Laser and Light Treatments for Rosacea and Facial Redness
Dr. Gary can choose from an increasing array of laser and non-laser light treatments available for treating rosacea. Laser therapy provides a scalpel-free form of surgical and cosmetic treatment for the facial redness associated with rosacea.
f you have rosacea or general facial redness, you may think that nothing can be done to create a clear complexion. But through the use of prescription medication and advanced laser technology, Dr. Rothfeld is able to improve the appearance of redness for an enhanced skin tone.
Laser therapy uses high-energy beams of light to heat and disintegrate tiny blood vessels under the skin, as well as sculpt areas of the face that have been disfigured by rosacea.
Lasers are used primarily to treat these signs of rosacea:
- Persistent redness
- Dilated, visible blood vessels
- Thickening skin on nose and cheeks (also known as rhinophyma)
For the first two symptoms, dermatologist may use a pulsed dye laser (PDL), which delivers pulsed light beams (instead of a continuous wave of light) to treat damaged skin while leaving surrounding tissue intact.
For rhinophyma, a CO2 or erbium:YAG laser or electrosurgery may be used to reshape the affected tissue by cutting, heating, or abrading it. For some cases of rhinophyma, laser therapy may be combined with another procedure such as hot loop recontouring.
Intense pulsed light (IPL) is a non-laser light therapy initially used for treating dilated facial blood vessels, which may also be recommend for the persistent redness and flushing of rosacea.
When considering light therapy, keep in mind the following:
- These therapies are not typically covered by health insurance.
Laser and light therapies may provide only temporary or partial relief of your symptoms.
- It is important that you continue to avoid triggers, avoid sun exposure, and be aware that you may need multiple or maintenance treatments, as well as supplemental medications.
- Patients with other medical conditions, such as clotting disorders, diabetes, or light sensitivity may not be candidates.
Laser and light therapy is generally not as effective for the treatment of the bumps and pimples of papulopustular rosacea. This may be more effectively treated with oral and topical medications.
Although there is no cure for rosacea, a variety of rosacea treatments are available that will reduce its appearance and prevent further progression. Rosacea can worsen and become more difficult to treat if left untreated
Glycolic acid peels at low concentrations (20 to 40 percent), along with topical or oral antibiotics, are often used to treat the redness and the dilated blood vessels that are symptomatic of the condition.
The peels are usually performed at two- to three-week intervals in a doctor's office, and supplemented with a daily glycolic wash or cream.
Keep in mind: Though a chemical peel can help relieve rosacea symptoms, if you have very dry, sensitive skin, you may not be able to tolerate one; in that case, try a barrier-repair moisturizer and a nonirritating sunscreen along with topical or oral antibiotics.
Treatments for rosacea include oral and topical medications, laser and light therapies, and surgical procedures (used mostly for advanced cases). These treatments are often combined for better results.
Lifestyle changes and a rosacea skin care regimen are also important to reduce the chances of developing rosacea flares.
Dr. Gary will recommend a rosacea treatment plan based on the following:
The rosacea subtype(s) you have developed. See treatment options for rosacea subtype 1, rosacea subtype 2, rosacea subtype 3, and rosacea subytype 4.
The severity of your rosacea
Your skin type (light vs. dark, oily vs. dry)
Results from previous treatments
Your personal preferences
There are several safe and effective medications for the treatment of rosacea.
Topical medications (applied to the skin) include:
Metronidazole (MetroCream®). Topical metronidazole reduces the papules and pustules, as well as redness (erythema) of rosacea. Metronidazole may also be prescribed to prevent relapses of rosacea.
Azelaic acid (Azelex®, Finacea®). Azelaic acid treats redness, bumps and pimples of mild to moderate rosacea.
Other topical rosacea medications include clindamycin, erythromycin, and sulfacetamide and sulfur lotions (Clenia®, Plexion®)
Oral medications (taken by mouth) include:
Anti-inflammatory dose doxycycline (Oracea®). Doxycycline is used most commonly as an antibiotic for the treatment of bacterial infections, including acne. However, doctors rely on its anti-inflammatory properties when prescribing it for rosacea.
When prescribed for rosacea, doxycycline is usually prescribed in low doses of 40mg per day. This is referred to as an “anti-inflammatory” dose. This amount is below the standard antimicrobial dose of doxycycline that kills bacteria. The low dose reduces the risk of developing side effects associated with antibiotics and of developing bacterial resistance. Oracea® is the brand name of doxycycline that has been formulated to provide anti-inflammatory effects when taken once a day. Its low dose formulation makes it safe for long-term use.
