Just had 4th V-beam (Candela-Perfecta Laser)

[NannyBug]

This is my second message on this board. I did a lot of my pre-investigating of this procedure on this forum and from your articles. This is a very helpful site.

Today, I just had my fourth V-beam. They used the V-Beam Perfecta manufactured by Candela.

Things are going quite well. So far, I'm happy with the results. The Rosacea is, bit by bit, section by section, going into remission ... BUT ... V-beam is for the face as chemotherapy is for cancer. The treatment is almost worse than the disease itself. The rewards only come when it's all over and things go back to sleep. This process takes at least 6 months, maybe up to a year, depending on how many treatments you will need. This was my experience, anyway. Others who are not such strong histamine responders as I may see results sooner.

I started the whole nightmare/blessing at the end of May, 2009. The dermatologist thinks this fourth treatment will be the last laser treatment, at least for awhile.

I have one question ... has anyone heard of this problem? We were having some troubles with my forehead. I had developed a nasty seb derm on top of the rosacea. I asked the technician (who is quite experienced and is also a Registered Nurse) to pump up the volume a bit and do the treatment with purpura. Last time, try #3 we also tried purpura. The vessels didn't break then, but the higher power treatment was far more effective. Also faster recovery. Being American, I figured, more is better! This time she turned up the power on the laser ALL THE WAY. The vessels still didn't break! One exception is between the eyes. I have maybe a 5 mm diameter purpuric lesion. A couple of tiny half to one millimeter red splotches but no purpura. Anyone heard of that? This doesn't signal failure or anything. It's just strange.

She said the vessels didn't break because the laser was actually working at increasing collagen and basically making the skin tougher, thicker. Sounds like a good theory to me.

I'm also not as swollen as try #3, despite higher power. It's as if the swelling is more localized, or something. That's weird, too.

In about 8 months, I'll post a full pre and post V-beam rosacea experience. I'd do so now, but we're not finished. (I also look sunburned at this particular moment). The dermatologist has plans to put me on a course of low-dose accutane to shrink the sebaceous glands on my forehead. I'll be starting that after all the laser treatments are finished --- March or April. Honestly, I think I'll need my forehead nuked one more time. The rest of it is drying up quite nicely though. Slowly, but nicely.

V-beam made me break out worse initially and it usually takes me about 8-12 weeks before my skin looks normal again. I'm a heat responder. The tech told me heat responders sometimes break out in acne worse after laser. Breakout slows healing.

Other stuff:

I also have been using Red Light Therapy in conjunction with the laser. LED - Dimalux 3-headed Acnelamp. No blue light because it aggravates it. Just red. It really is true that it helps you heal faster. The lesions reabsorb faster with sporadic LED post-op V-beam. I did this after reading a paper on it. The Dermatologist thought Red LED's are good, too. Just don't overdo it with the Acnelamp. The red light basically does the same thing as the laser, except without killing vessels, only more slowly. It's more powerful than you think!

I'm also using metrogel/cream during this process. The skin texture is slowly improving. Slowly! The metro treatments keep being interrupted by laser. I did a lot of benzoyl peroxide "peels" trying to speed up the process. I'm not sure that was such a great idea in retrospect. Probably safer to use BP to improve skin texture 12-14 weeks after the last laser treatment, when the effect of the laser on collagen production is essentially over. Oh, and don't use 10%.

Anyway, when I do post a final outcome, I'll edit my post better. Promise! I also have before/after pics.

I recommend taking photos of yourself so that when you're having a bad skin day post laser or IPL you can look back and say, "Oh yeah, that plaque is gone. That lesion is gone. Skin's smoother. Less red. Less pain. Less flushing. You can bend over and kiss your toes without triggering a flare." That sort of thing. Just for reassurement.

I do have to honestly say that V-beam's been rough. It's been the roughest on my mental health. I'm trying to adopt a new, more patient attitude.

And other advice: Don't have a spa center nuke your face and don't have plastic surgeons do it, either. Rosacea is a disease and care and course of treatment should be under the direction of a dermatologist.

