A Guide to Laser Treatment Options For Rosacea

If you've been dealing with the redness, flushing, and visible blood vessels that come with rosacea, you know that it can be a pain (literally and figuratively). However, there are many options for managing Rosacea, such as Laser Therapy. In this blog, we’ll look at laser therapy for Rosacea and explain what your options are.

What is Laser Treatment Therapy for Rosacea?

Laser treatment therapy for rosacea is a medical procedure that uses laser technology that helps reduce and manage the appearance and symptoms of rosacea. This treatment mainly targets the small blood vessels beneath the skin that cause the redness, irritation and flushing that is experienced with Rosacea.

During the procedure, a dermatologist or a will use a specialised laser device to emit light energy onto the affected areas of the skin.. This process is called photocoagulation.

Depending on the type of laser, it can do different things. For example, certain laser therapies use light to target the blood vessels and excess melanin that causes the redness and flushing. Others focus on broken blood vessels (also known as spider veins), while others target skin enlargement caused by rhinophyma. Regardless of the specific therapy, it’s usually done in a series of sessions and with each treatment, you should start to see some improvement. The most common types of rosacea laser treatment therapy are:

• Intense Pulsed Light Therapy (IPL)
• Erbium YAG Laser Therapy
• CO2 Laser Therapy
• Pulse Dye Laser Therapy

But here's the thing – there are different types of laser treatments available, each one with its own benefits and drawbacks. So, how do you know which one is right for you? Some treatments may work better for certain skin types or for specific symptoms of rosacea. We’ve broken down the different types of treatment, and explained what the benefits, drawbacks, and methods are of each type.

Intense pulsed light therapy (IPL)

Technically speaking, IPL is not a laser treatment. Intense pulsed light therapy uses scattered light, which is not as concentrated as a laser. This allows the light to get deeper into the skin, reaching the second layer without causing harm to the top layer, the epidermis. This makes IPL a gentler option for skin treatment as it causes less damage to the skin. 

Intense pulsed light therapy uses a broad spectrum of light to target specific skin concerns. The light energy is delivered in pulses, which are absorbed by the skin's melanin (pigment) and blood vessels. IPL is often used to treat a variety of skin conditions, including rosacea, age spots, sun damage as well as to improve the overall tone and texture of the skin.

It’s a non-invasive procedure done in-clinic by a professional. The light energy heats up the targeted cells in the skin causing them to constrict, which is what reduces the appearance of redness and blood vessels. Intense pulsed light therapy can also help with collagen production, which improves the overall appearance of the skin by reducing fine lines and wrinkles. The treatment takes between 15 and 45 minutes depending on the size of the area. 

Potential drawbacks of Intense pulsed light therapy

• After the treatment, you might experience some mild redness and swelling, but this should only last a few hours. It’s important to note that IPL is not suitable for all skin types, and that a consultation with a qualified professional is necessary to determine if IPL is the right treatment for you. 

• Top Tip: If you would like to use IPL for Rosacea, but a therapist does not have much training or experience in treating this, then I would strongly recommend that you seek another provider. Good equipment in poor hands is worse skin waiting to happen. Get references where you can.

• The main drawback of IPL is that it’s not cheap and generally isn’t covered by insurance. It takes multiple treatments to get the results, and doesn’t tend to work as well on darker skin tones. Pregnant women, people on blood thinners and those taking Accutane medication should avoid IPL. 

• Remember that you will also potentially be a bit red after IPL treatment, but it should subside within 24 hrs…If you want to conceal the redness and also have a good high SPF, try the Finca Skin Organics tinted sunscreen. It not only provides skin protection from harmful UV rays, but it also helps to reduce the appearance of redness.

Below is an example of the redness you may experience after treatment (Image left). On the right, after applying Finca Skin Organics Tinted High-SPF, the redness is reduced.

Erbium YAG laser Therapy

The Erbium YAG laser therapy is a treatment to target and remove visible blood vessels on the skin. The laser works by giving out a specific wavelength of light that is absorbed by the blood vessels, causing them to eventually disappear.

In addition to treating visible blood vessels, the Erbium YAG laser can also be used to reshape the nose by removing excess tissue. This is the main symptom of phymatous/rhinophyma (type 3) rosacea. By removing this excess tissue, this laser can help to improve the appearance of the nose and restore a more normal shape. In a small study of 6 patients in 1995, all experienced improvement without complications.

