Laser For Rosacea: Everything You Need To Know
Dr Anjali Mahto answers all of your questions about laser treatment for rosacea
I get asked questions about laser for rosacea every single week but, because I haven’t had laser treatment (yet…), I asked the amazing Dr Anjali Mahto for her expert help with this article. It previously appeared on my blog, but I send it to someone at least once a week so I knew it deserved a permanent spot here on my Substack.
So here we go: all of your laser questions answered in one place!
If you aren’t aware of Dr Anjali Mahto and her incredible work, I urge you to go follow her on instagram. Anjali is a Consultant Dermatologist who has her own clinic - Self London - which I am lucky enough to have visited: it’s flipping beautiful and offers access to some fantastic experts.
Anjali herself has personal experience with acne and uses this experience to bring a sensitive, empathetic, and understanding approach to her consultations. She knows all too well the emotional side of living with a skin condition and how it can impact your life.
She also believes in, and practices, a holistic approach to skin: not just focusing on skincare and treatments but also taking the time to ask about and offer help with the many other things that can help or harm when it comes to skin.
She very generously took the time to answer all of your questions about laser for rosacea, so let’s dive in.
What is laser?
A laser is a highly focused and intense beam of light used in various skincare treatments. When the laser light interacts with the skin, it targets and heats up specific skin structures, such as pigment, blood vessels, or water, depending on the treatment goal. It delivers precise energy to target specific skin concerns, such as sun damage, wrinkles, rosacea, and pigmentation. They are a popular non-invasive or minimally invasive option in skincare, offering effective results with minimal downtime.
The main goal when using lasers for rosacea is reducing visible blood vessels (telangiectasia) and overall redness of the skin. To remove thickening of the skin (commonly associated with Rhinophyma), a dermatologist may use laser resurfacing with an erbium:YAG or carbon dioxide laser.
Please explain some of the terminology around lasers (e.g. IPL, BBL, fractional, ablative)
Broad Band Light (BBL)
BBL is a type of IPL (Intense Pulsed Light) and is technically not a true laser, as it uses multiple wavelengths of light. The main uses for BBL (relevant for this post) are for facial redness, rosacea, thread veins around the nose. There is minimal recovery time with BBL but some people may find that they are red for 24-48 hours, which can easily be covered by make up.
Is BBL better than standard IPL?
BBL uses a more precise and targeted broadband spectrum of light, allowing for better customisation of treatments to address specific skin concerns. It can deliver controlled energy at varying depths, so offers more versatility and better outcomes compared to traditional IPL treatments. BBL also has clinical trial data to demonstrate it can help boost collagen production in the skin compared to standard IPL so patients may also notice a secondary benefit in improvement of skin quality and pore size as a result.
What is Pulsed Dye Laser (PDL)?
This is a traditional laser treatment, where only one wavelength of light (at 595nm) is emitted. For this treatment, light is pulsed at a wavelength to penetrate and collapse visible blood vessels. The name refers to the dye used to make the beam coloured, to reduce the look of redness and inflammation (it’s also used on port wine stains and birthmarks). There are many types of pulse dye lasers on the market and the name will vary by manufacturer (e.g. V-Beam is a type of pulse dye laser by Candela).
What is a fractional laser?
The main difference between fractional lasers and confluent lasers in cosmetic dermatology lies in how they deliver their energy to the skin. Fractional lasers create tiny, evenly spaced microthermal zones, leaving surrounding skin unaffected. This promotes faster healing and minimal downtime. Confluent lasers, on the other hand, deliver a continuous beam of energy over the entire treatment area, affecting a larger surface area but with more downtime.
What is an ablative laser vs non-ablative laser?
The main difference lies in their depth of penetration and the extent of skin removal during treatment. Ablative lasers remove the outer layers of the skin, creating controlled injuries that stimulate collagen production and skin rejuvenation. This type of laser is more aggressive and is typically used for treating deep wrinkles, scars and sun damage. Non-ablative lasers, on the other hand, target the underlying layers of the skin without removing the surface. They are less invasive with shorter recovery times, making them suitable for mild wrinkles, pigmentation, and overall skin tightening. There is no wound to the skin with non-ablative lasers.
What do lasers do for redness?
Lasers and light based therapies (usually known as energy based devices) can effectively target redness by specifically addressing blood vessels beneath the skin’s surface.
