IPL Was Unsuccessful for Rosacea Redness. Pulsed Dye an Option?

Question

I have persistent redness in my cheeks and nose. I've tried 3 IPL sessions at a local business, with no results other than a patchy beard. I'm frustrated and I need options! I work as a Reserve Firefighter, so downtime is a concern. Do I have any more options? I've tried Topicals, Orals, everything! The redness is still at large. Thanks for your help!

Kimberly Butterwick, MD · Answer

If you have not received satisfactory results with IPL treatments, a pulsed-dye laser is a good next step. However, it is also possible the IPL previously used on your face was not powerful enough to produce an optimal outcome. In my practice, we use both the Stellar M22 and the Vbeam Perfecta for treating diffuse redness and visible vessels. The Stellar M22 is one of the most powerful IPL devices available today, offering our patients superior results. The Vbeam Perfecta is a vascular laser that targets the blood under the skin to eliminate veins and redness without harm to surrounding skin and tissue. We sometimes combine this treatment with ALA solution first, which makes the area more sensitive to the laser. If you have rosacea, this is a great treatment. I recommend scheduling a consultation with an experienced, board-certified dermatologist who can assess you more thoroughly in person and create a customized treatment plan that meets your needs and goals best.

Lorrie Klein, MD · Answer

In our office we have both a V Beam (pulsed dye laser) and a Lum 1 (IPL) and we use both for rosacea. Both work well and when one doesn't work well for an individual it is worth trying the other one. At higher levels the V Beam has more down time (purple marks) than the IPL (coffee grind appearance) but at lower levels the V Beam might only cause temporary redness as a side effect.

Harold J. Kaplan, MD · Answer

Hi FireDan.  Not only is the pulsed dye laser an option for you but it is a far superior option to IPL.  The problem with IPL is that it is a "jack-of-all-trades" but master of none.  It is designed with multiple uses and types of light.

	The problem is that it cannot achieve high enough fluences (energy) to properly close the troublesome small blood vessels associated with advanced Rosacea.  This is where the pulsed dye laser (and bruising doses come in).  Consider the pulsed dye laser but also note that if you refuse higher level bruising doses (which require some downtime) you may not achieve your goals.

Steven F. Weiner, MD · Answer

After failing an IPL, I highly recommend the pulsed dye laser (VBeam Perfecta). It was made specifically for treating red lesions. There is no appreciable downtime, no discomfort, and very little risk. It is usually a series of 3-4 that is needed to improve rosacea. It will not cure it, but you will get relief. It also helps underlying acne if that is associated with your rosacea.

Brian E. Dubow, MD · Answer

Pulsed dye laser is a much better option to treat rosacea, it is just that most offices do not own one so try and make their IPL machines work. If you are in the LA area feel free to come see me for a consultation, I am one of the 6 offices in Los Angeles to own a Vbeam pulsed dye laser, the top of the line for PDL.

Michael H. Swann, MD · Answer

I do like the V-beam for scars and it obviously works well for redness in general, but I prefer the KTP Laser (Gemini) for treating discrete blood vessels and background redness associated with rosacea.  Either pulsed-dye (V-beam) or KTP are both far superior to IPL for targeting redness.  IPL can improve redness, but this will take many treatments and is really just not the right tool for the job. 

	KTP lasers are more likely to give you swelling after the procedure, while the V-beam is more likely to give you a bruise.  The downtime associated with either procedure is 2-3 days of social downtime (not looking perfect), but can be minimized by an experienced operator and excellent post-procedure care.  Good luck!

Daniel Berg, MD · Answer

Pulsed dye laser may certainly be successful in situations where IPL hasn't worked.  Some people prefer the pulsed dye laser (PDL) as their first choice for redness in rosacea.

	My experience is that the flushing and background redness respond less predictably than the small red blood vessels which you can see on close inspection.  Most people have minimal side effects with 1-2 days, if that, of mild swelling.  In larger areas of treatment you may get some bruising (depending on settings) or uncommonly more dramatic swelling for a few days.  More serious side effects are quite rare.

Jason R. Lupton, MD · Answer

I always prefer the pulsed dye laser to treat the redness and fluching associated with rosacea. I feel it is superior to most IPL devices. The laser is more specific at targeting the unwanted blood vessels that impart the red and ruddy look to the skin. Downtime should not be too signifcant with this laser and there should be no removal of any facial hair either. Post operative effects usually include mild to moderate redness and swelling - but these can usually be improved with regular icing after treatment.

IPL Was Unsuccessful for Rosacea Redness. Pulsed Dye an Option?

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