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Thread: New Q&A with Dr Crouch

  1. #11
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    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!

  2. #12
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    Default 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.

  3. #13
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    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!

  4. #14
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    Default 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.

  5. #15
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    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.

  6. #16
    Moderator Melissa W's Avatar
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    Hi Dr Crouch, I hope all is well with you and your family. Thank you for taking the time and energy to do another Q and A with us. Your thoughtfulness is much appreciated by the RF.

    Are there any new or exciting treatments on the horizon for rosacea? Anything that has potential that might be coming up in the near (or distant) future?

    Thanks again Dr Crouch.

    Kind regards,
    Melissa

  7. #17
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    Hi Dr Crouch,

    Thank you very much for again taking the time to answer our questions.

    A derm I saw strongly invited me do have IPL done for my flushing but when I asked him about the risks, he answered that there were none. I asked a second one, who gave me the same answer. I, of course, know that there are risks and i would like to know if there is a type of skin which is more vulnerable to lazer treatment and in which case you would avoid doing lazer treatments. I am very scared of having it done as my skin is very thin and sensitive. I fear excessive swelling and fat loss . I mainly flush with going from cold to hot temp., emotional stress, eating, heat and have a few P&P's. I've had quite some sunburnts during my teenage years.

    Thanks again for your help.

    With my kind regards.

  8. #18
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    Hello Dr Crouch,

    Once again thanks for taking the time to read and reply to these questions, your views and experience are priceless.

    I forgot to ask in my earlier post - IPL is also advertised as a treatment for hair removal, if I were to have IPL treatment for my rosacea, which currently affects my cheeks, would I no longer be able to grow facial hair in this area or is the IPL set at a different setting for Rosacea IPL treatments?

    Sorry if it sounds like a silly question!


    Thanks again

  9. #19
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    Default Help for burning

    Hello Dr. Crouch,

    I have very sensitive skin which is dry and my face burns a lot (but does not always turn red). I have some mild redness on my cheek that seems to be always there but it is barely recognizable. Is there a laser that you would recommend for the burning or could it possibly make it worse?

    Also, I am having a difficult time finding a doctor who does laser in my area despite the fact that I live in a city that has great hospitals. It seems like most office have physician assistants who do the lasers. Would it be best for a doctor to do the treatment?

    I appreciate your time and help!

  10. #20
    Moderator phlika29's Avatar
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    We will be closing this thread at the weekend so any more questions please post them up.

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