Why? I have 2 big problems: lots of sun damage and lots of redness in my skin.
I was always freckly. Cute freckles when you're young turn into age spots in your 30s and 40s (and beyond). That's sun damage. And even if you have protected your skin faithfully for 10 years the damage will work its way to the surface of your skin and give you a mottled complexion.
The redness comes from 2 sources. Some of it is environmental damage in the form of broken capillaries. I remember when I was a 25-year old intern working in a dermatology clinic and the dermatologist pointed out (loudly!) to someone that I already had broken capillaries (except he used the term telangiectasia) in my cheeks.
The other source of the redness is rosacea, a chronic inflammatory condition of the skin that can include excessive flushing, acne-like blemishes, rhinophyma (think of W.C. Fields' nose) and eye involvement.
IPL is the perfect treatment for me because it specifically targets pigments, the melanin in the brown sun spots and the hemoglobin in the redness of flushing and broken capillaries.
Here's an example of how IPL eradicates sun damage:
BEFORE
AFTERI don't know if you've noticed in the media lately how everyone seems to have a perfect pale complexion. Of course, makeup plays a role but a large part of it is IPL treatments.
Here's an example of how IPL improves redness:
BEFORE 
AFTERIPL works on redness from many different causes such as acne blemishes, hemangiomas (little round red spots), dilated capillaries and diffuse flushing. The principle is the same for all: the red pigment, hemoglobin, absorbs the flashes of intense light and becomes heated up. The heat will either shut down the vessel, in the case of dilated capillaries, or alter the hemoglobin molecule. The body recognizes that the hemoglobin molecule is no longer normal and cleans it up.
OK, so IPL is a great treatment but I have to tell you that people who are prone to melasma, a familial predisposition to developing brown pigmentation on the cheeks, upper lip, forehead and nose, can actually become darker with an IPL treatment. These people need to be on good skincare, usually including retinoids and skin lighteners. IPL can be done only after the tendency to darken the pigment has been suppressed with skin lighteners.
21 comments:
In January '08 I had cataracts removed from both eyes. Shortly after surgery (4-6 weeks) I began complaining about unusual sensations in my eyes (IE. sand under my lid, chronic red eye as well as chronic dry eye). My ophthalmologist casually mentioned that I have and have had Rosacea which was causing these ocular symptoms. This condition was incurable and I will, essentially, just have to live with it. Interestingly enough, no one at the clinic ever mentioned anything about any pre-existing conditions before surgery.
I am looking for suggestions as to mitigating the chronic redness I have in both eyes. I don't drink but my eyes look like I always have a hangover. Any suggestions or suggested sources of information will be sincerely appreciated. I have researched these symptoms on the Internet without success.
Thanks for your help.
~Steve~
Hi Steve,
Here are the general principles for managing ocular rosacea but you should be under the care of an ophthalmologist to have the treatment customized to you:
- use of lubricants and good lid hygiene to decrease irritation to the eye
- use of topical anti-inflammatories (drops or ointment) to calm the eyes
- use of anti-inflammatory pills
- use of antibiotic pills (usually doxycycline)
This rosacea support website has lots of up-to-date info: http://rosacea-support.org/articles/ocular-rosacea
Best of luck,
Dr. Rose
Thanks so much for the information. Considering your suggestions I am curious as to your thoughts about using a vassal constrictor like Visine (Tetrahydrozoline ophthalmic)?
The eye drops won't hurt you but they are not addressing the underlying problem.
I strongly recommend that you see an ophthalmologist or dermatologist with an interest in ocular rosacea.
You may be better off with eye drops that replace your tears and lubricate your eyes rather than just address the redness.
The redness is a symptom rather than the disease and you need to have treatments that deal with the disease itself.
I too have the problem with inflamed eyelids and redness. I really appreciate your specific suggestions Dr. Jeans.
My Ophthalmologist has prescribed Zaditor. Is this for Rosachea? That's not what she called it but I can't remember what it was she did say it is.
Marilyn
Hi Marilyn,
Zaditor is an antihistamine compound that is prescribed for allergic conjunctivitis.
If your eyes are improving with Zaditor then the redness has an allergic component. If they're not improving, I would ask your ophthalmologist whether she thinks you have ocular rosacea.
All the best,
Dr. Rose
Update...After being diagnosed by my Opthamologist with Rosacea as an explanation for the chronic redness and dryness in my eyes I sought out a second opinion. The second opthamologist said that it appeared that I had an infection causing the ducts in my eyelids to become blocked resulting in the dryness which contributed to the redness.
He then prescribed TOBRADEX OPHTH OINT 3.5GM and TOBRADEX OPHTH SUSP 5ML. He also suggested that I wash my eyelids (where the eyelashes meet the eyelids) with a Q-Tip and baby shampoo. The results were almost immediate and unexpected. My eyes, for the first time in memory, felt truly refreshed and the redness began to fade. As of today the redness and dryness of my eyes has been significantly reduced, if not totally eliminated.
Hooray for second opinions!
Hi Steve,
This is great news! I'm glad to hear that you have found a solution to your sore eyes.
Your experience highlights for me the importance of having a face-to-face assessment rather than relying on generic advice from the internet.
Also, it shows the importance of getting a second opinion.
