Skin care against blackheads and rosacea?

Question

My dermatologist prescribed me Differin Creme 1% Metrogel My problems are enlarged pores, blackheads and diffuse redness, no acne. I get KTP laser treatments against the redness. I am only using Paula's Choice products, for more than 1 year (alongside cleanser, toner, SPF moisturizer) 1% BHA LOTION EXFOLIANT 2% BHA LIQUID 10% NIACINAMIDE BOOSTER TREATMENT WITH 10% ALPHA HYDROXY ACID ARGAN OIL BOOSTER to balance dryness Is there any recommendation you have or should I proceed?

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

Michael H. Gold, MD · Answer

Thanks for your question and we always recommend that with a diagnosis of rosacea, you see a board certified dermatologist to learn the best treatment options.  Blackheads are usually not common with rosacea so that needs to be addressed. For the redness associated with rosacea, we are going to have a really good medicine coming in the next month – called Rhofade – from Allergan.  Ask your doctor about it – it may be something worth considering to keep the red away.  Good luck.

Kevin Cavanaugh, MD · Answer

Hi and thank you for your question. Blackheads technically are considered acne and are best treated with a retinoid, such as Differin. The latter is less irritating than traditional tretinoin (Retin-A), but is also less effective. Metrogel works well for papular rosacea, but is not effective for redness. KTP laser or IPL are great for overall redness from rosacea. When you start a retinoid it is important to apply a non-comedogenic moisturizer afterwards to help combat any redness or irritation. For drug store brands I recommend CeraVe. For more elegantly formulated  products I like ZO or Skin Medica. I hope this is helpful. 
Kevin Cavanaugh, MD

Davin Lim, MBBS, FACD - Account Suspended · Answer

Proceed. This is because your dermatologist has assessed and seen your skin, and we have not. 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. 
  
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. Dr Davin Lim. Brisbane. Australia.

Skin care against blackheads and rosacea?

Answers (4)

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