Hi Jen,
i am not sure if it is too late for post interview questions...in case it is not, i wondered how Dr Crouch feels about treating people with Rosacea and other conditions such atopic dermititis or seb derm. I actually have all 3 and IPL makes them flare up pretty bad. Is there any hope of new machines that could help seb derm as well for example? Or, does he use a different approach for these people?
thanks,
eric
Yep, no worries Eric. I forgot to mention to Max that Dr Crouch agreed to do a follow up set of questions after I e-mailed him.
I'm going away shortly and will be back by the end of the month. Will send the questions to Dr Crouch then.
Jen
Excellent stuff. Have fun RH!
BB
what did I miss?
Where do we get to see the answers? Sorry , I have been away for awhile so I must have missed info.
thanks
Aimee
Re: what did I miss?
Hi AimeeOriginally Posted by Aimee
If you go back to page 2 of this thread, you will find the answers.
I will submit the extra questions to Dr Crouch this evening. Anyone else with follow up questions before I do this?
Jen
Just seen the answers.
Thanks Dr. Crouch, Jen.
Thanks James
Dr Crouch certainly provided comprehensive answers, which is wonderful. The more informed we are about all treatment options, the easier it is for us to make decisions on what we chose to try.
I have just e-mailed Dr Crouch with follow up questions and will post the answers when they come in.
Jen
The answers to the second round of questions are now in. Thank you again to Dr Crouch for taking the time to answer our questions.
T.R.I.P.L.C. Protocol
Q. Regarding IPL settings listed on http://triplc.info ("Typical Treatment Parameters"): Assuming patient responds fine to energy levels mentioned (20 to 24 J/cm²) in first treatment - do you usually go higher in subsequent sessions? If so - what steps do you make with each treatment and what would be a typical limit that should not be exceeded?
A. Thank you for the question – I am always cautious with any new patient especially if there has been no previous exposure to Intense Pulsed Light. Provided that the initial treatment has shown no signs of danger (i.e. any treatment associated redness settles down immediately) and (hopefully) some sign of improvement e.g. reduction in flushing or baseline redness, then I would discuss increasing the fluence (power) settings on subsequent treatments. The important thing to bear in mind is that some improvement at each treatment with no side effects is a worthy goal. The temptation is to increase the fluence constantly on subsequent treatments but this may just lead to a fluence that causes side effects. Generally, I think that this temptation should be resisted and this is what I advocate – provided the general trend is steady improvement then it is often best to remain improving and not risk side effects.
Q. Is there anything that can be done/taken to reduce bruising If there are no safe drugs at all - would stopping drinking water some time before treatment thicken blood and cause less bruising?
A. Thank you for the question - Combining treatments may reduce bruising e.g. Nd:Yag and Pulse Dye on sub-purpuric (= no bruising) settings. I wouldn’t recommend restricting fluids (this won’t actually significantly “thicken” the blood).
Q. Can applying treatment head with too much pressure on skin result in less efficient treatments? In addition to above concern - is it better to wait until device has recharged (which can take some seconds) before applying head to skin?
A. Thank you for the question - Some very fine vessels can be “blanched” by heavy pressure so a light touch may be required. For those machines which use contact cooling (like the Lumenis One) then contact is necessary in order to cool (and therefore help protect) the epidermis of the skin.
Q. I wondered how Dr Crouch feels about treating people with Rosacea and other conditions such atopic dermititis or seb derm. I actually have all 3 and IPL makes them flare up pretty bad. Is there any hope of new machines that could help seb derm as well for example? Or, does he use a different approach for these people?
A. Thank you for the question - When Seb Derm is present then IPL can cause a flare and patients should be prepared to have one condition flare up whilst the other is being treated. Hopefully, this will be a temporary flare and, once this has settled, the other condition i.e. the Rosacea may be better controlled as a direct result of the IPL treatment. If a patient is prepared to accept that one condition may get worse for a short while in order to treat the other then IPL can still represent a viable treatment option for a mixed seb-derm/rosacea picture.
Thank you Jen.
This was helpful and informative.
Happiness is a choice.
The first set of questions and answers and the followup questions and answers for the second interview have written in stone to http://rosaceagroup.org/QandA/Dr_Pet..._Interview.php
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