Laser Treatment for Rosacea in Kelowna

V-Beam & KTP Laser Treatment for Rosacea

 

Rosacea (pronounced "roh-ZAY-sha") is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Rosacea affects mostly adults, usually people with fair skin, between the ages of 30 and 60. Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead. It typically first appears as a flushing or redness that comes and goes. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Sometimes referred to Acne Rosacea or misdiagnosed as adult acne, Rosacea has no specifically known cause.

 

Before Treatment

 

After Treatment

 

Rosacea is a common medical condition that usually includes capillaries on the face (nose, cheeks, chin) that give the skin a much more red looking appearance than normal.  The KTP and V-Beam laser treatments close these blood vessels quickly and with minimal discomfort.  For optimal results you may require more than one treatment.  Discuss your particular condition with Dr. Crippen to see what can be done.

 

 

Symptoms Associated with Rosacea

 

Flushing

Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.

 

Persistent Redness
Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away.

 

Bumps and Pimples

Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.

 

Visible Blood Vessels

In many people with rosacea, small blood vessels become visible on the skin.  To remove these blood vessels, Dr. Crippen will use the Vbeam laser. Vbeam affects the vessels within the skin and does not affect the surface skin.

 

Other Potential Signs and Symptoms

 

Eye Irritation

In many people with rosacea, the eyes may be irritated and appear watery or bloodshot, a condition known as ocular rosacea. The eyelids also may become red and swollen, and styes are common. Severe cases can result in corneal damage and vision loss without medical help.

 

Burning or Stinging

Burning or stinging sensations may often occur on the face. Itching or a feeling of tightness may also develop.

 

Dry Appearance
The central facial skin may be rough, and thus appear to be very dry.

 

Plaques
Raised red patches, known as plaques, may develop without changes in the surrounding skin.

 

Skin Thickening
The skin may thicken and enlarge from excess tissue, most commonly on the nose. This condition, known as rhinophyma, affects more men than women.

 

Swelling
Facial swelling, known as edema, may accompany other signs of rosacea or occur independently.

 

Signs Beyond the Face
Rosacea signs and symptoms may also develop beyond the face, most commonly on the neck, chest, scalp or ears.

 

 

Common Rosacea Triggers and How to Manage Rosacea Symptoms

Culprit #1. Avoid sun exposure, which adversely affects more than 80 percent of Rosacea sufferers. Minimize exposure from 10 a.m. to 2 p.m.

 

When you do go out, use a UVA sunscreen with an SPF of 30 or higher.

 

Physical sunscreens with zinc and/or titanium oxide are less irritating and work instantly.

 

Avoid Stress. Expect the unexpected. Also, don't try to do too much in a day.

 

Staying Cool. Retreat to air-conditioning when temperatures rise.

 

Dress "Cool." Keep it light, loose and topped with a broad-brimmed hat.

 

Stay Hydrated. Drink plenty of cold liquids. You may also want to mist your face when you are outside in the heat.

 

The Spice Connection.  Steer clear of spices, hot drinks and foods that may cause you to flush.

 

Choose your Workout Time. Early or late in the day is best, when it's cooler outside.

 

Umbrellas in the Sun. A must at the beach...anywhere without shade.

 

Keep Your Routine. Don't sporadically start and stop your treatment. Successful management of Rosacea only happens when you follow your treatment program.

 

Avoid Harsh Products. Your skin care routine should consist of mild cleansing products and your prescribed topical medication. Don't add scrubs or glycolic acids which will only irritate already sensitive skin.

Rosacea Treatments

Because the signs and symptoms of Rosacea vary from one patient to another, treatment must be tailored by a physician for each individual case.

 

Typical Rosacea treatment options and program.

 

Various oral and topical medications may be prescribed to treat the bumps, pimples and redness often associated with the disorder. Dermatologists usually prescribe initial treatment with oral antibiotics and topical therapy to bring the condition under immediate control, followed by long-term use of the topical therapy alone to maintain remission.

