Will Rosacea Laser Treatment Cure Rosacea?
Rosacea laser treatment has been around a long time, but to date, there have not been a lot of studies to either support or discredit its use in treating rosacea.
The term rosacea is derived from the Latin word rosaceus, which means rosy. However, rosacea is not pleasant. It is a chronic, progressive disease, a serious skin condition that can require expensive and time-consuming treatment.
The exact cause of roseacea is not known, but the signs and symptoms - erythema (redness of the skin), telangiectasia (permanently dilated small blood vessels), and flushing reactions - are caused by dilation of the blood vessels, and these changes are likely due to inflammation of the dermis, destruction of the compounds that give skin its tone (elastin and collagen) and changes to the blood vessels close to the surface. Oral and topical medications can be used, and 'triggers' that stimulate flushing can be avoided, but for many serious cases of rosacea, rosacea laser treatment is the only answer.
Laser is an acronym for light amplification by stimulation of emitted radiation. The first working laser was produced in 1960, and they are in common use in medicine today. The laser works by applying energy to subatomic particles; this places them in an 'excited' state and they gain energy. These particles then move back to their original energy level and as they do, they release energy in the form of particles of intensely focused light - the laser. The light emits heat and the laser destroys the targeted tissue of rosacea.
How does rosacea laser treatment work? Although no one knows for sure what causes rosacea, there is a good idea of what happens to produce the characteristic erythema, flushing and teleangiectasia. Blood vessels close to the surface dilate (again, because of inflammation, changes to the blood vessels, etc.), often in response to an environmental trigger, stress, etc (The dilation can be temporary or permanent). This brings more blood to the surface of the skin and produces the characteristic appearance of rosacea.
Laser treats rosacea by selectively destroying the inflamed, dilated, and hyper-responsive blood vessels without damaging surrounding skin. The laser 'energy' is absorbed by oxyhemoglobin (hemoglobin is the molecule in the blood cells that carries oxygen; oxyhemoglobin is hemoglobin that is saturated with oxygen) in the blood. This generates thermal energy that damages the adjacent blood vessel wall blood. The exact intensity of the wavelength is carefully chosen to destroy the dilated blood vessels using thermal energy without significant damage to the surrounding skin and to avoid surface scarring.
How successful is rosacea laser treatment? That can depend on several factors, and there are many treatment protocols and many different types of lasers that can be used; argon, pulse dye, neodymium, carbon dioxide and krypton lasers have all been tried.
Multiple treatments are often necessary and these are time consuming and expensive. There is certainly anecdotal evidence for the effectiveness of the laser in clearing up erythrosis and teleangiectasia, and many patients are satisfied. But surprisingly - given that rosacea laser treatment therapy is not new (it's been around since the 1980s) and is in widespread use - there is relatively little hard data about how useful it is; there is a distinct lack of controlled studies, and the Food and Drug Administration classifies laser therapy as a procedure, so its effectiveness is not evaluated in the same way as drugs.
Some rosacea laser treatment clinicians have reported success rates of up to 75%, but other studies have reported much lower rates of success. As well, laser cannot be used for everyone. You should not have laser therapy if you have dark skin or a tan, it is contraindicated for people who have disorders of blood clotting, people who easily develop scars (keloids), or people with insulin-dependent diabetes. And although rosacea laser treatment can work for some people, it is not a cure. Relapses are possible and it is possible that the laser can make your rosacea worse.
If you're interested in an alternative to rosacea laser treatments, click here for more information.