Gemini Laser Treats Rosacea With Green Light

Millions of Americans have rosacea, a skin disorder in which frequent flushing in the center of the face can cause discomfort and embarrassment.
"When you are younger you think it's blushing, and you get in your 20s and it still looks good, and you get into your 40s and it gets darker, redder, until it's like a neon sign," said rosacea patient Janet.
Topical medications and antibiotics can help control the redness and breakouts caused by rosacea. But now, the latest in laser technology can literally zap away tiny blood vessels in minutes.
Janet's broken blood vessels were zapped away by the Gemini Laser -- a laser that uses green light to target blood vessels.
"The green light selectively heats hemoglobin which is in the blood," Scripps Clinic dermatologist Dr. Victor Ross.
"The blood becomes very hot and the blood vessel coagulates and closes off and once it closes off, it's gone for good," Ross added.
The light spares healthy skin from the heat.
"The wavelength is selectively heating the red vessels; the normal skin is relatively cool," Ross said.
Ross said he has seen amazing results when he uses the Gemini Laser treatment to treat rosacea patients.
"Typically, we will do about two or three sessions about four weeks apart and then have them come very six months for maintence," Ross said.
Janet said her chronic redness disappeared rapidly after her first treatment.
"All of a sudden I stopped using foundation makeup altogether," Janet said.
Janet's results were so profound, Ross said she may only need to have the laser treatment once a year to keep her rosacea at bay.
Treatments with the Gemini Laser range between $300 and $500. It is not covered by most insurance.
Roos said people with light skin will see the best results.
He also said rosacea patients may see longer-lasting results if they have a laser treatment and continue to use medications to control inflammation.

Exercise Is A Rosacea Trigger

Exercise is a common cause of rosacea flushing, but altering exercise regimens can reduce the effect.

According to the survey of almost 1,300 people with rosacea, more than 83 percent said exercise triggered or aggravated the signs and symptoms of their disorder. However, 42 percent said they modified their exercise routines because of the skin condition, and nearly 9 out of 10 of those that did so said those changes reduced the effect of exercise on their rosacea.

"While exercise is important to a healthy lifestyle, people with rosacea should anticipate flare-ups of rosacea signs and symptoms, especially with strenuous activity or outdoor heat exposure," Dr. James Del Rosso, an assistant clinical professor of dermatology at the University of Nevada Medical School."

By doing simple things, such as working out in the early morning or late evening when the weather is cooler or in a cool indoor environment, rosacea sufferers may be able to reduce the intensity of flare-ups."Other ways to reduce or avoid flare-ups: exercising more often, but for shorter periods of time; running a fan or opening a window in order to keep cool indoors; and cooling off by drinking cold fluids or by keeping a damp towel around the neck.

The survey found that walking triggered rosacea in 36 percent of the respondents,
followed by jogging or running (33.5 percent),
aerobics (30.5 percent),
weight lifting (16 percent),
push-ups or sit-ups (15 percent),
and bicycling or spinning (15 percent).

Along with exercise, other common triggers of rosacea flare-ups include hot weather, alcohol, sun exposure, emotional stress, humidity, indoor heat, spicy foods, heated beverages and irritating skin-care products.

