Some people stay well by avoiding triggers of flushing such as certain
foods and beverages, sunlight and certain cosmetics. The active flare
ups when spots break out are best treated with antibiotic lotions to rub on or as
tablets to swallow. The better active flare ups are controlled the
fewer thread veins are left behind. Lasers and IPL machines are used to help the
remaining redness and broken veins.
What
is IPL?
IPL stands for intense pulsed
light. The machine contains a flash lamp, this is an extremely bright
light source. The shorter dangerous wavelengths are filtered out. A
computer is used to set the length of the flash and calibrate the
machine. IPL is used to treat a wide variety of conditions apart from
Rosacea such as red birthmarks, pigmented skin lesions, thread veins and
unwanted hair. There are
several different manufacturers of IPL machines, all with different names. We use a Vasculight
Quantum machine manufactured by Lumenis. This is an improvement on their
earlier Photoderm machine.
What
does the treatment involve?
You will be asked to keep your
face as pale as possible by avoiding sun exposure before and during your
course of treatment. At your first visit you can discuss the pros and
cons of treatment and a patch test can be performed to check the
reaction of your skin. A week later the first full, treatment is carried
out. The whole of the affected are will be treated, except in men where
the beard area is avoided. There is a feeling of heat during the
treatment and your face will be redder for a short while afterwards.
Cooling packs can be applied afterwards. You will need to wear goggles
to protect your eyes from the intense light. A course of 4 – 6
treatments at 3-4 week intervals produces the best benefit.
Improvement may continue for many weeks after the course has
finished. Rosacea is a
relapsing condition and this treatment improves the appearance but does
not cure the Rosacea. If
you have active inflammatory Rosacea then this will need to be
controlled with medication before you can have IPL treatment.
How
does it work?
It is believed that the IPL has
two actions that help in Rosacea. Firstly red thread veins absorb the
light energy, this makes them hot. This damage encourages the body to
reabsorb them, improving the appearance. Secondly the light energy warms
the collagen fibres in the skin this stimulates new collagen and
collagen remodelling, this improves the support of the small blood
vessels which helps to delay the development of more thread veins.
What
are the possible unwanted effects?
IPL light is not though to be
cancer forming as it utilises visible and infra red light that is
outside the ultraviolet range that causes sunburn, skin cancer, and
aging of the skin. The flashes of bright light that are produced may
damage the eyes so goggles have to be worn during the treatment. The
treatment is generally well tolerated but some patients find it
unpleasant. Exposure is limited to an extremely short flash that feels
like the snap of a rubber band. A
mild burning sensation can be felt for a while afterwards. Occasionally
there is some swelling that will subside in a day or two.
The beard area is avoided in men as the treatment may cause some
hair loss. Bruising is unlikely but if it occurs will settle in a few
days. There is a chance that pigment changes may occur in the skin,
either dark marks, hyperpigmentation, or pale marks, hypopigmentation.
These are temporary and fade in 1 – 6 months. To help reduce the risk
of this it is very important that sun exposure is avoided for 4 weeks
before your treatment and throughout the course of treatment. Crusting
and blistering may occur after the treatment, this is best left to heal
undisturbed so as to reduce the risk of scarring. It is important that
you follow any aftercare instructions carefully.
Who
should not have IPL treatment?
Patients with light sensitivity
should not have IPL treatment. Its effects during pregnancy are unknown
and it is safer to avoid the treatment when pregnant.
You should not have IPL treatment if you have any suntan however
mild. You should not have
IPL treatment whilst taking Roaccutane (Isotretinoin) or for 12 months
afterwards.
What
alternative treatments are available?
The inflammatory part of rosacea
causes spots, these should be treated with antibiotics, either by
rubbing them on as a lotion or taking them by mouth as tablets. If the
inflammatory type of rosacea is left untreated it will cause more thread
veins. Lasers can be used for treating the thread veins and these are an
alternative to IPL. The pulse dye laser has been used for many years for
facial thread veins, it leaves dark bruises for a week or two.
We have a pulsed dye laser in the department. The KTP laser
is also used this leaves less bruising but there is a slightly increased
risk of scarring.
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