And right now ... the Perfecta brand of V-beam is #1 for Rosacea.

I had considered IPL, but no one around here was doing it. A colleage of mine, an oculoplastic surgeon, had just purchased an IPL-type machine (BBL) and offered to do me. (My face! HA!) He'd have probably done it for free. But ... I would've been their first. I nicely declined and asked him about the dermatologist I had selected. Asked about V-beam. He told me he refers stuff to him all the time and that the guy IS THE LASER expert for Southern Oregon. Period. He said, "You are under expert care."

Just ask around. Use Google and do some research on your derm doc. I did. I found that what was said of him was totally true.

Also, one more thing about IPL: I had read that it leaves the skin hotter than V-beam and that's one other reason I opted to continue V-beam rather than switching to IPL. I'm a heat responder. I also have Papulopustular in addition to erythomatotelangiactatic rosacea. For the latter alone, IPL may be better? I know it goes a little deeper. One nice thing about the V-beam lasers is the Cool-Touch technology. That helps.

Some people are concerned about pain. The first treatment didn't hurt at all. The rosacea areas were more sensitive, but the less affected areas felt like having a feather hit your face. The first treatment was low intensity. Basically, higher power = more possibility of pain. The attempted purpuric treatments, 3 and 4 hurt. It felt like a rubber band hitting your face HARD. I think my third one hurt the worst because it lasted so long. Half hour. Todays hurt, too, but only lasted 15 minutes.

Cost wise -- in Oregon it's not so bad. The laser treatments so far have been, combined, only a few hundred dollars more than my acnelamp! In retrospect, the pain, long healing time, mental distress have been worth it. I would do it again.

Anyway, sorry this is so poorly written. It's late here.

I'll post more on my progress after the TANE treatments are over, probably sometime next Fall. I'll post pre/post v-beam pictures maybe just before I go on TANE.

Moral of the story: Have realistic expectations before choosing to do V-beam.


I'll reply if anyone wishes to comment or ask questions.

Thanks!

P.S. Yes, do work in healthcare. And yes, there is much more to my Rosacea story. I'm a walking atopic (allergies) nightmare, but that's a subject for another post!

[NannyBug]

Just a little addendum:

There were also a few other extenuating factors contributing to my slow healing: 1) My silly experimentation with Benzoyl Peroxide and Acnomel to improve skin texture and to speed healing from P&P's. and 2) The mosquito incident.

The Mosquito Incident occurred when I was hiking (with my then boyfriend) up Salt Creek Falls on a fairly warm Summer's Day about 4 weeks post-V-Beam #2. My skin was looking good. Even my forehead was looking good. I wasn't healed, but I was on my way.

I got home that evening, took off my hat and looked in the mirror, horrified at finding THREE giant red spots on my forehead.

What were these spots. I reasoned they could either be papules or bites. Looked identical. I hoped for the former, but suspected the latter. See, rarely ever get paps or pustles on my forehead. Benzoyl peroxide had zero effect on any of the red spots, which GREW to about 1 centimeter to 1/2 inch diameter over the next few days. I used cortisone to slow it down, but too late! The redness just spread from the forehead, down nose, to cheeks. I regressed quickly. It took 4 weeks for those those three spots to go away, and a couple more for the skin to be calm enough for nuking #3.

I was so mad! I dumped that boyfriend. Not because of the bug bites though.

The bugs were hungry that day. They saw a small section of my nice, raw, pink, freshly-lased skin peeking out from under my hat and thought in their bug minds, "That looks like something GOOD to suck on!"

In retrospect, it's pretty funny though. I mean, the buggers had to pick the WORST part of the rosacea (forehead). There were no other bites anywhere else on my face! I mean, they literally picked the absolute worst spot to suck on. Or the best, depending on your point-of-view. Even worse, they got away with it alive! Had I been aware of their presence between my brows, I'd have pulled a Dexter. HA!

[TheQueenCity]

Hi NannyBug!

