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  • New Q&A with Dr Crouch

    Dr Crouch has kindly offered to do another Q&A for the forum. So if you any questions about the treatment of rosacea with lasers or IPL please post them in this thread. We will then pass them onto Dr Crouch.

  • #2
    i have v beam laser for ten days ago...i have purpuric in my face...i seem fading away but in the 8 th days until now , not seem fading look like the same...what should i do?thx anyway...its normal?


    • #3
      mild rosacea, treat with lasers?

      Hi Dr. Crouch. I just was diagnosed with rosacea and it is mild. I have a lot of burning annd redness that comes and goes at it pleases. My nose also flushes for no reason. I'm trying to be proactive and want to treat my skin before it gets worse. Do you recommend doing. Laser treatments on mild rosacea? Could that keep it at bay? I have flushing and burning.

      Thank you,


      • #4
        2 months post V Beam

        I had the bruising pretty severely and now I am left with brown spots across the cheek bones on both sides of face. I would like to know if Dr Crouch thinks another light v beam or ipl would be appropriate to remove these pigment spots? or any other suggestions ?


        • #5
          Lyra laser for rosacea

          I manage to keep my rosacea under control except for one patch on my cheek. It's about 3cm diameter, angry red and sometimes (like now) has pustules. I decided to try the laser route and recently had an IPL treatment combined with Lyra laser
          targetting this stubborn redness.
          That was exactly a week ago. The patch now looks worse than ever - the pustules have expanded in size, the area is dry and a bit crusty and very red. Worst of all, it caused a fair bit of swelling - I looked like I had a black eye. The swelling has gone down a bit but has not gone completely - my face still looks lop-sided. Is it normal for swelling to last this long? And is Lyra suitable for treating rosacea with pustules?

          Thank you for any advice.
          Female, age 42. Using Zia Fresh Cleansing Gel, emu oil and ZZ cream.


          • #6
            Early stage rhinophyma

            I'm a 48 year old female diagnosed with mild Rosacea earlier this year. About 3 years ago I noticed a lumpy area on my nose which gradually spread. At the same time tip of my nose became more prominent and weird looking. When I initially went to see a private derm she was not entirely convinced it was Rosacea as I had no history of it and not really suffered with pustules etc though It was prone to getting hot, red and more inflamed undercertain conditions. She did a biopsy on my nose to rule out anything sinister. Where the swelling spreads I'm left with what feels like a hard compressed lump and little hairs The biopsy confimed mild Rosacea and I was then put on Isotretinoin, 4 months on that and no result but lots of side effects it was promptly stopped. I was told at this point we can't do anything more for you your next option is private laser treatment. I am very self consious of the rapidly changing appearance of my nose. You can clearly see the enlarged subaceous glands Everyday it feels like its grown a little bit more and the realiseation its only getting worse is scary and depressing. Everything I've read tells me the earlier I can treatment the better. Yesterday I visited the derm department for another matter, I metioned my situation to the nurse who went and asked my derm who I should contact re laser treatment she advised these people but having looked at their site I dont think they treat Rhinophyma. What I need to know is who do I go to now. Do i need to see a plastic surgeon privately, I don't want to waste to much money finding the right person as I'm going to need it to pay for the treatment. Any advice would be greatly appreciated
            as I feel pretty desperate

            Thank you


            • #7
              Early stage rhinophyma

              Re my earlier post. I forget to say I am in Derby East midlands uk. Though I am willing to travel for the right specialist



              • #8
                Post v beam perfecta swelling

                How long after having non purpuric v beam treatment, can you expect swelling and lumpiness in cheek area? What is the lumpiness from?


                • #9
                  Hi Dr Crouch

                  I have had 2 IPL treatments with an Alma Harmony machine - one at 13 joules and one at 15 joules at 4-week intervals. I have redness on cheeks and nose, but no p and ps. I have been diagnosed with a combination of seb derm and rosacea. My derm has recently prescribed efracea (European oracea) in the hope that this will help my skin.

                  When should somebody start seeing results from IPL? Is it worth carrying out the full 5 treatments? I stopped because I felt I couldn't justify the cost after having 2 treatments with no obvious improvement. Was this foolish?

                  Many thanks for all of your efforts.


                  • #10
                    hyper pigmentation and also broken capillaries?