At my clinic, Self London, we do this by using a technology called BroadBand Light (BBL). BBL emits a spectrum of wavelengths of light that are absorbed by haemoglobin in the targeted blood vessels. This absorption leads to vessel coagulation and eventual collapse, reducing visible redness.
BBL is particularly effective for conditions like rosacea, facial flushing and broken capillaries. Moreover, it stimulates collagen production, enhancing overall skin texture and tone. Its versatility allows for tailored treatments, ensuring optimal outcomes for our patients.
What do lasers do for pustules?
Energy based devices are limited in what they can do for the papular or pustular component of rosacea. These treatments need to be combined with lifestyle advice, and prescription creams and tablets alongside skincare to specifically tackle the bumps.
What do lasers do for texture?
Contingent on the type of energy based device you’re using and the type of treatment that is being performed, some laser treatments can also promote cellular turnover, resulting in fresher, more youthful-looking skin. Depending on the specific texture concerns, different types of lasers - such as fractional lasers, ablative lasers, or non-ablative lasers - may be used.
Can lasers help with other skin issues? (pigmentation, scarring etc)
Absolutely. The scarring aspect is something that is very close to my heart and when deciding on what lasers to bring into the clinic, choosing a laser that was backed by masses of clinical data for its impact on scarring was paramount for me.
I chose the ProFractional laser for this as it’s an ideal treatment for scars, as well as select cases of pigmentation. It is widely considered to be the gold standard for acne scars. Unlike full-field resurfacing which removes the entire surface area of the treatment site, the ProFrac laser treats columns of skin by ablating or vaporising narrow channels when fired. Only ‘fractions’ of the skin are treated; these are enough to generate a wound healing response in the skin for clinical improvement, but allow for a much more rapid recovery time as the normal columns of treated skin speed up healing times.
Does laser hurt?
Laser treatments typically involve minimal discomfort, often described as a sensation similar to a rubber band snapping against the skin or a mild tingling or warmth. However, pain tolerance varies among individuals and certain areas of the body may be more sensitive than others.
To ensure comfort during the procedure, topical numbing creams or cooling devices may be applied to the skin beforehand. Additionally, newer laser technologies (and the ones we use at Self) are designed with built-in cooling systems to enhance patient comfort during treatment.
Overall, while some temporary discomfort may be experienced during laser sessions, it is generally well-tolerated and any discomfort usually subsides shortly after the procedure. It’s important to discuss any concerns about pain management with your dermatologist before undergoing laser treatment.
What results can I expect from laser treatment?
The results of laser treatments vary depending on the specific concerns being addressed, the type of laser used, as well as the individual factors such as skin type and condition.
Generally, patients can expect noticeable improvements in their skin texture, tone and overall appearance following laser treatments. These improvements may include reduction in wrinkles, fine lines, acne scars, redness and pigmentation irregularities, as well as enhanced collagen production for firmer, more youthful-looking skin.
However, it’s essential to have realistic expectations and understand that multiple sessions may be needed to achieve optimal results. Additionally, results may continue to improve gradually over time as the skin continues to regenerate and heal. To maximise the benefits of laser treatments, it’s crucial to follow post-treatment care instructions provided by your dermatologist and to maintain a consistent skincare routine. Having your laser treatment with a consultant dermatologist can help you understand what results to expect based on your specific concerns and treatment plan.
Please bear in mind that laser treatment for rosacea can treat existing visible blood vessels, but will not prevent new ones from forming in the future. This is why it’s very important to maintain your skin with trigger management, regular sunscreen use, appropriate skincare, and lifestyle management plus maintenance laser sessions are required (e.g. 2 per year) to keep the status quo.
I always tell everyone in clinic that they are still being exposed to UV, pollution, daily triggers etc. and – as rosacea is a chronic condition – there is no doubt that laser will not be permanent It’s a bit like laser hair removal – you probably will still need top up sessions at some point.
Are results from laser immediate?
While some immediate improvements such as smoother texture and reduced redness or pigmentation may be visible following laser treatment, full results typically develop gradually over time and it’s important to keep this in mind when booking in.
The immediate effects may include temporary redness, swelling, or mild irritation, which usually subside within a few days to a week. The longer-term results, such as collagen stimulation, tissue remodelling and continued improvement in skin texture and tone, become more apparent as the skin heals and regenerates following the treatment sessions.
