Rosacea unresponsive to IPLs

Question

I have been suffering with rosacea for years and recently decided to seek medical treatment for it. I tried 3-4 prescription topicals, none of which worked. I read that IPL's have good results so I decided to try it. I've had 3-4 IPLs performed last spring, ceased treatment in the summer, and have had 4-5 this fall/winter. With the exception of 1 treatment, I've seen no results or improvement in my redness. Have I just not been through enough tx's or should I start to consider the Vbeam??

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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Morris Westfried, MD · Answer

Either the beam or q switched yag which are lasers Dan be more effective. These are lasers and I find them more effective than iPod. For diffuse redness however there may be an end for follow up visits. You see response on first session.

Benjamin Barankin, MD, FRCPC · Answer

IPL or BBL can be effective for more diffuse redness of rosacea, but for stubborn vessels (telangiectasia), you're better off with a true "laser" instead of light source, such as Vbeam or KTP or Nd:Yag. Make sure your dermatologist has confirmed rosacea as your diagnosis as there can be other issues causing it to some degree. You could also try brimonidine gel in the morning.

Alim R. Devani, MD, FRCPC · Answer

There are many things like avoiding trigers (stress,
temperature changes, alcohol, spicy foods, exercise, sun, heat, cold and many
others), medical skin care products, topical antibacterials, topical
anti-inflammatories, oral antibacterials, oral retinoids (isotretinoin), lasers
(Cutera Excel-V KTP laser) and light based devices (blue/red light, IPL/BBL,
PDT with metvix or levulan) to treat your rosacea. Skin care products that I
have found great results with are the following:

VivierSkin® HEXAM Cleanser -  Rosemary extract,
grape seed extract, and vitamin C aid in thoroughly removing environmental
pollutants, excess oil and makeup.  This is an oil free, alcohol free,
hypoallergenic, non-comedogenic cleanser.

SkinCeuticals® Redness Neutralizer -  Formulated
with NeurMed Complex to help neutralize the environmental triggers that
exacerbate redness. Also contains biomimetic peptides to cool the skin, provide
instant relief and help alleviate and heat sensation.

ViverSkin® LEXXEL Moisturizer -  This cream calms,
soothes, and helps reduce signs of redness, inflammation, irritation and
bacteria. Contains hexamidine, an antimicrobial with powerful anti-redness
properties.

EltaMD® UV Physicial Broad Spectrum SPF 41 - 
Contains zinc oxide, titanium dioxide and is chemical free, natural UV
protection. Water resistant. Light tint.

For the best results please consult a board certified
dermatologist with experience with your condition.

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- as your case has proven.

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.

Rosacea unresponsive to IPLs

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