Rosacea is a common skin disease. It often begins with a tendency to blush or flush more easily than other people do.
Rosacea can cause more than redness. Rosacea can cause acne-like breakouts, visible blood vessels on the face, and dry, irritated eyes. To treat these diverse signs and symptoms, dermatologists divide rosacea into 4 subtypes.
Rosacea typically begins as redness on the central face across the cheeks, nose, or forehead, but can also less commonly affect the neck, chest, ears, and scalp. In some cases, additional symptoms, such as semi-permanent redness, telangiectasia (dilation of superficial blood vessels on the face), red domed papules (small bumps) and pustules, red gritty eyes, burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma), may develop.
Recently, a few studies investigated the effectiveness and potential side effects of using lasers and IPL to treat rosacea. Here are the findings along with some general information about these devices.
LasersToday, lasers are used to treat these signs of rosacea:
Dilated blood vessels
Thickening skin on nose and cheeks (also known as rhinophyma
After just one treatment, every patient in the study experienced significant improvement. With two treatments, redness decreased by 40% to 60%. Patients also reported reductions in flushing, burning, itching, dryness, swelling, and sensitivity, which they said significantly improved their quality of life. Side effects included crusting and spots of darkened skin on the treated areas. These side effects were successfully treated. All improvements were maintained from one treatment to the next.
This study also found that effectiveness increases when the pulsed dye laser causes temporary bruising, which may last for 1 to 2 weeks. While bruise-free treatment is possible with some of the newer pulsed dye lasers, researchers concluded that inducing bruising leads to a consistent decrease in redness and other symptoms, such as burning and itching. The researchers firmly believe that inducing bruising increases effectiveness.
Other lasers used to treat visible blood vessels include the KTP laser, diode laser, and Nd:YAG laser. These lasers are less likely to cause bruising. Each is used to treat single, large, visible blood vessels. Findings indicate that these lasers may not be as effective in reducing redness as the pulsed dye laser.
Some patients with longstanding rosacea develop thickening skin on the nose and cheeks, which is called rhinophyma. The CO2 laser and erbium:YAG laser can be used to remove this thickening skin and improve the contour of the nose.
Intense Pulsed Light (IPL)A newer form of therapy, IPL uses a non-laser light source. The first IPL product received FDA approval in 1995 for treating fine dilated blood vessels on the face. Since then several other products have been approved. Recent studies conclude that IPL can safely and effectively reduce the following signs of rosacea in some patients:
- Dilated blood vessels
- Persistent redness
- Acne-like breakouts
To investigate the safety and effectiveness, four patients with dilated blood vessels and persistent redness received five IPL treatments, which were given at three-week intervals. Patients averaged a 30% drop in blood flow, a 29% reduction in visible blood vessels, and a 21% decrease in redness.2 Since only four patients were evaluated, these numbers cannot predict how people with rosacea in general will respond. Some dermatologists believe, IPL is more effective than these numbers indicate.
Another study looked at the effects of IPL treatment on the persistent redness, flushing, and breakouts associated with rosacea. In this study, 32 patients received between one and seven IPL treatments. Following treatment, 83% experienced reduced redness, 75% said they had less flushing and improved skin texture, and 64% reported fewer acne-like breakouts.3 As the above studies indicate, IPL is not effective for everyone. However, most patients notice some reduction in dilated blood vessels and redness after only one or two treatments. In one case, a patient’s flush response returned to normal. Side effects from IPL are temporary and include redness, swelling, bruising, and skin lightening.
Thinking about laser or light therapy?If you are considering laser therapy or IPL to treat your rosacea, it is important to keep the following points in mind,.
On this slide, many forms of Rosacea:
- Not a cure. While some patients experience dramatic results (such as the return of a normal flushing response) and the results can be long-lasting, neither laser nor light therapy cures rosacea. You still need to continue to see your dermatologist for treatment and avoid your personal rosacea triggers. To maintain results, additional laser or light treatment may be needed at a later time.
- Some patients not candidates. Do you have a suntan or any of the following medical conditions?
- Clotting disorder
- Tendency to develop keloids
- Insulin-dependent diabetes.