4 IPL treatments with little/no change. Some advice please

[alex5]

Dear all
I'm just posting on here really to ask for advice about how to proceed from some people who know what they're talking about.
Any advice would be much appreciated

To explain; I'm a 22 year old guy (UK) who has always (as far as I remember) had symetrical red patches covering most of my cheeks (as well as some mild redness on my chin and above my eyebrows) which fluctuate in colour from mild/splotchy red to solid blocks of bright crimson. Increased redness is normally brought about by extremes of heat/cold, wind, exertion or alcohol as well as any physical contact. At worst; the cheeks are sore and itchy and best; slightly sensitive.

Anyway - until recently, I hadn't paid a lot of attention to possible ways that I could treat the problem, instead focusing on covering up the redness as and when it seemed like a good idea. But, I heard the word rosacea and started looking around the internet. To cut a long story short, after trialling a variety of fairly ineffectual cremes, I heard about IPL and visited the "Cambridge Skin and Laser Clinic". The dermatologist there, after examining my skin said that IPL would be productive and estimated that 2-3 treatments would clear up my skin. Although I was fairly sceptical, I signed up for a course of treatments, and have, in fact, have 4 treatments at one month intervals over the last 6 months. It has been over 2 months since my last treatment. Yet, if there is any change then it is fractional.

Should I return to the clinic and continue with the IPL treatment?
Or should I try different types of laser?
Or is there another possibility?

Whilst this is a priority for me, it is worth noting that as a postgraduate student I don't have a lot of money to throw around. The 4*£150 I spent on the IPL was paid for by part-time work over the summer. I'm willing to spend more money/time but would like some sense that what I am doing is productive.

One of my worries with this doctor is that he's very confident and bullish, which initially seemed encouraging but now following little result, seems like over-confidence/spin. Are there any particular questions I should ask of him or particular things I should draw to his attention?

Many thanks, I look forward to hearing from you soon,
Alexander

[Naturaltreatments]

I think you should hope for some more improvement after four visits, but maybe other members of the board would disagree? I think there is quite a bit of skepticism amongst some board members about the effectiveness of treatment that general laser centres can give for rosacea - effective treatment of rosacea involves quite a skilled use of lasers/IPL. Dr Peter Crouch in Swindon has a lot of expertise if you wanted to go down the laser route. There are, however, lots of other possible treatments as well if indeed what you have is rosacea (e.g. antibiotics, creams etc). There are also low level light treatments (see the relevant section of this forum), where you can gain the benefits of light by treating yourself over a longer period of time - some people have found this very effective. It is also cost effective compared to multiple laser treatments, as you shouldn't have to pay more than £300 for a top range red light that will last you years - some people however advocate having IPL/laser and low level light treatments. From your description what you have does sound quite rosacea like but I couldn't be 100% sure so in that regard it might be worth getting a second opinion from another dermatologist. Feel free to PM me if you want any more suggestions.

[Naturaltreatments]

I think the over-confidence and bullishness would definitely concern me if I was choosing someone to give me laser treatments. He should have told you about the limitations of the laser treatments and the possible side effects too.

[Aurelia]

Hi Alexander and welcome to the group

Naturaltreatments has given you some really excellent advice.

In their training, doctors (indeed, probably all professionals) are encouraged to be very positive with their clients, and it is entirely natural that laser/IPL practitioners will have great faith in what their equipment can achieve. After all, if they weren't convinced that it was capable of great things, they wouldn't have bought it. However, nothing can be guaranteed - as with most treatments doctors perform. Even with simple medical procedures, it is usually acknowledged that it is always possible for something to go wrong, even if that is unlikely, hence the signing of waiver forms before operations, etc. Even the most skilled and careful doctor can never be absolutely certain how any particular patient will respond, imho.

Yes, it might be wise to seek a second opinion, both on the rosacea and on different kinds of laser or IPL therapy. Also, it's certainly well worth trying other forms of rosacea treatment, starting with the simplest and cheapest, just in case some of them might benefit you.

BTW I don't recall hearing of the Cambridge Skin and Laser Clinic before. It isn't something any of our other members have reported on.

Kind regards,

Aurelia

[alex5]

Just quickly, as so many interesting points have been raised that I really need to have a proper look round the forums and elsewhere to find out more; thanks very much for the replies, they're both thoughtful and helpful.
So aside from the IPL, I have three options -> creams/antibiotics/low level light treatments (in order of cost?)
http://www.cambridgelaser.com/ is the website for the Cambridge centre. The doctor there has experience with Rosacea, but he's not a rosacea specialist. Has anyone had a positive experience with Dr. Peter Crouch?
I'd be very interested in more opinions though (not to imply any disrespect at all to Aurelia or Natural Treatments. )
Thank you again,
Alex

[Naturaltreatments]

I think you might find it helpful to read through some of the question and answer sessions about laser treatment on the Rosacea Support site with Dr Peter Crouch and Dr Soldo (he's based in America though so more for information). If you google "Dr Soldo" and "rosacea" or "Dr Crouch" and "rosacea" you'll find them I think. You could also find a range of opinions about laser/IPL treatment on the Rosacea Group forum. You're wise to seek out as many opinions as possible! I saw Dr Crouch and found him helpful, though decided laser treatment is probably not for me at the moment.

[Naturaltreatments]

Apart from those treatments you list you also have possibility of using various dietary supplements like MSM, which can reduce the flushing. The Sher System, based in London, provides an alternative approach to conventional medicine for rosacea that some people find beneficial but other people don't (you can get a refund on the products if you don't like them, but not the cost of the consultation). Many people have found that effective cleansing regimes for rosacea make a surprising difference to their condition, especially when combined with oral antibiotics or dietary supplements. There are a series of triggers for rosacea as well which are not the same for everyone, but can include flushing red during and after having a hot shower, certain foods, sunshine/cold weather, etc - so if these impact on your rosacea, you may want to reduce the effects of these as best you can (e.g. wearing an appropriate sunscreen when you go out in the sun - e.g. Zinco by Rosacea Care - not a problem at the moment!).

[Aurelia]

I think you might find it helpful to read through some of the question and answer sessions about laser treatment on the Rosacea Support site with Dr Peter Crouch and Dr Soldo (he's based in America though so more for information).

Here's the link to the relevant section of our Rosacea Support Resource Pages:

http://rosacea-research.org/wiki/index. ... oldo%2C_MD

Kind regards,

Aurelia

[drsoldo]

Dear Alex5--I have read your post and have been asked for comments---I cannot speak of your case specifically since I have not evaluated you but will respond in generalities as to my 12 years of experience doing IPLs and treating patients with Rosacea---My routine usually consists of a mimimum of 5 IPL sessions and in all honesty often requires a series of another five to obtain even better results--Results vary from patient to patient and is very dependant of the physicians experience, equipment used and technique employed--Most of the time other modalities as topical and/or oral medications are also needed--I use a triple pass at 3 different depths at slightly milder fluences and repeat these every 2 weeks---You may wish to consult with Dr Crouch in the UK as he is quite knowledgeable and may be of assistance---Again I can only speak of what seems to work for me and my patients--Best of luck DR SOLDO

[Aurelia]

Many thanks for that, Dr Soldo. Our understanding is that the norm with IPL is a series of at least 5 well-spaced treatment sessions, so just 2 or 3 sessions sounded surprisingly light.

Alexander, have you checked this thread to see if you can find anyone with similar skin type and symptoms as you, to see what treatments they have found most helpful?

viewtopic.php?f=37&t=669

Kind regards,

Aurelia