I was recently diagnosed with Rosacea but I also have Melasma. My Melasma is mixed epidermal and dermal and not very noticeable, in fact I don't think my dermatologist would have identified it if I hadn't pointed it out. Which is the best modality for treatment of my vascular Rosacea and carries the least risk of triggering hyperpigmentation? I realize there is always a risk but I'm hoping one is less risky than the other.. I just don't know which.
IPL vs. V-Beam for Rosacea
Doctor Answers 10
Vbeam is the fastest and safer option
Vbeam is actually safe on melisma prone skin yet powerful enough to treat redness.
V beam treatment is so safe that it has been used successfully for the treatment of port wine stains in infants and young children. The Vbeam skin laser can also be used to treat rosacea, stretch marks, warts and keloids, or even tiny spider veins on the legs or face.
After applying numbing cream, the laser light is applied to the patient’s skin. Vbeam skin laser treatment is relatively painless and does not require a long healing time. The most common reaction patients experience include just a few hours of mild redness.
Treatment with the Vbeam may consist of multiple treatments, depending upon the condition and needs of the patient’s body. For facial veins, one treatment may be sufficient for clearance (that said, additional treatments are not uncommon). These treatments occur on an average of every 4 weeks depending on the area and type of treatment.
In contrast, IPL can cause further hyperpigmentation because it works on melanin in the skin.
IPL for Rosacea Rx
VBeam vs IPL
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V beam pulse dye laser, conservative settings PLUS HQ and Lytera
This is how I manage these two conditions in the one patient.
1. Treat melasma first- this means SPF+++. I like Lytera as it is less irritating on your skin and hence won't flare up your rosacea.
2. Add HQ in a steroid base - short term. Percentage depends on how sensitive your skin is, as you have rosacea.
3. Treat your rosacea like walking on egg shells- namely medical treatments before laser. Your medical dermatologist may use creams or compounded solutions.
4. If the above fails, then I would use V Beam PDL - settings are different from my normal rosacea patient without melasma. I would be conservative, and most importantly you should be on melasma management 2-4 days after the laser (this decreases the chances of flaring up your melasma)
hope this helps you understand our thought processes in treating two conditions in the one patient.
All the best
Dr Davin Lim
Use Melarase AM and Melarase PM with PDL and IPL treatments
Raffy Karamanoukian MD FACS
V-Beam for rosacea
V-beam is a targeted therapy for rosacea. It helps with overall redness as well as dilated blood vessels on the face. You may need multiple treatments to achieve the results you want.
V-beam vs IPL for rosacea
V-beam is a pulse dye laser that attacks red pigment in your skin, in other words small dilated blood vessels and red spots that are a hallmark of rosacea. The nice thing abot V-beam is that it targets just the red stuff, while sparing the rest of the skin. It does not work as well for the purple vessels though. Usually you may need multiple treatments to improve skin color. This therapy is good in conjunction with topical therapy or medical therapy non-responders.
Go with the V-beam
The v-beam is a more specific and safer treatment for your blood vessels than any IPL and will usually require far fewer treatments than IPL. If you are trying to get improvement for the melasma, you might be a good candidate for the Fraxel Dual laser. Definitely wear sunscreen after your v-beam treatment given your set of issues.
IPL vs. Vbeam
In general, almost any laser can worsen melasma; however, this risk can be decreased by using a prescription bleaching cream prior to the procedure, such as hydroquinone. In general, the Vbeam is a more targeted therapy for blood vessels, rosacea, and facial redness. This is because the Vbeam is single wavelength of light, whereas the IPL is a broad spectrum of light and is much riskier to use when treating patients with melasma.
Go With Vbeam for Rosacea
The Vbeam laser is highly specialized for treating Rosacea. The general idea behind lasers is that they use a single wavelength to accomplish a specific objective. The Vbeam uses the 595nm wavelength because this form of light is easily absorbed by oxygenated hemoglobin carried by your blood cells. This serves as the target point of entry for the laser to enter your skin. Once it is in your blood vessels, it heats the walls which causes them to seal off and become non-functional tissue that is disposed by the body.
Since Rosacea is basically a condition of unwanted blood vessels, the Vbeam is an ideal tool for clearing this condition.
IPL is not able to accomplish this because it uses many different wavelengths. Although positive benefits have been reported, the outcomes are not predictable.
Watch the video below to see the Vbeam in action on a real patient.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.