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Thread: 2008-Q&A-interview with Dr Crouch

  1. #1
    Moderator phlika29's Avatar
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    Default 2008-Q&A-interview with Dr Crouch

    Dr Crouch has kindly offered to take part in another Q&A session. For the next two weeks this thread will remain open for people to post questions, after which they will be sent off to Dr Crouch for him to answer.

    I would be grateful if members would take the time to reread the previous Q&A's Dr Crouch has taken part in in order to minimise duplication of questions. You may also like to have a look at Dr Crouch's Triple C website .

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    Moderator phlika29's Avatar
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    Well I will go first then

    Have there been any developments in lasers/IPL or the techniques used since the last Q&A in 2006?

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    Moderator phlika29's Avatar
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    Many people seem to be particularly affected by flushing of the nose. What laser do you think might help the most?

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    Moderator Melissa W's Avatar
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    Hi Dr Crouch. Thanks so much for offering to do this Q and A for us.

    Are there been any new drugs in development or in the market now for rosacea that you like? Either for flushing/burning or p&p's?

    Also, where do you stand on the preflushing issue before laser/IPL?

    Thanks very much.

    Best wishes,
    Melissa

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    Moderator Melissa W's Avatar
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    Also, if you have flushing of the nose can that be a sign you may develop rhinophyma? That is, what are the pre- rhinophyma signs and symptoms (if there are any).



    Melissa

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    Moderator Melissa W's Avatar
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    With each laser/IPL treatment is there an increased risk of side effects?
    That is, as more and more procedures are done on your face is there any increased risk of compromising the skin and affecting the healing process?
    Is there a point where it is just too many procedures for one person?
    I know it will depend on the individual of course and how they react to the procedure but I am asking for a generalisation.

    Also, as a part 2 of this question, In your experience does a patient reach a point where the laser/IPL has accomplished all it can and they now plateau and further treatments do not help. Again, I know it does depend on the individual but in general do you see this happening? Or in general would you say most people continue to find relief with maintenance laser/IPL(i.e. once or twice a year) once they get their condition under control with a series of treatments.

    Thanks again,
    Melissa

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    Dr. Crouch,
    My question regards treating visible vessels that many people have regardless of a diagnosis of rosacea. What platform or modality of treatment do you find gives the most consistently good results in eliminating visible vessels on the nose and cheeks?
    Have you found that any person is "laser resistant" as has been occasionally mentioned in articles (which somewhat overlaps with the question above)?
    Yours,
    Rob
    Last edited by boyandhisdog; 29th November 2008 at 04:14 PM.

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    Dr. Crouch,
    As the pulsed dye laser (PDL) is likely the most common laser platform most rosacea sufferers will have access to here in the states at their local derm (the V-beam probably representing 90% of the market), my question is about purpuric treatments.
    Have you found in your use of the PDL a better end result with sub-purpuric, purpuric, or stacked treatments for a) visible vessels and b) background redness?

    Secondly, a fear of "making things worse" is a common thread among rosaceans. There have been several anecdotal accounts of damage or specifically "fat loss" with PDL laser treatments although I myself have had great results with purpuric V-beam. It goes without saying that each patient must first do his or her due dilligence to be certain they are utilizing a skilled and trained operator. That said, in your experience, have you ever had anything you would consider permanent damage from a treatment or has anyone been referred to you that has had permanent damage from a therapeutic and correctly performed application of a PDL or IPL?

    Best,
    Rob
    Last edited by boyandhisdog; 29th November 2008 at 04:16 PM.

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    I'm about to undergo my first ever IPL treatment later this week and have 2 very short questions. Of the 6 derms I've seen over the last few years, it's only 50/50 on whether my skin issues are rosacea or not.

    (1) My skin, in addition to being quite red and prone to minor breakouts (whether they're p&p's or acne I'm not sure), is quite shiny and rather oily. Will the IPL worsen oiliness? Will it have any effect on the "shine" one way or the other (my skin is shiny even when "dry"/not-oily, so that's why I mention it separately).

    (2) On my cheeks, temples, and occasionally forehead, I get "itchy patches" that sometimes come before a small bump. These patches look redder than the rest of my red skin, are a little hotter to the touch and raised, but tend to go away within an hour or so, especially if I cool them down. I've asked derms, and they sort of shrug and don't seem to know what it is, although they've said "it sounds like hives." No one has ever said seb derm, by the way. Is there a chance this sort of thing could be made worse by IPL?

    Thank you!

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    Q1. Theoretically speaking, which treatment is most effective against erythema – KTP or IPL?

    Q2. Many people use fans, cold water and cooling face masks to rapidly reduce a flush. Some people suggest that “forcing” blood vessels shut in this way will only add to the problem in the long run and can result in rebound flushing and increased erythema. Where do you stand on this?

    Thank you.

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