Depending on the specific concerns being addressed and the type of laser used, multiple treatment sessions may be necessary to achieve the desired results.
How long do the results of laser last?
Sadly I can’t give a definitive answer here as it completely depends on the type of treatment, the skin condition we’re treating and how many sessions have been performed. From a rosacea perspective, energy based devices for redness and flushing can provide some improvement for months to years with occasional top up sessions being required, as covered above.
Can I have laser done with active rosacea?
Yes, you can certainly have certain types of laser done if you have active rosacea. In fact, it’s something we would encourage you to do. The BBL treatment mentioned above is the gold standard for rosacea treatment and it’s absolutely fine to have this done if your rosacea is active/flaring. It should however be combined with a robust medical treatment plan by a consultant dermatologist who can provide a holistic approach to treatment as well as manage any complications.
What is the downtime from laser treatment?
It’s contingent on the type of laser treatment that has been performed. Some of the less invasive lasers have very minimal downtime (sometimes a couple of hours maximum), whereas more in depth laser treatments (i.e. deep resurfacing laser treatments for things like deep wrinkles and acne scarring) can take a couple of weeks of downtime.
All of this will be discussed thoroughly with you though when you book in for a consultation. This is why it’s incredibly important to go to a dermatologist who has extensive experience and expert knowledge of laser treatments.
What products can I use on my face after laser treatment?
We ask patients to keep their skincare routine fairly simple following any treatment. Typically this would involve using a gentle, fragrance-free cleanser and moisturiser, as well as a higher spectrum sunscreen. We recommend a broad-spectrum SPF 50, as laser treatment can make your skin more susceptible to UV rays, so it’s important we protect your skin adequately.
Will laser make my skin more sensitive afterwards?
It would depend on the type of laser used. Generally patients report very little sensitivity following the laser, however, if a deeper treatment/surface remodelling treatment has been used, you can expect skin to feel more sensitive than normal for a couple of weeks until the skin is fully healed.
Can laser cause rosacea to get worse?
In some cases, laser treatments can exacerbate rosacea symptoms if not performed correctly or if the wrong type of laser is used. Certain lasers can potentially increase inflammation and redness in individuals with rosacea, especially if they are overly aggressive or target the wrong areas of the skin.
This is why a formal diagnosis of rosacea by a Consultant Dermatologist is key. We have seen patients who have had treatment elsewhere for rosacea when in fact they have acne and vice versa.
However, when performed by a qualified dermatologist experienced in treating rosacea, laser therapy can be a valuable tool for managing the condition. As mentioned, specific types of energy based devices, such as pulsed dye lasers or BroadBand Light (BBL) therapy, are often used to target the blood vessels responsible for the redness associated with rosacea while minimising the risk of exacerbating symptoms.
It’s crucial for individuals with rosacea to consult with a dermatologist who can assess their condition and recommend the most suitable treatment approach. Properly administered laser treatments, combined with appropriate skincare and lifestyle modifications, can help manage rosacea symptoms effectively while minimising the risk of worsening the condition.
If the skin is light sensitive, can you still have laser?
If the skin is light-sensitive, laser treatment may still be possible with precautions such as avoiding sun exposure before and after sessions, applying sunscreen diligently and using protective clothing. Certain lasers, like BroadBand Light (BBL), can be adjusted to minimise potential adverse reactions in light-sensitive individuals.
However, it’s crucial to discuss your sensitivity with a dermatologist to determine the diagnosis and then the most appropriate treatment plan to ensure safety and effectiveness.
Who is trained to do laser treatment? How do I find a trustworthy practitioner?
Your initial consult for laser should always be with a Consultant Dermatologist. This is so we can ensure the treatment you’re requesting is going to be the best course of action for your skin condition (and we can properly assess the skin condition as the same time).
Laser treatments can be performed by qualified healthcare professionals, under the guidance of a dermatologist for medical or cosmetic skin concerns. To find a practitioner, consult the GMC medical register and check to see if the person you are seeing is on the dermatology specialist register. Ensure the practitioner has experience with the specific laser treatment you’re considering and enquire about their credentials and training.
Can I get laser on the NHS?
Typically, laser treatments for rosacea are not covered by the NHS, as they are considered cosmetic procedures. In such cases, individuals may opt for private treatment options.