Wow! This is some really great information! I have been thinking of IPL and I really appreciate the info on V-Beam. I often wonder the difference between the two and which is best. This is soooo helpful! Thank you for posting!

Oh...and thanks for adding in a lil humor to the mix! Always fun to read! "I dumped that boyfriend. Not because of the bug bites though." hahahahah!!!! too funny!

Thanks again for this useful info!
Chantel

[NannyBug]

Chantel:

Glad to be of help and of humor.

I honestly couldn't say which is better with regards to IPL or V-beam. It would depend on the type and severity of your Rosacea, I suppose.

If I had only flushing problems, not p & p's, I might have tried IPL first. But if you have any papules or pustles, I would probably go for V-beam, only because IPL is hotter. (Might cause more breakout if you have inflammatory acne).

You'll probably need less treatments with V-beam. I think the average on this board is five treatments. With IPL, you'll probably need twice that. IPL, from what I understand, is also done at much shorter intervals than V-beam. I waited between 6 to 8 weeks between treatments. With IPL, it's usually 2 or 3.

I've read some good stuff on IPL though. Don't discount it. I'd get a good dermatologist and ask him or her.

Thanks!

[WrinkledClue]

I, too, am very impressed with the Candela V Beam. I've had tons of IPL and they worked well to remove broken blood vessels on my face and 'mop up' the vascular damage my horrible flushing was causing.

But they seemed to work less well as time went on, so I tried the V Beam Perfecta. I'm impressed with how much power it can put into my face with less heat and less downtime than the IPLs.

Also it's quicker because you don't have to use gel like with an IPL.

The Perfecta my dermatologist uses blows really cold air on the area of the face he's zapping. That lessens the pain and the downtime. He also gives me three prednisone tablets to take later to lessen the reaction to the treatment.

I've had three hot ones so far and I'm impressed. I'll be doing them for a while, as I've been flushing for a long time and have laid down tremendous damage. Now I control the flushing with Clonidine and Remeron, so here's hoping that blunting the flushing with pharmaceuticals and zapping the damage with V Beam will give me some good progress.

I highly recommend the Perfecta, especially in good hands. My doctor does all the treatments himself, he adjusts the settings differently each time, and he inspires great confidence in me. Wish me luck!

[NannyBug]

I actually am getting purpura 3 days out. The nurse said that may happen. Blood gets darker as it reabsorbs. But it's hardly noticeable except for one spot.

[NannyBug]

I'm about 10 weeks post V-beam #4. I elected not to have treatment #5.

I broke out in p&p's after using Born to be Mild facial cleanser (for the overlying seb derm). I used this about week one after the last laser treatment.

So I used Metrogel. The p&p's healed but only to a point. Then, they looked like they might be getting worse after about 5-6 weeks.

I ran an experiment and firsted tapered the MetroGel and then discontinued it. That was 3 weeks ago.

Two weeks ago, I started applying Really Raw Honey masks to my face at night for the seb derm. I also started using Benzoyl Peroxide at night (full-face and neck) over my Jojoba oil moisturizer. Also, I'm tapering the Doxycycline. I'm at 50 mg three times a day. Will taper that again around Valentine's day.

Well, my face is really looking pretty good. The p&p's are slowly going away. The Seb derm is better, not resolved, but better. The honey has done wonders. Or maybe it was laser. Or both.

My only complaints are: VERY, VERY oily skin. The pores are slightly enlarged, too, probably because my face thinks it needs to produce massive amounts of oil. I dab my face every two or three hours during the day and use up about 6 oil blotting papers per day! UGH! It's annoying.

Am looking forward to a course of low-dose accutane! I want dryer skin. Tane should take care of the oil problem and the seb derm. Hopefully will help with p&ps so that I don't need as much benzoyl peroxide.

Perhaps the topicals are drying the skin and my skin is oily because it's dry??? But the catch-22 is that I need the topicals for the p&p's. I'm hoping TANE can break this catch-22 I'm in. It's frustrating.

