Do I have Rosacea Telangiectasia or is it sun damage? (Photo)

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

This is difficult to determine from your photos. It sounds like your having a reaction to the retinol. I recommend discontinuing its use and getting a formal evaluation with a cosmetic dermatologist. Lasers and microneedling/prp can help either rosacea or sun damage. See an expert. Best, Dr. Emer

Besides any baseline rosacea that may be present it appears that your skin has become irritated from your skin care regimen.  At this time it is best to stop all of your skin care regimen and go on a mild cleanser and sunscreen.
Once your skin has calmed it will be easier to decide on the next treatment.  You may benefit form treatment with a vascular laser and/or some topical medication.  This decision should be deferred until your skin has calmed.

You have very sensitive skin and a combination of treatments such as the V-Beam, milk compresses, and topical emollients will all help.  Since you have had a pretty bad reaction I would recommend that you avoid any irritating products including retinols in the future. Please consult an expert in Rosacea and sensitive skin for treatment and product suggestions.  Best, Dr. Green

The type and pattern of redness shown in the photo is more typical of an irritant reaction to a substance.  Retinol, benzoyl peroxide, alcohol, fragrance, sunscreens.. all these chemicals/products can cause irritation in individuals with sensitive skin. That being said, it is still possible that you also have underlying rosacea and/or sun damage. Both rosacea, specifically the erythematotelangiectatic subtype, and sun damage ("poikiloderma") can cause redness and tiny blood vessels to appear on the face. Often, the 2 can look alike. It is not possible to diagnose you with rosacea or sun damage from this photo. Some differences: rosacea patients to to have very sensitive skin, that blushes and flushes easily; there is usually redness that appears in the middle of the cheeks; often tiny vessels can be seen too. You are right that rosacea can also have "bumps" or "pustules", however these are not always present in all patients. If you do have rosacea, retinol and hydroquinone may not be appropriate for you, as they can cause irritation. The best advice I can give you is to see a dermatologist with experience treating rosacea, as this is a chronic ongoing skin problem that deserves proper attention.

It is hard to tell from the photos but if this is acute it is a reaction to the retinol. let the redness subside and leave off the retinol for a few days.  This is not sundamage.  it may be rosacea but again it is not easy to tell from the photos. see a board certified dermatologist for definitive diagnosis and treatment