Question:
I'm new to this group and would like to offer my gratitude to everyone here for helping to truly increase my knowledge of rosacea. I've purchased Dr. Nase's book and it's fantastic. My question is this: while I'm fairly certain I have rosacea, I don't know if I should confirm this with the dermatologist I've seen for my seborrheic dermatitis and other skin problems, or should I bypass him and go directly to the Dr. Bitter-trained dermatologist in a nearby city? I've recently been diagnosed with blepharitis and dry eye and possible ocular rosacea by my ophthalmologist. He prescribed lid scrubs, warm compresses, Restasis, and flax seed oil. I've had definite seborrheic dermatitis for a number of years, and have regular periods of facial flushing. That is, I seem to go through periods of weeks or months where I flush frequently, then weeks where the flushing isn't so frequent. I do have very definite spider veins on my nose and some smaller veins on my cheeks, along with a constant redness of the cheeks. I'm afraid if I see my regular dermatologist, he'll give me a prescription for topical and/or oral antibiotics, the avoid-your- triggers speech, and send me on my way. But I'm very self-conscious about the spider veins and would like to at the very least look into having Photoderm to treat them; and, of course, I'd like to treat the underlying vascular problem that leads to the flushing and spider veins in the first place. I'm also somewhat afraid that my regular doc will want to use his lasers to treat me, and, to be honest, I don't really know how much experience he has with treating rosacea with lasers. Is going to a Bitter-trained physician and receiving light therapy as an initial treatment for rosacea advisable? Or should I try more conventional treatments first?

Answer: While I always recommend a full facial treatment for rosacea, if you just want to focus on the spider veins, then IPL is not the best device. The 1064 YAGS can treat these one time and literally erase them with no downtime. The V-beam can also treat these usually in one pass, but you will experience some purpura.