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Rosacea Laser Treatments

As the American Academy of Dermatology states: Experience is required. As with any surgical technique, finding a dermatologist who is skilled in using lasers or IPL is essential. You should ask prospective doctors about their experience and training in this area. Extensive experience in performing laser or light procedures helps ensure the best possible results. And with any medical procedure there is always the possibility that you will only see a minor change or not see a response. Rosacea also may worsen.

Laser Skin Resurfacing

The term "LASER" is an acronym for "Light Amplification by Stimulated Emission of Radiation". Laser is defined by the Merriam-Webster's Medical Dictionary as a device that utilizes the natural oscillations of atoms or molecules between energy levels for generating coherent electromagnetic radiation in the ultraviolet, visible, or infrared regions of the spectrum.

Light energy is changed into a tight, intense beam of monochromatic radiation capable of delivering large amounts of power or heat. All lasers possess a lasing cavity consisting of two mirrors placed parallel to each other. One of these mirrors is partially reflective and between these mirrors is a lasing medium or conduit which can be either a gas (CO2 or Halide, etc.), solid (Alexandrite or Ruby) or liquid state.

Laser resurfacing is not for everyone and certainly not for those with rosacea as their skin is already sensitive enough. For the person "without rosacea," that exhibit the rough aged skin such as the "Marlboro man with weather skin", the removal of fine layers of the skin by burning of skin spots, wrinkles, etc. is fine as the purpose is to remove the aged worn skin that has been used for protection against the weathering of sun and wind as a callous on the hand is likewise protection from heavy friction of labor. So as the purpose is to remove skin the protection is lost with a more refined smooth skin which is more beautiful to the eye. However, limitations are 'not going to far' to cause redness and irritation of the skin.

Laser skin resurfacing is a modern cosmetic procedure for removing facial wrinkles, aging spots, facial discolorations, acne scars, skin growths, tattoos, and weathered skin. The laser is passed over the treatment area to eradicate wrinkles around the eyes and mouth or anywhere that weathered or photo-damaged skin or lines, hyperpigmentation or blemishes exist. Lasers are an effective way to remove those superficial lines that have make you appear aged. And laser resurfacing is considered a safer, less invasive procedure than deep chemical peels or dermabrasion. Laser skin resurfacing is a quick and effective procedure that leaves patients with smoother, younger looking skin if you have 'aged' skin only and 'without rosacea'. Please remember that rosacea patients have skin that is at the limit of abused skin from various abuses of harsh medical treatments of retinoid, wrinkle removal systems, steroids, etc. that have resulted in skin that is already inflamed, thus laser resurfacing is not for rosacea patients as the objective is to let the skin heal and not to burn the top layer off. Even trying to remove skin is successful as it can be done, but the skin is programmed to grow back which it does with the same problems after healing from laser treatments. The ideal concept is to stop the irritation or causative irritation and let the skin heal.

Resurfacing with a laser is considered ablative (such as CO2) and non-ablative (NLite). Ablate literally means to remove by cutting, abrading, or evaporating. With ablative lasers, the skin surface will appear red and weep afterwards with resulting swelling and pinkness as the top layers of the skin have been removed.

Wrinkles which were more severe and caused by excessive muscle movement such as forehead wrinkles had the least improvement (86%).

Persistent redness (erythema) which is an abnormal redness of the skin due to capillary congestion or inflammation and hyperpigmentation are the most common complications but these usually resolve after several months. Other potential complications include acne, dermatitis, infection, hypertrophic scarring, and milia which is a small pearly firm non-inflammatory whitehead. Milia is due to retention of keratin in an oil gland duct blocked by a thin layer of epithelium. Most complications are related to postoperative care.

Types of Lasers

There are many types of lasers which address the variety of conditions to be treated. Some of the more commonly used lasers are listed below.

Carbon Dioxide Laser

This is technically called a carbon dioxide gas lasing device. This is the most common type of laser treatment. Unfortunately CO2 lasers aren't for everyone. They can be used to eradicate excessive or irregular scarring from a prior procedure although care must be taken when determining a candidate. Hyperpigmentation and hypertrophic scarring may occur in persons who are prone to such or in persons of ethnicity (Italian, Asian, African, African-American, Greek, etc.)

If the treatment is for sun-damage or sun-damage induced wrinkles, you will only continue to get sun damage if you frequently subject yourself to UV light exposure or spend a lot of time in the sun without a proper sun block or hat, etc.

Approximate Cost: $1,500 - $6,000.US

Cool Touch 1320 Laser

Technically known as the thermescent Nd: YAG 1320 LASER. This is also a selective dermal heating type of procedure such as NLite. This laser supposedly can be used on any skin color, any skin type, and on any part of the body without the risks of hypo- or hyperpigmentation or the healing times associated with conventional lasers. It is considered a non-ablative lasing device. Outer skin and sensitive nerve endings are treated with a unique cooling spray, and then precise laser pulses stimulate cells called fibroblasts which produce the natural collagen that is the foundation of your skin. As the collagen layer thickens, skin tone and elasticity improve.

According to a lecture by Dr. Robert A. Weiss, the assistant professor of dermatology at the University of John Hopkins School of Medicine in Baltimore, Maryland on non-ablative treatments: Thermescent CoolTouch 1320 treatments are usually performed 3-4 times in one month a part although you will not see results until the 2nd or 3rd treatment. Also the improvement may appear immediate although this is due to edema (swelling), etc.