When appropriate, rosacea treatments with a Vascular laser (Vbeam), KTP Laser or other medical and surgical devices may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Ocular rosacea may be treated with oral antibiotics and other therapy.

In addition to medical treatment, Rosacea sufferers can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors that trigger rosacea flare-ups or aggravate their individual conditions. The National Rosacea Society offers a free Rosacea Diary Booklet to assist patients in identifying factors that may affect their individual cases, as well as a booklet called "Coping with Rosacea" that provides tips on lifestyle management. Rosacea Q and A's.

 

What Rosacea Looks Like

Subtype 1: Facial Redness (Erythematotelangiectatic Rosacea)

   
Rosacea sufferers typically experience flushing and persistent facial redness.

Small blood vessels may become visible in some patients, and stinging, burning, swelling and roughness or scaling may also occur.

 

 

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Subtype 2: Bumps and Pimples (Papulopustular Rosacea)

In addition to persistent redness, bumps (papules) and/or pimples (pustules) are common in many rosacea sufferers.

Some patients may also experience raised red patches known as plaques.

 

 

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Subtype 3: Enlargement of the Nose (Phymatous Rosacea)

Rosacea may be associated with enlargement of the nose from excess tissue, a condition known as rhinophyma.

This may include thickening of the skin and irregular surface nodules, which in rare cases may also develop in areas other than the nose.

 

 

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Subtype 4: Eye Irritation (Ocular Rosacea)

Rosacea affects the eyes in many patients, and may result in a watery or bloodshot appearance, irritation and burning or stinging.

The eyelids may also become swollen, and styes are also common.

 

What kinds of problems can the Vbeam pulsed-dye laser treat?

• Red or pink scars from any surgical or traumatic event to the skin
• Port wine stain birth marks
• Pink or red marks from acne
• Angiomas
• Hemangiomas
• Broken capillaries on your face
• Rosacea
• Venous Lakes
• Stretch marks (must be new and purple. Can only only treat lighter skin types I,II,III.)
• Acne (treats it by killing the bacteria)
• Poikiloderma of Civatte (uneven coloring of the neck)
• Psoriasis

What causes unwanted blood vessels?

Unwanted blood vessels on the face (sometimes referred to as: "broken capillaries") are more common in people who have a tendency toward acne rosacea, and are often made worse by sun exposure. As with unwanted vessels on the legs, there is sometimes a family history of other people with a similar problem.

Spider hemangiomas on the face and other parts of the body are a common nuisance, and can be quite disfiguring. Most children and adults who have a few spider hemangiomas are perfectly normal and healthy. Rarely, numerous spider hemangiomas are found to be associated with serious liver disease or other disorders. People who are otherwise healthy and have just a few spider hemangiomas do not need any blood tests or other investigations.

Telangectasia on the face and other parts of the body can sometimes be associated with medications like prednisone and other corticosteroids, and with certain skin diseases like lupus.

Sometimes children are born with "port wine stains" or other types of hemangiomas, or these may become apparent as the years go on. Some of these hemangiomas can be improved or even eliminated by vascular lasers.

 

How does the pulsed-dye laser work?

The Flashlamp Pulsed-Dye Laser's long pulse width gives desired longer (gentler) heat impact while its multiple wavelengths allow deeper penetration. The laser's Dynamic Cooling Device (DCD) delivers a spray of cool air prior to the laser pulse, protecting the epidermis and reducing the risk of blistering, purpura, and pigmentary changes.

This laser is "tuned" to affect only the darker, dense blood vessels deep in the skin that cause birthmarks, port wine stains (PWS), and other red spots, leaving the lighter less dense outer skin with no damage. It is safe and effective, often requiring no local anesthetic (although it is available if needed), and causes no scarring. The VBeam is a non-invasive laser specifically designed to eliminate undesired blood vessels from all parts of the body. The laser generates a pulse of intense, concentrated light that is directed through a handpiece that is gently applied to the treatment site.

