V Beam laser or low dose isotretinoin? I've been recommended Pulsed Dye Laser for my rosacea. (Photos)

Question

Hi, I've been recommended Pulsed Dye Laser for my rosacea, but I'm unsure if I should go with the bruising (purpura) setting or not. I was told that the purpura setting is the equivalent of having 3 non- purpura sessions; is this accurate? Also, would roaccutane (isotretinoin) help with my rosacea in a low dosage?

Jason Emer, MD · Answer

A combination approach will give the most improvement. I recommend getting a following up with a cosmetic dermatologist. For rosacea, I like a combination using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V, Clear + Brilliant), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

In our office, we have several treatments that can help improve common vascular skin issues, including rosacea, post-inflammatory erythema, red scars, facial blushing, and spider veins. The Vbeam laser continues to be the gold standard for redness, including rosacea and post-inflammatory erythema. In some cases, we add Venus Viva RF coagulation to help improve redness on the skin from spider veins, inflammation, and rosacea. 
  
Generally, several sessions are required to improve redness on the skin. Vbeam laser, IPL Limelight, and Venus Viva all work very well with minimal downtime. 
  
Patients with rosacea may benefit from topical creams to help soothe inflamed skin. We recommend Elevase Moisture Booster. For Post-inflammatory erythema, Plato’s Scar Serum is recommended twice daily. 
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Timothy G. Rodgers, MD, FAAD · Answer

Using the purpuric (bruising) setting on a pulsed dye laser will typically result in faster clearance of redness and blood vessels.  However, this eggplant purple-type bruising can often last 10 to 14 days, making it unacceptable for most patients to have that much social downtime.  It is difficult to predict how many purpuric sessions would be equivalent to non-purpuric settings, but half is probably a good estimate. 
Some patients have experienced improvement in rosacea with topical retinoids, such as tretinoin, or systemic retinoinds, such as isotretinoin.  Usually only low-doses are needed.

V Beam laser or low dose isotretinoin? I've been recommended Pulsed Dye Laser for my rosacea. (Photos)

Answers (3)

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