Oral antibiotics (minocycline,doxycycline, erythromycin, tetracycline)
A combination of medications may be recommended for maximal benefit. For instance, an oral medication, such as Oracea®, may be combined with an antibiotic applied to the skin, such as metronidazole or azelaic acid.
Procedures for Rosacea
Your doctor may also recommend one of following procedures:
Laser therapy—used to shrink a bumpy or swollen nose, reduce persistent redness, or decrease the number of visible blood vessels (telangiectasias)
Electrosurgery—a procedure in which the skin is numbed and a small electric needle is used to destroy visible blood vessels (telangiectasias)
Multiple treatments may be necessary to achieve optimal results. Your doctor may also recommend future treatments to maintain long-term results.
If left untreated, chronic rosacea can lead to rhinophyma and skin thickening, which are more difficult to treat. Your doctor may recommend procedures to reshape areas, such as your nose or forehead, to a more normal appearance:
What should I expect from rosacea treatment?
It takes time for rosacea medications and other therapies to work, but many rosacea treatments will show results within the first 2 months. Your doctor can provide a reasonable estimate of results, depending on the treatment(s) prescribed and any lifestyle changes you make.
Be sure to follow your doctor's instructions. Sticking to your rosacea treatment can help reduce the chances of experiencing another flare-up and keep your rosacea under control.
It is important to continue with your treatment regimen and lifestyle modification even if your rosacea clears up.
The U.S. Food and Drug Administration approved Mirvaso (brimonidine) for the treatment of the redness -- clinically known as erythema -- that is a hallmark of rosacea. The gel is made by Galderma Laboratories, of Fort Worth, Texas, and was approved based on two month-long clinical trials involving more than 550 patients.
This is a turning point in rosacea treatment where we will be able to provide patients to deal with the daily anxiety caused by the redness of rosacea.
The new approval of Mirvaso is very interesting because for the first time, we have a topical gel to treat facial redness of rosacea, where in the past we only had a limitation of lasers.
Only time will tell. After a few years it is a possibility that the lasers for redness will be extinct.
Mirvaso is thought to work by constricting otherwise dilated facial blood vessels, cutting down on the appearance of redness.
The gel is applied once a day to the forehead, chin, nose and cheeks according to Galderma Labs. The good news It will be available in pharmacies in September 2013.
It would be very interesting if Mirvaso would come out in a cream form also since a gel has a drying up effect and a cream has more of a moisturizing effect which would enhance the calming effect of the facial redness. Again only time will tell.
I personally see every new patient who visits our office. I am not just a physician, I am a Board Certified Dermatologist. My goal is, quite simply, to provide the type of dermatology care which I would seek for my own family. This is a very important point, since physicians often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be treated: with courtesy, dignity and respect. I carefully listen to their hair and skin-care concerns and offer a variety of options including a treatment plan that I believe will give them the best results
Dr Gary sees every patient himself and believes in personalized care. The Doctor does not employ any physician assistants, nurse practitioners, or other physician substitutes to do his treatment. He sees every patient himself at every visit.
A significant percentage of my Hair Loss, Dermatology and Cosmetic Dermatology Conditions are diagnosed on listening to the medical history of the patient alone, a further percentage on examination and the remainder on further detailed or careful examination and my patients teach me the rest. It is clear to me that history and examination skills remain at the very core of my dermatology practice. Older Dermatologists like myself rely on history and physical to a greater degree than the younger dermatologists. I think that the pendulum has swung too far towards all these cosmetic procedures where the younger dermatologists are just doing cosmetic procedures and not listening to their patients. This is an important point because if the Dermatologist does not spend enough time with the patient during the consult the cosmetic procedures will probably not work.
It is vital to undergo a full pre assessment to ensure that your skin type is fully assessed and to be accurate about your medical history. This particular procedure might not be the right treatment for you. It is crucial that the Doctor does a full History and Physical Examination and listens to your concerns. It very important to understand the individual needs of each patient because one procedure could work on one patient and then not another.
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New York Dermatology
Board Certified Dermatologist
30 E. 60th St. Ste. 805 (Park Avenue)
New York, NY 10022