Again, will post photos of my final result with the v-beam just before I go on accutane.

On the plus side: Redness has subsided substantially. Maybe 70%. I hardly ever flush anymore. No burning sensation on my face. My ears and neck never flush anymore (used to daily). Much less p&p's. I can have a cup of coffee without triggering a flare. I can do moderate-impact cardio exercise without significant flushing. I mean, I flush a tiny bit when I exercise, but I make sure to dab a cold paper towel across my face halfway through my workout. I also keep a water bottle nearby and squirt oxymetazoline up the nose prior to any long workout, just to protect my investment. It's pretty cool that I can do a 3 hour workout (50 minutes split moderate-impact cardio, stretching and weights) without doing damage to my face.

Overall, I'm glad I did the laser.

[Aurelia]

Two weeks ago, I started applying Really Raw Honey masks to my face at night for the seb derm. I also started using Benzoyl Peroxide at night (full-face and neck) over my Jojoba oil moisturizer.

Thanks for that stupendous and fascinating thread, NannyBug. Wonderful to hear that your face is now "really looking pretty good". Bravo! However, I was surprised to learn that you are still keen on benzoyl peroxide, even over a moisturiser. It would be interesting to know what your derm thinks of your whole regime, if you wouldn't mind sharing.

My only complaints are: VERY, VERY oily skin. The pores are slightly enlarged, too, probably because my face thinks it needs to produce massive amounts of oil. ... Perhaps the topicals are drying the skin and my skin is oily because it's dry??? But the catch-22 is that I need the topicals for the p&p's.

I know what you mean, but many rosaceans with the pustular subtype have found that they were making their skin worse by stripping the oil until the skin was parched, which does tend to step up oil production. In contrast, using gentle cleansers and applying a light moisturiser that is non-comedogenic (meaning that won't clog the pores) can sometimes make a major difference, as can adding healthy oils to the diet and drinking lots of water. I would be interested to know your opinion.

It's pretty cool that I can do a 3 hour workout (50 minutes split moderate-impact cardio, stretching and weights) without doing damage to my face.

Absolutely! Again, bravo! I am slowly building up my strength by indulging in gentle 10-minute workouts once or twice a month, especially while lying on the floor in front of the telly, reading the newspaper at the same time as playing with the cat. (Women like to multitask.) Should reach peak fitness in a few more years - me and the cat.

Kind regards,

Aurelia

[Auburn]

My only complaints are: VERY, VERY oily skin. The pores are slightly enlarged, too, probably because my face thinks it needs to produce massive amounts of oil. I dab my face every two or three hours during the day and use up about 6 oil blotting papers per day! UGH! It's annoying.

Hi Nanny,

Glad to hear that your seb derm is improving with the raw honey treatment. Please continue for the whole month, every other day, and then switch to weekly maintenance. You are seeing results now and you will continue to see improvement. And, though it is hard to believe right now , the warmer weather will indeed arrive in just a couple of months, which will also help your skin/seb derm.

Am looking forward to a course of low-dose accutane! I want dryer skin. Tane should take care of the oil problem and the seb derm. Hopefully will help with p&ps so that I don't need as much benzoyl peroxide.

I've got a proposition for you . Before you start Accutane, how about you give this a try: stop using the jojoba oil as a moisturizer and begin to apply virgin coconut oil, very thinly (to avoid saturating the skin which leads to breakouts), right after cleansing, morning and evening. If the coconut oil works for you (and chances are it will) your skin will gradually start to produce less oil. You'll notice improvement in texture and looks within the first week. It will also help with the seb derm. Within a month your skin should be producing a lot less oil and your pores will tighten, as well. I wish I could show you the way my skin looked last April and the way it looks and feels now. Give it a try.

Wishing you continued success.

[Aurelia]

Hi Auburn,

Do you think virgin coconut oil and/or raw honey are healing for the skin even if the person has bacterial involvement, as in pustular rosacea or acne?

Kind regards,

Aurelia