Pulsed Dye Laser vs IPL for Rosacea

Recently, I went to the doctor because I suspected I had Rosacea. He said it looks like I have a mild version (face is pink and break out frequently). He prescribed metronidazole (10days) and metrogel. I've had two Vi Peels and two IPLs in the past. I'm considering getting IPL again for the spider veins on my face and to improve rosacea but after reading some stories and seeing pics of sagging skin and burn marks, I'm really scared. Is more downtime required with the laser? Does Pulsed dye laser have similar side effects as the IPL? Thanks for your input.

Doctor Answers 5

IPL and Pulse Dye Laser treatments work well on facial redness associated with rosacea

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IPL treatments are great for patients with diffuse redness and dilated vessels on the face whether it is associated with rosacea or from other causes.

IPL treatments use a bigger spot size which allows for quicker treatments of large areas. There is also less bruising usually with IPL treatments.

Pulse dye laser or VBeam treatments are probably the gold standard for treating dilated blood vessels on the face. I use both on my patients. I usually will have the patient do a series of IPL treatments to do the majority of clearing and will touch up any resistant lesions with my VBeam.

Both treatments are very safe if they are performed by well trained and knowledgeable professionals. I personally perform or oversee every treatment. You should request the same from your physician to ensure your safety and for the best results.

I hope I was helpful.
Steven E. Rasmussen, M.D., F.A.A.D.

Austin Dermatologist

Possibly, depends on the severity of your rosacea

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Yes, pulse dye laser can,  and does have down time, especially for treating veins and blushing- flushing rosacea. The more severe the redness, means a downtime of a few days. Ice-ice-ice is the way to reduce swelling. Make sure you re off your anti inflamatories NSAIDS, or fish oil. Most good laser dermatologists will start you on a conservative setting, and then see how you react, pushing you higher if needed. 

In my opinion, V BEAM pulse dye is better than IPL for rosacea in the majority of cases, 

Dr Davin Lim 
Brisbane, Australia

IPL vs. PDL for rosacea

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Both IPL and PDL treat rosacea well. The selection depends on the patient's rosacea presentation, down time availability and period of commitment as well as affordability. Both procedures are safe and well tolerated without anesthesia and take about 20 minutes to complete in the office.

If the rosacea is general a ruddy complexion with few break outs of acne rosacea and few fine broken capillaries, then IPL would likely be a better selection. Also, it has minimal downtime (just a bit pink for an hour after the procedure). Additionally, if the patient has a few brown spots from sun exposure, then they can get simultaneous improvement with IPL. In general, it takes three to five sessions to see nice results.

However. if rosacea is very bright red with lots of outbreaks and prominent blood vessels, PDL would be a better choice. In general, for more rapid (only a few monthly treatment sessions) and more effective results, stronger energies are indicated, which means longer down time (bruise-like purple discolorations for about 2 weeks after the procedure). However, if that is not an option for the patient, milder energies can be used without significant recovery time (just pink for an hour after the procedure), but it takes much longer to accomplish the ideal result, requiring about five monthly treatments.

Good luck!

Marianna Blyumin-Karasik, MD
Davie Dermatologist

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IPL PhotoFacials work well to decrease facial redness associated with rosacea.

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The color of your skin is the best predictor of laser or IPL complications. The lighter your skin, the less likely you'll get a burn. Most burns will not scar if recognized and treated appropriately.

I have had good success treating facial redness and flushing with my Palomar StarLux IPL. You'll require around 4 or 5 treatments spaced weekly to get an optimal result, and you'll need to do follow-up treatments quarterly to maintain your result.

If there are any visible capillaries on your face after a series of treatments, I will coagulate them with a needle-tip Hyfrecator at no additional charge to my patients.

I am not aware of "sagging skin" as a recognized complication of IPL PhotoFacial treatments.

I hope you find this helpful.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Pulsed Dye Laser for Rosacea

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I typically prefer pulsed dye laser for the treatment of acne rosacea. It is more specific for the blood vessels and I feel like I get more clearance in fewer treatment sessions with this laser.

Downtime depends upon how aggressive the treatment is - redness and swelling may last a few minutes or up to a few days. Icing the treated area after treatment can greatly reduce the amount of downtime.

Jason R. Lupton, MD
San Diego Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.