What to do first, rosacea treatment or microdermabrasion?

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

You need a cosmetic dermatologist who specializes in acne scarring/pigmentation and does a combination of treatments including: surgery, subcision, or TCA cross for deep or pitted "ice pick" scars; fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars; Eclipse Micropen for all types of scars and improvement in texture and tone; lasers such as co2 laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Sublative or Viva to improve the scars and give long term collagen production. Microdermabrasion doesn't help acne scarring and can make rosacea worse. There are many options but you want someone who can customize a regimen for your short and long term goals based on your individual situation.  If you also have redness/rosacea, I used a pulsed dye laser on the same day as the other treatments.  Best, Dr. Emer.

Hello Gian.  Agreed with Dr. Talei.  Microdermabrasion will just aggravate Rosacea in most cases.  For Rosacea consider pulsed dye lasers or [prescription medication.  We would have to see the scars, but if they are red, then the pulsed dye laser will also help with these.  To see some examples of before and after photos for Acne and Acne Rosacea with pulsed dye lasers, click on the link below.

The VBeam and Excel V can treat both problems simultaneously. I would try these. Microderm won't do much to acne scars and is a waste of money. If the scars remain, Infini or Fraxel are good choices. For the deeper scars, try using Bellafill.

The main thing to consider before you start your treatments
is to have a consult with a reputable dermatologist/facial/plastic surgeon. My
practice has been considered by Lumenis lasers to be a Lumenis laser center of
excellence and I have been a "Luminary" (Lumenis physician teacher)
for the last 10 years. Not many physicians have these recognitions. I also help
develop and teach my own Rosacea and Melasma protocols for the Lumenis IPL
systems to other physicians and technicians.I will treat the acne scars first with fractional CO2 resurfacing. This treatment may encourage more rosacea at the beginning as it will create an inflammatory process of the skin. Then treat the rosacea after the skin has healed.In my humble opinion I believe that a multi-treatment combination is needed in order to effectively control rosacea. Oral & topical medications, and IPL laser are the main tools to combat rosacea in my opinion. you will need to add the avoidance of the triggers like alcohol, sun exposure, sudden temperature swings, mood changes, stress.Hope this helps,Dr. Gus Diaz

The answer to this is quite complex. Firstly, microdermabrasion will have almost no effect on acne scarring other than to aggravate the underlying rosacea.  Then you must assess whether you have acne with associated rosacea or a subtype of rosacea which is papulopustular.  In either case there are a variety of topical medications which can make a very big difference and should be started prior to abrasive or ablative treatments.  Depending on your skin coloration and type of scarring you may use a variety of lasers, excisions, or actual dermabrasion

Microdermabrasion will not treat acne scars, and in most cases can flare up rosacea. My approach is to treat acne scarring, and come up with a medical plan for rosacea. This can include anti inflammatory creams and tablets. Once your acne scarring treatments are completed, a series of V Beam pulse dye laser can reduce rosacea flare ups and potential redness you may get from acne laser treatments. Dr Davin Lim Laser DermatologistBRISBANE, Australia