If IPL & V Beam don't work, what else is there?

Question

I've been dealing with Rosacea for probably 18 years. I've had 11 IPL treatments which helped change my skin tone from a reddish color to more of a pinkish color and just over the past few months I've had 4 Vbeam sessions (3 purpuric) with a very well known Cosmetic Dermatologist, but neither have really helped substantially. I will have one more Vbeam, but I don't know what else I will do. I went to another dermatologist and they recommended Rhofade, Ziana and Targadox. Any thoughts?

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

J. Daniel Jensen, MD · Answer

In addition to the topical medications such as RhoFade and Mirvaso, which require daily application, another laser option would be the Excel V laser, which is different from the VBeam and IPL. The Excel V laser, in my opinion is an excellent laser which may arguably give better results. Don't get me wrong... the other devices you mention are good for rosacea... but if you are looking for another potential option, the Excel V may be the best choice. Best of luck to you

Michael H. Gold, MD · Answer

Thanks for your question and we always recommend that you see a dermatologist for this – rosacea is a chronic skin concern and there are great medical and cosmetic treatments for this – but they require maintenance over time --- if there is a trigger for your rosacea and you are clear, the rosacea will come back, no matter what you do.  IPL and PDL are great adjuvant treatments for rosacea but most patients require oral and topical treatments from time to time to control the disease process.  Some are now using micro-Botox injections for the redness – again not permanent but this helps too.  I would keep up the IPL of PDL treatments and do what they say medically – that’s the best we have at this point.

Michele S. Green, MD · Answer

V-Beam is the gold standard for Rosacea. There is no reason to use the purpuric settings for the V-Beam for what you are describing.  I would definitely post photos to see what the problem is.  I would consider topical Mirvaso since that helps control the redness for up to 12 hours.  Please consult an expert in facial rosacea and lasers. Best, Dr. Green

Davin Lim, MBBS, FACD - Account Suspended · Answer

Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)
To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. 
  
A detailed history, together with a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -
  
1. Lasers ( to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 755 alex can be used in resistant cases. 
2. Creams - anti inflammatory
  
3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. 
  
4. For females- Mineral make up is recommend, over make up that contains parabens. 
  
For the best results, consult a dermatologist for both medical and laser treatment options. 
  
Kind regards.
  
Dr Davin S. Lim.
  
Laser Dermatologist.
  
Brisbane, Australia.

If IPL & V Beam don't work, what else is there?

Answers (5)

Answer: IPL and V-Beam

Answer: IPL and V-Beam

Answer: Lasers and rosacea.

Answer: Lasers and rosacea.

Recommended reading

Everything you need to know about Laser Resurfacing

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

If IPL & V Beam don't work, what else is there?

Answers (5)

Answer: IPL and V-Beam

Answer: IPL and V-Beam

Answer: Lasers and rosacea.

Answer: Lasers and rosacea.

Browse related questions

Recommended reading

Everything you need to know about Laser Resurfacing

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