                    In advance thank you for your time and response.
                    my cheeks flush heavily from emotions, exercise, food, the sun, and alcohol. i have flushed at times since i was a teenager. now i am 28 and i flush more than ever and longer than ever. i now also have broken capillaries and some hyper-pigmentation on my upper cheek bones. Aside from the adjusting of my diet, cutting exercise, and limiting sun exposure, should i do a lazer, and if so what kind etc? will lazer make me more photo sensitive? will it block flushing? what can i expect realistically?
                    thank you


                    • #11
                      Hi Dr Crouch - thankyou for again answering our questions. I have had mild transient flushing on and off for 5 years but it has never been a real problem. The last couple of months, after starting a new job around lots of artificial lights my skin has gone crazy. I have flushing and burning and my nose in particular flushes bright red every evening and is a bit swollen in the morning, although the redness has subsided by then. Am i likely to benefit from laser treatment? I had started on a low course of roaccutane for persistant acne and am aware i cant be doing both, but right now the flushing if more troublesome so i would be willing to stop roaccutane in view of laser therapy. what do you think? (i was flushing before beginning roaccutane so i do not attribute it to that). thanks so much!


                      • #12
                        Rosacea Treatment

                        Hello Dr Crouch,

                        Thanks in advance for taking the time to read and reply to my question.

                        I have suffered from Roscaea since I was approximately 12/13 years old (I am now 23), the symptoms consist of permanent redness to both of my cheeks and ears however all of these areas flush heavily when reacting to the trigger factors – extreme in temperatures, anxiety, stressful situations, exercise and exposure to windy environments. I also find that when I get embarrassed and all other situations where a ‘normal’ person would go slightly red I flush heavily due to my Rosacea.

                        I currently do not have any visible broken blood vessels however I find the flushing very painful and the redness does bother me slightly.

                        Is it possible that light or laser treatment could help treat my condition? If it is possible, is there a high chance that the treatment could prevent extreme flushing in situations where a ‘normal’ person may just go a little red or pink to the cheeks e.g. embarrassing situations.

                        Once again thanks for your help.


                        • #13
                          Hi Dr Crouch - im sorry i forgot to ask previously, ive read about hair removal as a side effect of ipl. if this is a wanted side effect can it be permanent following a series of ipl treatment for rosacea? or are settings different for hair removal? thanks again!


                          • #14
                            Questions Regarding IPL and PDL

                            Hi Dr. Crouch. Thank you for taking the time to do this session. I have some questions on your IPL process, as I have had several light and laser treatments that have shown minimal improvement. I lead a very miserable life, with severe flushing, depression and seclusion as a result of this disease and I would greatly appreciate any advice that you can provide.

                            I have had severe flushing Rosacea for 2 years. When I initially was diagnosed, I had a purpuric VBeam treatment that really was too aggressive. It took 6 months to heal - I believe my flushing was made worse and I was left with hyperpigmentation that took 6 months to heal. After the hyperpigmentation was gone. I then undertook IPL treatments with another leading practitioner using his triple pulse triple pass technique. I had 10 of these treatments (he used very minor settings at first progressing to standard settings toward the 10th treatment) and had minor improvement in both redness and flushing. I notice that the two of you have some differences in the way you conduct your triple pulse triple pass technique, and I would like to understand if these could have significant impact on the effectiveness of the treatments, or if they are minor differences. Can you please comment on the benefits of your methods:

                            - Why do you start with the shallow filters first and then progress to the deeper filters. My practitioner starts with the deeper filters and then progresses in the final pass to the more shallow filters.

                            - I also noticed that you prescribe Clarithromycin following your treatments. That is not a commonly prescribed drug here in the US. Do you still use that as a mechanism to stop angiogenesis between treatments - or is Oracea/Docycycline just as effective?

                            - I also noticed that you change the orientation of the "head" of the IPL between passes. What is the benefit of this?

                            - My treatments were spaced 2 weeks apart, instead of the 3-4 weeks that you use.

                            - What percentage of your patients require greater than 10 sessions to see acceptable results? What percentage of your patients simply do not improve from IPL?

                            After I had the 10 IPL's done and didn't see much improvement, I had 2 PDL treatments done again. Once again, my skin simply cannot handle PDL or Vbeam - it is too sensitive.

                            On a separate note, are there laser/light treatments that are better for countering major flushing triggers such as high stress, high anxiety, extreme temp, etc.? We found that IPL makes a difference for minor flushing triggers, but not the major ones.

                            Thanks again for your time.


                            • #15
                              Hi Dr. Crouch,

                              I am a 27 year old male who was first diagnosed with mild rosacea about 7 months ago. At this time is is concentrated to my upper cheek bone on both sides of my face. The right side is the trouble spot; The blood vessels are very noticeable and lately it seems like everything causes it to flare (constantly red). I had a consult with a medical esthetician for IPL and have an appointment scheduled in a couple weeks. I'm just wondering what I can expect in terms of results (in your opinion)? Will the IPL destroy all the problem blood vessels in the area or will they return in time? Is the IPL the most appropriate laser for my condition? And if so, what is the approximate timeframe on that? What kinds of questions should I ask the esthetician before/afterwards? How long can I expect to have bruising?

                              Thank you in advance for your time and I look forward to your reply.