Adjust Your Rosacea Treatment To Your Rosacea Symptoms

Many individuals who are struggling with redness, pimples and visible blood vessels on their face may incorrectly diagnose their condition as acne, sunburn or sensitive skin.
However, they probably have rosacea, a skin condition which if not treated early, can continue to flare or begin to worsen. Therefore, it is important to visit a dermatologist who can make the correct diagnosis and recommend treatments and skin care products that will control the rosacea and keep the skin healthy.
Speaking today at the 64th Annual Meeting of the American Academy of Dermatology, dermatologist James Q. Del Rosso, D.O., clinical assistant professor in the department of dermatology at the University of Nevada, Las Vegas, spoke about the individualized treatment options that are helping patients with rosacea manage their condition.
"Rosacea can have devastating effects on self-esteem because it is so noticeable on the face," said Dr. Del Rosso. "When it affects teenagers and young adults, it can cause feelings of isolation and self-consciousness. Adults with rosacea often are caught unaware because they assume they would have outgrown skin conditions. But rosacea treatments are more effective than ever, offering a variety of therapies that are having successful results."
Rosacea is a chronic and often progressive skin disease that causes redness and swelling on the face. As many as 14 million Americans have rosacea. Rosacea may begin as a tendency to flush or blush easily, and progress to persistent redness in the center of the face that may gradually affect the cheeks, forehead, chin and nose. As the disease progresses, the redness becomes more severe and persistent, and small blood vessels, acne-like pimples and nodules may become visible on the surface of the skin. Rosacea can be exacerbated by exposure to extremes of hot and cold, sunlight, emotional stress, hot beverages, alcohol, spicy foods and certain skin care products.
"Since what triggers rosacea in one patient may not trigger it in another, dermatologists often recommend that patients with rosacea keep a diary of flushing episodes and note associated foods, products, activities, medications or other triggering factors," said Dr. Del Rosso.
Topical treatment options such as metronidazole and azaleic acid can reduce redness, red or pus-filled bumps and other symptoms associated with rosacea. With topical medications, individuals are instructed to be consistent with the application of the product and to be patient, as it may take four to eight weeks to see noticeable improvement.
Oral tetracycline antibiotics, such as doxycycline or minocycline, are the most common oral medications used to treat rosacea. A new form of doxycycline, called anti-inflammatory dose doxycycline, is currently under review by the U.S. Food and Drug Administration (FDA) for the treatment of rosacea. This form of doxycycline reduces inflammation without any "antibiotic effects," such as antibiotic resistance. "Whether or not an oral antibiotic is recommended for treating rosacea depends on how severe the case is," stated Dr. Del Rosso.
Glycolic acid peels often are used in conjunction with antibiotics to hasten the control of rosacea. A series of peels are performed every two-to- four weeks and may be used in combination with low concentration glycolic acid washes and creams. Glycolic acid peels for rosacea are timed and generally take three-to-five minutes. The peeled facial skin will be red for a few hours following the treatment and makeup should be avoided during this time.
While topical or oral therapies do not remove the redness on the face or reduce the appearance of dilated blood vessels associated with rosacea, vascular lasers and intense pulsed light therapy are now being used to treat these symptoms.
Vascular lasers emit specific wavelengths of light targeted for the tiny visible blood vessels just under the skin. Heat from the laser's energy builds in the vessels, causing them to collapse. The newest generation of vascular lasers does not produce any bruising, but may cause redness and minimal swelling that lasts approximately 24-to-48 hours.
Intense pulsed light therapy is used to treat the persistent redness caused by rosacea, destroying the dilated blood vessels with multiple wavelengths of light.
Both treatments, laser and intense light, take 15-to-30 minutes and are performed at six-to-12 week intervals. Patients may require several treatments initially, and may return annually for treatment of new blood vessels.
In advanced cases of rosacea, rhinophyma may develop, a condition that occurs when oil glands enlarge on the face and a bulbous, enlarged red nose and swollen cheeks develop. This condition usually occurs in men over 40. The excess tissue can be surgically removed using lasers, dermabrasion or laser surgery to sculpt the nose back down to a more normal shape and appearance. These procedures may be performed on an outpatient basis using local anesthesia, and healing generally takes seven-to-10 days.

Rosacea Sufferers Found to Have Thicker Skin

Dr. Diane Thiboutot, professor of dermatology; Hilma Benjamin and Dr. Klaus Helm, Division of Dermatology, Pennsylvania State University College of Medicine.

In a study of the moisture level, elasticity, skin thickness, extent of photodamage and other characteristics of rosacea skin, investigators found rosacea patients had thicker facial skin than normal subjects, which might be a result of edema (swelling). However, the researchers found no significant difference in skin water loss and elasticity between the 20 rosacea patients and 20 patients without rosacea.
Their questionnaire revealed that rosacea patients, who are often affected by sun exposure, were more likely to keep the upper body covered from the sun while doing outdoor work and were less likely to have had sunburns that required medical attention. Despite their apparently reduced sun exposure, however, those with rosacea had more visible blood vessels and blood vessels with a larger diameter.
Vascular endothelial growth factor (VEGF), a regulator of blood vessel growth that may be associated with sun exposure, was highly expressed in the sebaceous glands of the rosacea patients, Dr. Thiboutot said. She noted that previous research has found VEGF may be involved in the formation of visible blood vessels in rosacea, and that rosacea patients may therefore be especially sensitive to sunlight.

Azelaic Acid May Soon Be Availabale as a Water Soluable Salt

Azelaic acid is a completely new class of acne and rosacea therapy, chemically different from most of the currently available acne or rosacea medications, including retinoids and alpha-hydroxy acids. Azelaic acid is believed to work uniquely with dual modes of action: antimicrobial activity and normalization of keratinization (the process by which epithelial cells mature as they move toward the skin surface and then slough off) thus addressing two of the major causes of acne.However, azelaic acid, as currently marketed, can cause burning and irritation of the skin. The company's patented chitosan azelate addresses this problem by making the azelaic acid completely water soluble. By increasing the water-solubility of this topically applied drug, increased efficacy is expected. Azelaic acid is FDA approved in the US and is approved abroad for the treatment of acne and rosacea. This molecule can also be developed for the treatment of malasma.

Rosacea Is Often Mistaken For Acne

Many U.S. adults with redness, pimples and visible blood vessels on their face may think they have acne, but they may have rosacea.
Rosacea is skin condition that if it is not treated early, can continue to flare or begin to worsen, but a visit to a dermatologist who can make the correct diagnosis and recommend treatments and skin care products that will control the rosacea and keep the skin healthy.
"Rosacea can have devastating effects on self-esteem because it is so noticeable on the face," said dermatologist Dr. James Q. Del Rosso, clinical assistant professor in the department of dermatology at the University of Nevada, in Las Vegas. "It is important for individuals with rosacea to seek treatment early to avoid progression of the condition and avoid any permanent scarring to the face."
As many as 14 million Americans have rosacea, most between the ages of 30 and 50.
Del Rosso presented the findings at the 64th Annual Meeting of the American Academy of Dermatology.