Laser treatment for rosacea

Is laser treatment right for your rosacea?

Persistent redness. Broken capillaries. Acne-like breakouts that you know really aren’t. The frustration that make-up can’t hide it, the embarrassment when someone asks you about it and the depression when you have yet another flared-up day.

If this sounds all-too familiar, let’s face it — rosacea is affecting more than just your face. And you’re not alone. More than 14 million people in the US have rosacea, and of those nearly 70% of people feel it lowers their self-confidence and erodes self-esteem.

The good news? Rosacea therapies have come a long way. Treatments such as Brimonidine gel, Azelaic acid, and Ivermectin creams can offer quick results. Over-time, they may even get you completely clear.

But if you want to take it even further, laser treatment for your rosacea might be the next best option. Intense pulsed light therapy — also known as IPL therapy, IPL lasers and photofacials — can be highly effective, particularly if your rosacea is moderate to severe, has caused skin thickening or visible blood vessels (also called spider veins and broken capillaries), and you’re under 40 years old.

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How does it work? Special lasers, called “vascular lasers,” emit light at wavelengths that target those little spider veins, heats them up and causes them to disintegrate. IPL lasers can also generate multiple different wavelengths to address a wider variety of problems.

The upsides?

• It can be highly effective.IPL lasers can often significantly reduce or even completely remove those visible blood vessels around your cheeks and nose, helping your skin appear less red overall. Most patients experience a 50–75% reduction, while for some it’s as much as 100%.
• It can sometimes treat even difficult areas.Permanent redness on your face can sometimes be reduced with IPL therapy as well, including the redness surrounding those pimple-like areas. When treated early, laser resurfacing can be highly effective on rosacea’s thickened skin.
• It can provide long-lasting relief.When used to treat visible blood vessels, results can last — usually up to 3–5 years.

The downsides?

• It takes time.Most patients will need at least three treatments, usually spaced 3 to 6 weeks apart.
• It’s rarely covered by insurance.While topical and oral medications for rosacea were covered by insurance for 72% of those surveyed, only 5% reported coverage for laser and light-based rosacea treatments.
• It’s expensive. Each session will typically cost $150–$500, depending on the extent of your rosacea and you’re likely to need more than one session.
• There is down time. Expect to be sore and swollen for 24–48 hours after treatment. Bruising may last 5–10 days, and you may experience some peeling, similar to that of a sunburn.
• You’ll probably still need medications. Laser treatment alone is rarely enough keep rosacea under control. Oral and/or topical treatments will likely still be necessary to prevent progression and recurrence.
• It’s not a cure. Unfortunately, rosacea is a chronic condition — meaning laser treatments won’t solve the underlying condition. While blood vessels or thickened skin that has been removed won’t reappear, new ones are likely to form. Additional laser treatments may be necessary over time.
• Lasers or intense pulsed light therapy can address both redness and removal of visible blood vessels. Though expensive, this approach provides more permanent redness reduction, lasting up to three years. Side effects generally include temporary redness and swelling. Selection of an experienced and skilled physician is essential, however, as serious side effects can occur, including burns, skin discoloration, and even permanent scarring.

If you’re ready to give laser treatment for rosacea a try, remember that choosing the right physician is essential. Look for only board-certified doctors (they will have “FAAD” after their name) with extensive experience in both rosacea and using IPL lasers to treat it. With a little research, you (and your skin!) will be in good hands.

References

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases, “Rosacea In-Depth,” PDF https://www.niams.nih.gov/print/view/pdf/advanced_reading_pdf_/easy?view_args%5B0%5D=2431
2. Schroeter CA, Haaf-von Below S, Neumann HA, “Effective treatment of rosacea using intense pulsed light systems” https://www.ncbi.nlm.nih.gov/pubmed/16188180
3. Dermatol, Ann, “The Efficacy of Intense Pulsed Light for Treating Erythematotelangiectatic Rosacea is Related to Severity and Age,” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135105/
4. American Academy of Dermatology Association, “Lasers and lights: How well do they treat rosacea?” https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/lasers-and-lights-how-well-do-they-treat-rosacea
5. American Academy of Dermatology Association, “Rosacea: Signs and Symptoms,” https://www.aad.org/public/diseases/acne-and-rosacea/rosacea#symptoms
6. National Rosacea Society, “New Survey Shows Insurance Covers Medication for Most” https://www.rosacea.org/blog/2014/february/new-survey-shows-insurance-covers-medication-for-most
7. National Rosacea Society, “Lasers Used to Treat Some Rosacea Signs” https://www.rosacea.org/rosacea-review/2001/summer/lasers-used-to-treat-some-rosacea-sign

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