This laser energy passes through the skin to the blood vessels that you wish to have eliminated, where the energy is absorbed by pigment in the blood, causing selective damage to the lining of the target blood vessel without damaging the surrounding tissues and skin. The laser is pulsed, or "turned on", for only a fraction of a second. The duration of the pulses is carefully determined so that laser energy will be absorbed by the blood vessels without transferring excessive heat to the surrounding skin.

Your body reabsorbs the damaged blood vessels, and the flow of blood is directed back down into the deeper vessels, where it belongs. Laser treatments are a safe, fast, gentle, and effective method for removal of unwanted blood vessels. In just a few treatment sessions (in some cases only a single treatment session) using the gentle power of lasers/pulsed light, you can greatly improve the appearance of skin which is disfigured by unwanted blood vessels and "broken capillaries."

 

Are laser treatments safe?

Lasers have been used successfully in hundreds of thousands of treatments. In the hands of a trained professional, laser therapy is very safe. There are many benefits to laser surgery including little, if any pain; no needles; less bruising and swelling; and, once removed, no returning of lesions.

 

Are there any skin types that cannot be treated?

This laser is best suited for lighter skin types. Darker skin such as Type V and VI cannot be safely treated with this laser.

 

What are the risks of laser removal of blood vessels?

Short-term side effects may include a reddening of the skin over the treated vessels or local swelling which typically lasts less than a day, although it may infrequently last a few days. New laser/pulsed light systems with longer wavelengths are less likely than older lasers to cause prolonged irritation, pigment changes, or blistering.

Occasionally there can be increased or decreased pigment change in the treated area. This is seldom a major cosmetic problem, and generally resolves after several months. Even a single blister is unusual, and generally will resolve within a week or two with some Polysporin or Aloe Vera.

Though risks of side effects are low, even with the best of care, adverse reactions can happen. Individual sensitivities to laser and pulsed light cannot be determined prior to treatment. Side effects that are possible include redness, blistering, brui In very rare instances scarring can occur. Laser treatments do not cause skin cancer.

 

Is laser removal of blood vessels covered by insurance?

Private insurance companies do not offer reimbursement for "cosmetic" procedures like laser vein and vascular treatments. Sometimes insurance companies are willing to pay for Vbeam for rosacea or port wine stains on the face. We are happy to write a letter and give you an invoice to submit to them, but payment is expected at the time of service.

 

Is laser removal of broken vessels permanent?

"Permanent removal" means 100% of ALL vessels are gone, FOREVER. There are NO treatments (including laser) that are permanent. The most realistic description would be "long term blood vessel reduction." After one to two treatments the vessels should be greatly reduced by 70-90%. Rosacea takes more treatments (3-4) and may need to be touched up every 6 months to keep it suppressed. Most people are very happy with those results as long as they know what to expect. There is no way to promise a 100% removal. If a clinic tells you they can do this, you should avoid them at all costs.

Because lasers have been around for approximately 10 years, there is no way to know if the results will be felt in 15-20 years. However, we do know that stable, long-term blood vessel reduction commonly lasts for at least 2 years, and many people are still enjoying the benefits of treatment many years later.

 

How many blood vessels will grow back, and how fast will they grow back?

The re-growth of blood vessels after treatment by laser is highly individual, and depends on both your genetic background and medical conditions like acne rosacea, medications you may be taking (like prednisone, or estrogens, for example), and on external factors like sun exposure. Sun exposure can speed up the appearance of new vessels on the face and legs -- this gives you one MORE good reason to protect yourself with an appropriate Sunblock with Zinc Oxide. If you take care to control medical conditions like Acne Rosacea, and protect yourself from sun damage, you can stop, or at least slow down, the rate at which new unwanted vessels appear on the skin of your face, neck, or upper chest.

 

How many treatments are needed?