As with NLite, this type of laser delivers the amount of infrared energy to trigger a thermal wound response but without the harmful effects to the epidermis. In other words, the laser heats up where your dermis/epidermis meets, thereby stimulating your collagen production and correcting the wrinkles from within. The difference with CoolTouch 1320 is that the cryogen spray cools the epidermis allowing the penetration of the Nd: YAG to depths of 200-400 microns in the dermis layer with a surface temperature of no more than 44º to 48º Celsius (111.2º to 118.4º Fahrenheit). Improvements were seen on wrinkles, acne scars, pore size reduction and "crepiness".

If it is for sun-damage or sun-damage induced wrinkles, you will only continue to get sun damage if you frequently subject yourself to UV light exposure or spend a lot of time in the sun without a proper sun block or hat, etc.

Approximate Cost: dependant upon area and practice.

Er:YAG Laser (Erbium)

Technically known as the Erbium: yttrium aluminum garnet) This LASER is at a wavelength of 2940 nm and is absorbed by superficial layers of the epidermis. When "Q-switched", the laser is emitted in pulses which evaporates or "blasts" the damaged or unwanted tissue or vessels. The pulsing actually lessens the heat on the skin emitted by the LASER so there is less damage or bruising. Each is used to treat single, large, visible blood vessels.

If it is for sun-damage or sun-damage induced wrinkles, you will only continue to get sun damage if you frequently subject yourself to UV light exposure or spend a lot of time in the sun without a proper sun block or hat, etc.

Approximate Cost: Approximately $3,000.US for a full face treatment.

NLite

Technically known as class IV medical, non-ablative HeNe flashlamp pumped, pulsed-dye LASER. ICN Pharmaceuticals' NLite is a class IV medical LASER, specifically designed for non-ablative removal of wrinkles and collagen rejuvenation. Ablative lasers are more damaging and invasive - they remove quite a chunk of your skin in order to "resurface" it - actually removing the wrinkle along with its surrounding skin. Whereas, the yellow light of NLite passes right through the epidermis without damaging it, thereby stimulating your own dermis to produce its own natural collagen.

It is natural collagen and will age like natural collagen - since this is a newer laser its long term effects are not yet known. However it is believed that you will not have as deep of lines as you would have without ever having the treatment. If it is for sun-damage induced wrinkles, you will only continue to get sun damage if you frequently subject yourself to UV light exposure or spend a lot of time in the sun without a proper sun block or hat, etc.

Approximate Cost: This can vary from $800 to $1,800 US for full face and neck. For specific areas, it costs approximately $10 US per pulse with a minimum of $100 US at some offices.

Approved: The SLS NLite Non-ablative Wrinkle Reduction device was approved by the FDA for use on peri-ocular wrinkles (wrinkles around the eye); although, NLite is also used effectively elsewhere.

EpiStar Diode Laser System

The EpiStar Diode Laser System can be used to remove hair and to treat vascular and pigmented skin lesions such as birth marks. The EpiStar system uses an infrared diode laser to treat a 2-millimeter to 5-millimeter area of the skin in a random scanning pattern. The device's thermoelectric cooling system cools the skin to 5 degrees Celsius, protecting the area from heat exposure and minimizing patient discomfort.

Most laser systems use a gas such as carbon dioxide to cool the skin during the procedure, but the EpiStar system does it electronically by blowing cool air onto the skin site.

Results are permanent, unless you develop another lesion, which has nothing to do with the prior lesion. If it is for sun-damage, you will only continue to get sun damage if you frequently subject yourself to UV light exposure or spend a lot of time in the sun without a proper sun block or hat, etc.

Approximate Cost: dependant upon area and practice.

Smooth Beam Laser

This is more like CoolTouch Laser than NLite with its miniburst of cryospray to cool the epidermis and the subcutaneous levels before the laser pulse to reduce damage. NLite does not need cryospray and passes harmlessly through the epidermis and subcutaneous levels without pain. It seems that the SmoothBeam must have the cryospray burst or the proteins coagulate and the tissues are damaged - not to mention it is more painful if there is no cryospray. Although technically dissimilar, the Smooth Beam Laser may produce the same type result as the NLite system because of the thermal wound response they create.

If it is for sun-damage induced wrinkles, you will only continue to get sun damage if you frequently subject yourself to UV light exposure or spend a lot of time in the sun without a proper sun block or hat, etc.

Approximate Cost: dependant upon area and practice

Dye Laser VStar

Technically known as Pulse Dye Laser, this laser isn't exactly a resurfacing laser but a laser designed for spider veins, redness, broken capillaries and other types of vascular lesions. This machine is capable of 4 pulse lengths for varying cases.

Long term results are unknown, as this is a newer laser although they are reportedly permanent.

Approximate Cost: dependant upon area and practice

Genica V

Technically known as photo-flash lamp-pumped pulsed dye photo laser, this laser is yet another vascular lesion removal system. A treatment area usually takes under a half an hour. Bruising is apparent after treatment. These bruises will subside within 7-10 days. Patients report "stinging" sensations and seldom need sedation. However, for patients without a high pain threshold tropical anesthetics can be used. It is reported that the treatment affects depths up to 1.5mm.

Long term results are unknown, as this is a newer laser - reportedly permanent.

Approximate Cost: dependant upon area and practice

Depilase YAG Laser/"Depilase YAGLASE"

Technically known as High Power Long Pulse Nd:Yag laser system, this system was designed to remove both vascular lesions and even hair. The unique factor regarding this laser is that it can be used on dark skin types, whereas, most other lasers, are contraindicated in some ethnic skin types.

Long term results are unknown, as this is a newer laser - reportedly permanent.

Approximate Cost: dependant upon area and practice

Q-switched Nd:YAG laser

This system can remove general pigmentations and for darker pigments, such as professional tattoos which may be blue or black, may take between 8 and 12 sessions.

Long term results are unknown, as this is a newer laser - reportedly permanent.

Approximate Cost: dependant upon area and practice.

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