to no downtime.  I suggest seeking an experienced practitioner who specializes in facial aesthetics for best direction and results.  Good luck!

Hi thanks for posing this question. I think the most important thing is to keep the Rosacea controlled with either Dual yellow or ProYellow laser first. This targests the haemoglobin or red component of the face. You can also supplement this with topical Soolantra which is US FDA Approved for the treatment of Inflammatory Rosacea, used every night on the face. When this has settled down, you can try a gentle non ablative Laser Genesis for the pores. Skin resurfacing with Co2 Laser and Microneedling RadioFrequency are still my Go To treatments of choice, but for patients with Rosacea, I would be cautious and use the latter when the Rosacea remits. After the treatment I would advocate moisturising with an emollient and a good sunblock. Talk to your physician again and see what he/she thinks.

I can certainly appreciate that you don't want to be the experimental guinea pig on your face! You will like find that it will take 2 different types of treatment, one for each problem. I find that IPL or Broad Band light works quite well for rosacea redness although it can take 4-5 treatments initially to get this under control. This likely will not do much for the textural issues which are better addressed with the laser. I have found that the Halo laser works quite well for texture and pores with about a 4-5 day down-time with skin looking more pink than red. This will even initially make the rosacea redness worse, but at approximately 3-6 months, the rosacea redness looks better and is decreased when compared to the pre-treatment level of redness. It is always important to find a physician experienced in treating rosacea with these type of treatments and to remember that rosacea is a chronic problem so we can only hope to control, not cure it. Sometimes it works well to combine medical treatment with the energy-based devices to get the best control. Best wishes, Mary Beth Mudd