The number of treatments will depend on:

• desired degree of blood vessel reduction/and present clinical status of vessels
• hormonal status
• area being treated
• medication (for example, medicines like prednisone and estrogens can increase superficial blood vessel growth)

For simple facial broken vessels it may require only 1-2 treatments, whereas more advanced stages of rosacea may take 4-5. Cherry hemangiomas (red dots on the body) usually require only one or two treatments.

On average, treatment can be done every 4-6 weeks on the face. Some people start with the area that troubles them the most; then when they can see the results, they often return to have other areas treated.

Additional "touchup" treatments on small troublesome areas can be arranged at relatively low cost. There is no safety limit on the number of treatments one person can have. IN some cases, people who have been partially treated with other types of blood vessel removing laser and/or injection sclerotherapy might need a smaller number of laser treatments.

 

What will happen on the treatment day?

Other than your regular skin care routine, there is no standard "prep" for this procedure. There are no restrictions on what you may eat or drink prior to your appointment. Many people like to take 2 or 3 plain Tylenol to prevent or reduce any potential discomfort.

 

Please shave or clip the areas to be treated before you come in for treatment. Freshly shaven skin is more sensitive, and there is less discomfort if you wait at least an hour between shaving and having laser treatment. Excess dark hair above the surface of the skin absorbs and wastes laser energy, and reduces the amount of energy that reaches the undesired blood vessels, where it is really needed. Excess hair above the surface of the skin also increases the chance of burning or irritating the skin. If there is just a bit of "peach fuzz" on your skin, this will not be a problem. "Peach fuzz" is very fine and fair and therefore does not absorb laser energy. It would be best to shave about 24 hours before a laser procedure.

 

When you come for treatment, it is important not to wear any makeup -- or at least wear simple water-based makeup that can be easily removed -- because makeup can sometimes absorb laser energy. This could interfere with treatment, or even cause overheating of the skin surface and burning. Makeup also makes it diffilcult for us to see the vessels you would like to have treated. Makeup can be re-applied immediately after laser treatment, if done gently, if you wish.

After all of your last minute questions have been answered and paperwork handled, the areas you wish to have treated may be cleansed and pre treatment photos may be taken. Everyone in the treatment room must wear protective goggles when the laser is turned on. The laser is a high powered system, and can cause eye injury if proper eyewear is not worn while the laser is used.

 

The length of the procedure itself can range from a few minutes for a few spider hemangiomas, to an hour or more for very extensive blood vessels on the face.

 

If you decide before coming in that you would like to have additional areas treated, please call ahead so that we can schedule enough time to accommodate your needs.

 

You may bring a friend or family member if you like. Generally, because of room size, crowding, and need for laser goggles, we tend to restrict the treatment room to the patient and one additional support person only. Young children under 12 years of age are not allowed in the room during the treatment!

 

How should I care for my skin after a Vbeam laser treatment?

There are a couple of things you can do to decrease possible swelling/bruising after your treatment:

• Use cold compresses for the first 24 hours after the procedure for comfort if necessary.
• The night after your treatment we recommend that you sleep as upright as possible, resting your head on 2 pillows.
• You may take arnica montana tablets by mouth. Arnica helps to speed healing time from possible bruises. This is available in our office or can be purchased through a health food store.
• We also have a topical Vitamin K cream that should be applied several times daily, only to individual bruises (should you have any). Vitamin K cream helps to cut the bruise-healing time almost in half.
• Makeup can be applied immediately.

Treat your skin gently for the first 7 days after your treatment. No scrubs or abrasive material should be used during this time. Use a gentle cleanser twice daily. Moisturize as needed. Use sunscreen on a daily basis that contains either zinc oxide or mexoryl xl. We have several excellent sunscreens available for purchase. Sunscreen "in your makeup" is not enough to protect you from UVA damage.

 

Do NOT use Retin A for the first 2 nights after your treatment.

You may resume normal physical activity immediately after the treatment.

Follow up in our office one month after your treatment.