Laser Rosacea Treatment

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 at 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 hinder 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.

Article of the Week:

THE CONTROVERSY OVER LASER THERAPY AND ROSACEA

Laser treatment has been an option in rosacea treatment for time now, but to date, there has been only limited research to either support or discredit its use in treating rosacea. The National Rosacea Society along with Rebecca Prescott of Acne-to-Health state that, "Despite years of use, research on the effectiveness and safety of these products is limited. The U.S. Food and Drug Administration (FDA) classifies laser and light therapies as procedures, so stringent, long-term studies are not required. Most of what is known comes from observations made by dermatologists while treating individual patients."

What exactly does laser therapy involve? The term "LASER" is an acronym for Light Amplification by Stimulated Emission of Radiation. In Laser therapy, 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.

Ms. Prescott explains how laser works: "the first working laser was produced in 1960, and they are in common use in medicine today. The laser works by applying energy to subatomic particles; this places them in an 'excited' state and they gain energy. These particles then move back to their original energy level and as they do, they release energy in the form of particles of intensely focused light - the laser. The light emits heat and the laser destroys the targeted tissue of rosacea. Laser treats rosacea by selectively destroying the inflamed, dilated, and hyper-responsive blood vessels without damaging surrounding skin. The laser 'energy' is absorbed by oxyhemoglobin (hemoglobin is the molecule in the blood cells that carries oxygen; oxyhemoglobin is hemoglobin that is saturated with oxygen) in the blood. This generates thermal energy that damages the adjacent blood vessel wall blood. The exact intensity of the wavelength is carefully chosen to destroy the dilated blood vessels using thermal energy without significant damage to the surrounding skin and to avoid surface scarring."

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 can be 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.

Rosacea patients have skin that has been damaged or abused by harsh medical treatments of retnoids, wrinkle removal systems, steroids, etc. that have resulted in skin that is already inflamed, thus laser resurfacing may not be in the best interest of the rosacea patient. One can try to remove rosacea damage with laser but it is important to note that 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 allow the skin to heal.

Ms. Prescott further states: "IPL is not effective for everyone. However, some patients will 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". Interesting to note there has only been one documented treatment success using laser to treat rosacea flushing.

In many diseases, doctors help the body to do what it already wants to do. For example if you get an infection, your doctor prescribes an antibiotic that works together with your body's immune system to clear the infection, once better you stop taking the antibiotic. In laser therapy the opposite is true, your doctor is trying to oppose what your body wants to do. The body wants to make the blood vessels grow, to live and survive to keep the skin healthy and alive. The doctor in this case is attempting to stop the growth and kill the blood vessels. Laser treatment can destroy or kill the blood vessels, but sooner or later the body will go into survival mode and will try to make the blood vessels grow again, to rejuvenate and restore health to the skin. Your body has an instinct for survival, rejuvenation and life. As the skin heals and rejuvenates the blood vessels will re-grow.

The short-term success of rosacea laser treatment can depend on several factors, and there are many treatment protocols and many different types of lasers that can be used; argon, pulse dye, neodymium, carbon dioxide and krypton lasers have all been tried. Multiple treatments are often necessary and these are time consuming and expensive. There is certainly anecdotal evidence for the effectiveness of the laser in clearing up erythrosis and teleangiectasia, and many patients are satisfied. But surprisingly - given that rosacea laser treatment therapy is not new (it's been around since the 1980s) and is in widespread use - there is relatively little substantiated information about how useful it is; there is a distinct lack of controlled studies, and the Food and Drug Administration classifies laser therapy as a procedure, so its effectiveness has not evaluated in the same way as drugs.

Laser cannot be used for everyone. You should not have laser therapy if you have dark skin or a tan, it is contraindicated for people who have disorders of blood clotting, people who easily develop scars, or people with insulin-dependent diabetes. And although rosacea laser treatment can work for some people, it is not a cure. Relapses are possible and it is possible that the laser can make your rosacea worse.

"Laser therapy is now widely considered the primary treatment for telangiectasia (visible blood vessels) and rhinophyma (enlarged nose), and may also be very effective for reducing extensive redness," said Dr. Philip Bailin, chairman of Dermatology at the Cleveland Clinic Foundation. "At the same time, medications must continue to be used to manage the papules and pustules that often go along with rosacea, and to help maintain remission. "Generally, a minimum of three treatments are required at six-week intervals, depending on the severity of redness and telangiectasia," Dr. Bailin said. "Most patients will experience redness, swelling and soreness within the first 12 to 24 hours, but then they subside. Some patients also may have peeling, similar to that of a sunburn, and others may experience some bruising under the skin that lasts five to 10 days. He emphasized that, because of the chronic and relapsing nature of rosacea, patients should be given a proper perspective on their condition, including the need for continuing preventive therapy and avoidance of lifestyle and environmental factors that may trigger flare-ups. "The underlying cause of rosacea will still be there, and further laser treatment may again be required at a later time," he said. "There are no cures for rosacea, only good treatments."