The Erbium YAG laser is considered a safe and effective treatment option for both removing spider veins and reshaping tissue. However, it’s important to note that the treatment may require multiple sessions to achieve the results you want and some downtime might be needed afterwards. A study involving the use of YAG laser treatment found that half of the participants experienced "good to excellent" improvement in their rosacea symptoms. It’s possible that this treatment is more effective for people with vascular lesions rather than those with pustules from type 2 rosacea. 

Potential drawbacks of Erbium YAG Laser

• You will need to take some down time as the treatment area will be darker and crusty for a week or so. Your skin might also look red and swollen for a few weeks (or even months) after the treatment. 

• If the laser is used at a low power setting, it will only remove the top layer of skin and you’ll have less downtime. With this type of laser there is a risk of having discoloured spots on the treated area after the procedure. 

• You may need multiple sessions and this option is not recommended for pregnant women.

CO2 lasers

CO2 lasers (also known as ablative lasers) are a great option for reshaping your nose or other parts of your face that have been affected by rosacea. These lasers can help to reduce the appearance of rhinophyma, which is when the skin on your nose becomes thickened or enlarged due to inflammation caused by rosacea. 

These types of lasers work by removing the top layer of skin, revealing fresh, smooth skin underneath. In a study from 2009, 124 people who had a CO2 laser treatment for their rhinophyma were surveyed. Almost 96% of the participants were satisfied with the results and gave it a seven or higher on a scale of 1-10, with 77% giving it a 10 out of 10.

Potential drawbacks of CO2 lasers

• Side effects such as redness, swelling, itching, pain, changes in skin color, and scarring are always a possibility with laser resurfacing. 

• People who have taken the acne medication isotretinoin, have a connective tissue or autoimmune disease, a weak immune system, a history of scarring, radiation therapy to the face, previous laser resurfacing, cold sores, darker skin or are pregnant or breastfeeding should talk to their doctor before undergoing laser resurfacing as it mightn’t be suitable.

Pulsed Dye Lasers

Pulsed-dye lasers, such as Cynosure, V Beam, and V-Star, are another treatment option for reducing the appearance of redness and inflammation caused by rosacea. This treatment uses pulsed light to target vascular lesions or spider veins. The use of dye in the laser beam allows for different colours to be used, making it more effective at targeting specific areas. In a study of 19 people done in 2018, blinded reviewers were able to identify the before-treatment photos correctly in 96.5% of the images. They also rated 17 of the 19 participants as having an improvement of over 40%, and 11 participants as having an improvement of over 50%. On average, people showed an improvement of 53.9%.

Another study from 2004 showed that this treatment was successful for all 40 participants. Although some experienced complications or a return of symptoms, they all felt that the treatment was worth it.

This treatment is non-invasive and relatively painless. It can help to reduce redness and inflammation in the skin, improve the appearance of broken blood vessels and even out skin tone. It's important to note that multiple sessions may be required to achieve desired results, and the treatment has to be done by a trained and licensed professional. 

Potential drawbacks of pulsed dye lasers

• PDL’s usually require multiple sessions to achieve the desired results, which can be expensive. On top of this, maintenance is needed around every 6 months. PDL is not recommended for darker skin tones, or for acne patients. PDL doesn’t work on all red marks. 

The bottom line on Laser Treatment for Rosacea

Laser treatment for rosacea is expensive. It's typically not covered by insurance and needs multiple sessions to be truly effective, which can add up. The cost can vary depending on factors such as location, the clinic you choose, and the severity of your rosacea. So, it's important to keep in mind that it will likely be an out-of-pocket expense.

Having said that, laser therapy for rosacea seems to be a promising option. It's usually well-tolerated and effective, but as with any treatment, it's important to speak with a dermatologist or doctor first to see if it's the right choice for you. Keep in mind that rosacea is a chronic condition and while laser therapy can provide some relief, it's not a permanent solution. The most important thing is to get an experienced therapist, so that the right equipment for you, is also in the right hands. Ask for references or photographs of previous clients and make sure the photos match the actual therapist you will be getting, particularly if it's a big clinic with lots of different therapists.It can seem a bit pushy asking for this, but it's your face, and you deserve the best. You are paying for it, so weigh up the pros and cons while staying on top of your meds and skincare. But, it's definitely worth considering!

And don't forget to apply a good high SPF physical sunscreen – ideally with a tint in it. This will cover any initial redness immediately after treatment, and also protects your skin against UV rays, which are one of th most detrimental factors for your skin’s health. The face is very sensitive to UV light after any kind of laser treatment, so this step is essential.

With love from Ireland,

Finola