What are the best and latest treatments for Rosacea?

The redness from Rosacea is caused by tiny red blood vessels close to the skin’s surface. Therefore, patients are able to experience significant improvement by choosing specialized laser treatments which clear away these blood vessels. This is not dangerous or detrimental since the blood will simply be rerouted through other pathways in the circulatory system. An effective laser for this purpose is the Vbeam system. It uses wavelengths in the range of 585-595nm which is optimally absorbed by oxygenated red blood cells to enter the tiny blood vessels. The heat closes off the unwanted tissue which is then broken down by the body and carried away. Patients are able to experience long term and lasting improvements, free from the recurring flareups that used to plague them in the past. 

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Rosacea is best treated with light (IPL) or laser (Pulsed dye or Excel V) treatments.  Creams rarely work unless you have papulopustular type, and even then it can come back and always needs a topical treatment. Find a laser expert for your skin care.  Best, Dr. Emer.

There are many options available for treatment of rosacea. In our practice, many patients are satisfied with the Excel V laser for treating rosacea. The Cutera Excel V Laser treatment is best used to improve Rosacea, and overall facial redness. Two different lasers used to treat acne rosacea. The first laser treats more superficially, right below the skin. The second laser has a longer wavelength that can penetrate deeper. This laser can penetrate the deeper blood vessels, providing a more comprehensive, accurate treatment for rosacea.  The benefits of Excel V: Pores tighten, glands shrink, provides facial rejuvenation, and collagen reformation. Skin starts to clear, redness is reduced. We don’t just treat surface blood vessels, we go deeper since the vessels have a variety of depth. So to achieve the best results, you should not treat the surface alone, but also target the deeper layers. For best results, it is best to have an in-person consultation with a board certified dermatologist. Thank you for your question, best of luck!

I tell patients the right rosacea treatments and medical therapy can help control and manage this condition. Without treatment, the condition can get worse. Because the signs and symptoms of rosacea can vary from one patient to another, we customize treatments based on each individual patient.These rosacea treatments can include a mix of topical treatments (including antibiotics and anti-inflammatory gels) and oral medications (including antibiotics), only if absolutely necessary. We try to avoid oral prescriptions and our patients appreciate our approach which is unique to our practice. Oral medications can help to reduce inflammation and clear up breakouts.Our patients have achieved impressive results with our state-of-the-art lasers and/or intense pulsed light therapy; these treatments help to remove the visible blood vessels from the face—clearing up redness and dramatically improving the overall look of skin. The best laser treatment is the VBeam Laser. VBeam is the most advanced Pulsed Dye Laser Technology, VBeam treats red skin, broken blood vessels, rosacea, and birthmarks. This laser targets the selected area with an intense yet gentle burst of light. This laser is so safe that it’s used for the treatment of port wine stains on infants and young children. It also treats photoaging and sun damage with no downtime.

Thanks for your question. There are many things like avoiding trigers, skin care products, topical antibiotics, oral antibiotics and lasers (PDL, KTP, IPL) to treat your rosacea. Skin care products that I have found great results with: VivierSkin® HEXAM Cleanser - Rosemary extract, grape seed extract, and vitamin C aid in thoroughly removing environmental pollutants, excess oil and makeup. This is an oil free, alcohol free, hypoallergenic, non-comedogenic cleanser. SkinCeuticals® Redness Neutralizer - Formulated with NeurMed Complex to help neutralize the environmental triggers that exacerbate redness. Also contains biomimetic peptides to cool the skin, provide instant relief and help alleviate and heat sensation. ViverSkin® LEXXEL Moisturizer - This cream calms, soothes, and helps reduce signs of redness, inflammation, irritation and bacteria. Contains hexamidine, an antimicrobial with powerful anti-redness properties. EltaMD® UV Physicial Broad Spectrum SPF 41 - Contains zinc oxide, titanium dioxide and is chemical free, natural UV protection. Water resistant. Light tint. For the best results please consult a board certified dermatologist with experience with your condition.

I echo the other doctors recommendations of lasers for 'redness at rest' and MirVaso for facial flushing.  Recently, a new FDA approved product, Soolantra (1% Ivermectin), has been shown effective for the papules and pustules associated with rosacea.  -Dr. Keaney

For the best rosacea treatments, you need to see an expert dermatologist. The right treatment for you will depend on whether there are pimples/pustules. In that case, suitable RX meds like low dose doxy, metronidazole, azelaic acid, and sulfa derivatives might work. If there is redness and blood vessels, then vascular lasers, or IPL might be more suitable.Topical Mirvaso to constrict blood vessels has issues of rebound and irritation. Avoiding triggers and regular maintenance laser or IPL treatments is important. 

Mirvaso® is a great new anti-redness prescription for Rosacea. Any skin care products containing green tea polyphenols are great for rosacea. We like Biopelle®'s new KNR® serum. In addition light chemical peels such as AFA® (acidified amino acid) and Vbeam® (pulsed-dye) laser are great for both anti-aging and rosacea.

Rosacea can present in various ways so treatment is rarely a
“one size fits all.” For years, the mainstays of treatment have included
topical or oral antibiotics and sulfur based washes or creams. These treatments
are very effective in the papulo-pustular variant of rosacea. For patients
whose primary complaint is redness from dilated blood vessels, lasers have been
used with great success. A relatively new medicine on the market is mirvaso.
This works by constricting the blood vessels, thereby providing temporary
improvement in the redness. Further research is being conducted on drugs that
work in a similar manner. Treatment with LED – red light and photodynamic
therapy are also gaining popularity, both as a monotherapy and as an adjunct
treatments. While the anti-inflammatory
effects of LED have been widely accepted, studies proving its efficacy
specifically in Rosacea patients are sparse.

As far as anti-aging treatments, the use of sunscreen on a
regular basis can help prevent/lessen sun damage. Vitamin A creams have been
proven to lessen the appearance of fine lines and wrinkles with regular use. Topical
Vitamin C is also effective in reducing redness, and can work in conjunction
with sunscreen to ward off sun damage.