Lasers and lights: How well do they treat rosacea?

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Rosacea patient before and after 2 laser treatments: After treatment (right), the many tiny blood vessels on this patient’s cheek cleared.

If you have rosacea, laser or light therapy may be a part of your treatment plan. It’s unlikely to be your only treatment, though.

Different treatments for different signs of rosacea

When dermatologists create a treatment plan for rosacea, the plan often consists of  medication, a rosacea friendly skin care plan, and tips to help you avoid flare-ups. Sometimes, a treatment plan also includes a procedure, such as laser therapy.

Your treatment plan is most likely to include a laser or light therapy if rosacea has caused:

  • Visible blood vessels
  • Thickening skin

A laser or light treatment can reduce (or get rid of) the blood vessels. To remove thickening skin, dermatologists may use laser resurfacing.

Laser treatment can also reduce redness. In a few small studies, lasers were used to treat permanent redness on the face or the redness surrounding acne-like blemishes. Some patients saw a considerable reduction in redness. Most patients, however, had about a 20% reduction in redness.

Because different lasers and exposure times were used in these studies, more research is needed to know how well lasers can treat the redness.

If you have permanent redness on your face, your dermatologist may prescribe a medication. Approved by the U.S. Food and Drug Administration (FDA), this medication can reduce (or clear) the redness for up to 12 hours. After 12 hours, the redness tends to return.

To prevent side effects after laser or light treatment, stay out of the sun and protect your skin when you must be outdoors.

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What results are typical with laser or light therapy?

When used to treat visible blood vessels, most patients see a 50% to 75% reduction in visible blood vessels after 1 to 3 treatments. Some people see a 100% reduction.

Treatments are usually spaced 3 to 4 weeks apart.

If you have thickening skin, a skilled cosmetic dermatologist can give you very good results with in-office surgery and laser resurfacing. Patients who treat their thickening skin early tend to see the best results.

How long do results from lasers and lights last?

When used to treat blood vessels, the results tend to last 3 to 5 years. Treated blood vessels don’t reappear, but new ones can form.

Thickening skin tends to return after treatment. To prevent this and help you maintain results, your dermatologist can prescribe medication. You may also need follow-up laser therapy in the future.

What are the possible side effects from lasers and light treatments?

If you are considering a laser or light treatment, it’s important to know that your results depend largely on the person performing your treatment.

When you see a dermatologist, you’ll be in the care of a doctor who has the most experience treating the skin and skin diseases. Dermatologists:

  • Know the skin and treats rosacea often
  • Consider your medical history before creating a treatment plan
  • Can tell you whether laser therapy or light device can effectively treat your rosacea

If a laser or light treatment is right for you, you may have some temporary side effects after a dermatologist treats you. After treatment, it’s common to see some redness. This usually fades within 2 weeks.

You may also see a rash of purple or red spots. These, too, tend to clear in 1 to 2 weeks.

During treatment, some patients experience skin tightening, itch, or pain.

Scarring is rare in skilled hands.

To help you get the best results, you should receive instructions that explain how to care for your treated skin. Follow these instructions carefully.

While the instructions about sun protection may seem unnecessary, sun protection is really important. Staying out of the sun and protecting your skin from the sun’s rays help prevent permanent scars.

What to tell your dermatologist

To get the best results, communication is essential. If a laser or light treatment may be an option for you, it’s important for your dermatologist to know:

  • Which medications you take, including warfarin, isotretinoin, and aspirin
  • What other medical conditions you have, such as getting cold sores from time to time
  • If you are sensitive to light or bruise easily
  • What results you expect

Although the FDA has approved some lasers and lights for treating rosacea and patients get good results, health insurance rarely covers the cost.

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More research needed

Researchers continue to study how lasers and light treatments can treat rosacea.  As we learn more, these devices may play a bigger role in treating rosacea.

If you’re interested in this treatment, a board-certified dermatologist can tell you whether a laser or light treatment may help treat your rosacea. You’ll know a dermatologist is board certified if you see the letters “FAAD” after the doctor’s name.

Additional related information


Images
Images (before and after treatment) used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol. 2004;51:592-9.)

References
Abokwidir M and Feldman SR. “Rosacea Management.” Skin Appendage Disord. 2016 Sep;2(1-2):26-34.

Keller DM (with commentary by Harper JC). “Some types of rosacea respond better to laser therapies than others.” Dermatol News. 2017 Jul;(Acne & rosacea suppl):22-4.

Micali G, Gerber PA, et al. “Improving treatment of erythematotelangiectatic rosacea with laser and/or topical therapy through enhanced discrimination of its clinical features.” J Clin Aesthet Dermatol. 2016 Jul;9(7):30-9.

Seo HM, Kim JI, et al. “Prospective comparison of dual wavelength long-pulsed 755-nm Alexandrite/1,064-nm neodymium:yttrium-aluminum-garnet laser versus 585-nm pulsed dye laser treatment for rosacea.” Ann Dermatol. 2016 Oct;28(5):607-614.

Tanghetti E, Del Rosso JQ, et al. “Consensus recommendations from the American acne & rosacea society on the management of rosacea, part 4: a status report on physical modalities and devices.” Cutis. 2014 Feb;93(2):71-6.