Sebaceous Hyperplasia, Rosacea and early symptoms of Rhinophyma all by the age of 32. What can be done?

Question

Hi Doctors, as the title says it seemed I've drawn the short straw in regards to my skin. All my conditions are early stage including redness not being too bad. My current Dermatologist wants to put me on a long term low dose of Accutane with 3 - 4 IPL sessions a year. How long can I stay on a 3 10mg pills a week and is it even possible to control my conditions and give me confidence until an older age where I care a little less about my appearance. Thank you for time.

Harold J. Kaplan, MD · Answer

Hello,
As you indicated, genes/heritage can produce a more challenging skin condition.  With regards to the Accutane for long-term use, we think it's wise to consider the potential negative side effects that your dermatologist outlines as compared to the potential benefits.  This helps narrow down the options.  Although IPL's are good for managing redness, we do not think this technology is the best approach for your condition.  In our practice, we rely on the gold standard of pulsed dye lasers.  Given that you have early symptoms of rhinophyma, having bruising doses with a pulsed dye laser will offer a good cosmetic benefit as well as managing other symptoms associated with rosacea/rhinophyma.  In addition, ALA with PDT (Aminolevulinic acid with Photodynamic Therapy) has proven to be a good option to Accutane with a more direct impact with far less negative side effects.  We would encourage your researching the below options before initiating an Accutane program.  To encourage you - yes, maybe the short straw, BUT you are still very young and motivated, and technology has improved to provide far more options than decades ago.  Be diligent with your sunscreen.  Take care.
Research:
Aminolevulinic Acid with PhotoDynamic Therapy (ALA/PDT)
Pulsed dye lasers for rosacea
Debulking of rhinophyma with lasers

Raffy Karamanoukian, MD, FACS · Answer

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

Sebaceous Hyperplasia, Rosacea and early symptoms of Rhinophyma all by the age of 32. What can be done?

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Sebaceous Hyperplasia, Rosacea and early symptoms of Rhinophyma all by the age of 32. What can be done?

Answers (2)

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Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.