Leave a comment with your questions about laser, or say ‘hi and thank you!’ to Dr Anjali Mahto for generously sharing her expertise with us:
Is laser safe for POC?
Laser treatments can be safe and effective for people of colour when performed by experienced healthcare professionals who are knowledgeable about treating diverse skin types.
However, certain precautions should be taken to minimise the risk of adverse effects such as hyperpigmentation or hypopigmentation. This includes using appropriate laser devices and settings tailored to the individual’s skin type, performing test spots to assess skin response and employing cooling techniques to mitigate heat-related complications.
It’s essential for individuals considering laser treatment to consult with a dermatologist experienced in treating POC to ensure personalised care and minimise the risk of complications.
Can laser help ocular rosacea?
Energy based devices such as BBL can be beneficial for managing ocular rosacea by targeting the facial skin affected by the condition. While laser treatments primarily address skin symptoms such as redness and inflammation, they may indirectly alleviate ocular symptoms by reducing overall facial inflammation and vascular abnormalities associated with rosacea.
However, it’s essential to consult with an ophthalmologist and dermatologist experienced in treating ocular rosacea to determine the most appropriate treatment approach tailored to individual needs and symptoms.
NOTE FROM LEX: I have an article all about ocular rosacea with detailed information on treatments and medical interventions from Consultant Opthalmologist Mr Alex Day – you can read it HERE.
How does laser compare to light therapy?
Laser therapy and light therapy both utilise light energy to target various skin concerns, but they differ in their mechanisms and applications.
Laser therapy typically involves the use of focused, single-wavelength light beams to target specific skin structures or conditions with precision. It can be highly effective for addressing specific concerns such as vascular lesions, pigmentation irregularities, and skin texture issues.
Light therapy, on the other hand, encompasses a broader range of treatments that utilise various wavelengths of light, including visible light, infrared, and ultraviolet light, often delivered through broad-spectrum devices.
Light therapy may include treatments like photodynamic therapy (PDT), intense pulsed light (IPL), or light-emitting diode (LED) therapy. Light therapy is versatile and can be used for a range of conditions, including acne, psoriasis, and skin rejuvenation.
Both laser therapy and light therapy have their unique benefits and indications. The choice between them depends on factors such as the specific skin concern being addressed, skin type, treatment goals, and individual patient preferences.
Are there people who cannot have laser?
Certain individuals, such as those with active infections, autoimmune disorders, keloid scarring history, or pregnancy, may not be suitable candidates for laser treatments due to increased risk of complications.
Additionally, medications like isotretinoin or photosensitising drugs may interfere with treatment efficacy. Consulting with a dermatologist is crucial to assess candidates based on individual factors and medical history before considering laser therapy.
Is laser a last resort after trying other things?
Laser therapy is often considered as a treatment option after other conservative measures have been explored or deemed ineffective for certain skin conditions.
However, it is not a last resort and oftentimes may be the primary solution for a specific concern. This is why speaking to a professional who understands both the medical and cosmetic component of a skin condition is so important.
Why do laser results vary person to person?
Results from laser treatments can vary from person to person due to several factors, including differences in skin type, skin condition, treatment settings and individual response to therapy. Skin characteristics such as colour, thickness and sensitivity can influence how effectively the laser energy is absorbed and how the skin responds to treatment.
Additionally, factors like underlying medical conditions, lifestyle habits, and adherence to post-treatment care can affect outcomes. Furthermore, the expertise of the healthcare professional administering the treatment and the type of laser used can impact the results.
Overall, personalised assessment and treatment planning are essential to optimise outcomes and address individual variations in response to laser therapy.
What is the average cost of laser treatment for rosacea?
Here’s our price list that covers most treatments. Some of them are POA as we need to look at your skin first and come up with a personalised treatment plan which may on occasion include a combination of energy based devices for best outcome.
And that’s your lot! If you have any other questions about laser for rosacea (general questions, not specifics, as legally Anjali can’t give medical advice without seeing you as a patient!) please leave them in the comments, or come chat on instagram and I’ll update this post with the information.
I am so so grateful to Anjali for her detailed and thoughtful answers to these questions. If you found this resource helpful, I’m sure she would love to hear from you on instagram. You can find out more information about her wonderful clinic, Self London, HERE where you can also book in for a consultation.
Hi - and thank you!