While topical creams such as Ivermectin and Oral Antibiotics are good at treating the inflammatory, acne-like bumps of rosacea, they cannot eliminate the persistent background redness and dilated, broken blood vessels that are a consequence of longstanding rosacea. Vascular lasers remain the gold standard for addressing these issues.
The most common, effective, and extensively researched vascular laser utilized for rosacea is the Pulsed Dye Laser (PDL). Another commonly used laser is the NdYAG laser and this is more effective for deeper, larger blood vessels but can have more side effects. KTP lasers are also used, for example in the DermaV laser which combines an NdYag and KTP lasers.
Vascular lasers emit a highly concentrated beam of light at a very specific wavelength. This passes harmlessly through the outer layers of the skin, but it is absorbed by hemoglobin within the blood cells inside the dilated vessels.
As the red pigment absorbs the light, it converts the light energy into intense thermal heat. This heat coagulates the blood and destroys the target blood vessel. Over the following two to four weeks, the body's natural immune system clears away the destroyed vessel.
Typically, a series of 3 to 6 treatments spaced four to six weeks apart is required to achieve optimal results. Because rosacea is a chronic condition, patients should remain on topical and/or tablet treatments and may require a maintenance session every 12 to 18 months.
The procedure feels similar to a rubber band snapping against the skin. Patients may experience mild swelling and redness and some bruising for a few days.