What is the most "aggressive" (non-purpuric) V Beam settings for erythematotelangiectatic rosacea?

Question

I have had a few sessions of VBeam with fairly aggressive settings for the treatment of erythematotelangiectatic rosacea but I have had five sessions and the results have been rather slow (although there has been some improvement). Please could a qualified Vbeam specialist let me know the most aggressive non-purpuric (or borderline purpuric) settings and/or number of passes for optimal results. I have an appointment tomorrow so a speedy response would be much appreciated!

Raffy Karamanoukian, MD, FACS · Answer

Our protocol for hyper-erythematous redness uses a combination of lasers and Nanofractional RF to help reduce localized and perfuse hypervascularity in the skin. We begin with an evaluation of the redness and evaluate the cause of the hypervascularity. Treatments with Limelight IPL, Vbeam Perfecta, and Nanofractional RF are then used to reduce the blood vessels and telangiectasia within the skin. Patients benefit from post-treatment application of Elevase Moisture Booster with ceramides. 
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Davin Lim, MBBS, FACD - Account Suspended · Answer

No cook book answer, and the settings will be determined by your previous responses and your skin type. With ETR, the PD is usually 3-6 ms, but this depends on your calibre of your vessels and your skin type. Your dermatologist or plastic surgeon will know how to dial in the best parameters as each patient is unique. Laser only plays a small but important role in controlling rosacea. 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. 
  
Kind regards.
  
Dr Davin S. Lim.
  
Laser Dermatologist.
  
Brisbane, Australia.

What is the most "aggressive" (non-purpuric) V Beam settings for erythematotelangiectatic rosacea?

Answers (2)