All the best,
Dr. Rose
I have a question about IPL.
5 days agoI had this procedure done where the doctor colored on me with a clear stick, then i sat for an hour and then had the ipl. my face is not becoming extra red or dry and flaking off at all. im concerned nothing is happening as the pigmentation and brown spots are still there as ever.
how long does it typically take to see results from a treatment?
its great that ive had no adverse reactions but it seems to me that ive had NO reaction
Hi mtr320,
It sounds like you had photodynamic therapy, where the IPL treatment is intensified by having Levulan applied first.
This treatment is used to treat and prevent non-melanoma skin cancers, moderate-severe acne and aged skin.
I would expect you to see changes from the treatment within 24 hours, especially redness and darkening of sun spots.
The areas that absorb the most Levulan should appear sunburned, i.e. red and tender, after the treatment.
If you really are not seeing any changes, call the clinic and let them know. They may want to have a look at you to verify that there are no changes.
However, I would reserve final judgment on the treatment until 2 weeks after, when you should be able to see a difference if there is one.
I have a question. I am considering an IPL facial in this next week. My late 30s skin is fine..a little bit of faint freckling..age spots..undereye wrinkles a bit..really i am fine. The day I do the IPL facial..what should I expect? Will I get all red and look oddly? Will I peel or anything? I have an event to go to in a two weeks. thanks
Hi Gina,
You might be a little red immediately after the treatment just from having your skin handled but that should settle within the hour.
Immediately after the IPL, your freckles (anything brown) will start darkening and reach their darkest at the 24 hour mark. It takes between 10 and 14 days for the dark brown to disappear.
If the dark brown pigment is superficial, it might flake off as a thin scab. Otherwise it will look as if little bites are being taken out day by day.
I'm going to post a picture of our 10 Years Younger recipient, Catherine, to show the darkened pigment so if you go to 10yy.wordpress.com, it should be up by the end of the day today.
If you have a lot of dark spots, you will probably absorb enough energy from the IPL to get some skin tightening. You will see that your face keeps looking better and better for weeks after your treatment.
Good luck with your treatment.
Dr. Rose
Hi Dr. Rose,
WEll, I did the IPL facial and it has been a week and really it did nothing....no little specks of brown flaking, no difference. Can't even tell I did anything. I have not called Dr and told her this yet. Any thoughts? Thanks, G
Hi Gina,
If you had had the IPL at my clinic and came back and said that nothing happened, the first thing that I would do is re-photograph you and compare your before and after shots.
If I couldn't see a difference on your pictures then I would offer to redo the treatment or give you your money back.
If, for some reason, I do not have a before picture to compare with, I would give you the benefit of the doubt and offer to redo the treatment or give you your money back.
I hope everything works out for you. I love IPL and what the skin looks like when we erase sun damage and redness.
All the best,
Dr. Rose
hi,
i was wondering how old you have to be for IPL?
thanks
naomi
Hi Naomi,
In general, I prefer to treat clients who are 18 years or older. However, IPL has been used in children to treat port-wine-stain birthmarks.
As far as using IPL for sun damage, the big concern is that the client is going to avoid sun afterwards. I personally find that a lot easier to do in my 40s than I did in my 20s but it really depends on the individual.
I hope that answers your question.
All the best,
Dr. Rose
Hi Dr. Rose,
I got, I believe a photodermatitis on my cheeks post Profractional & Microlaserpeel treatment. With that, I am taking doxycycline to hopefully control it down as well as the occasional active acnes (so that the lasered skin cells can be free from acne while producing collagen). In about 2 weeks, I have an IPL treatment scheduled to reduce the redness on lasered area. My questions are:
1. Given that I am taking doxyclicne and have the photodermatitis issue, how safe is it to do IPL as well?
2. Do you have any suggestions on how to stop the photodermatitis since it is bloody itchy and made my skin like a sand paper? I am also taking Benadryl and birth control pill (ortho). It has been 3 days and still flaring and itchy.
Desperate, basya.
Hi Rosalina,
I just have to reiterate here that any ideas or suggestions I give here are based on my best guesses, that I haven't seen you for myself.
It would help me to know how aggressive your treatment was and what skincare products you were using after the treatment. How long ago was the treatment?
The first question that comes to my mind when I read your story is what is really going on with your skin?
If you truly have a dermatitis, that is, inflammation without infection, I would recommend a topical steroid to calm it down.
Doxycycline is an antibiotic that also has anti-inflammatory effects so if things are not calming within 3 days, you need to be looked at again to see if the therapy should be changed.
Doxycycline also makes your skin more light-sensitive so I wouldn't do an IPL until you have been off the antibiotic for at least 4 or 5 days.
You may have infection rather than just pure inflammation. Is there any discharge from the treated area, and if so, what does it look like?
In general, I would not do another treatment on you until you had completely healed from this reaction so you may have to hold off on the IPL.
I hope this helps.
All the best,
Dr. Rose
Hi Dr Rose,
I am considering having IPL to reduce the redness and broken capillaries in my cheeks and nose. I am quite scared. i'm also wondering how long- if it does work- the redness will stay away for. I have heard that IPL is not a permanent procedure and you need to keep going back every few years after the initial treatments. Also I dont really want my skin to tighten, I'm not worried about wrinkles, I dont have many, I am 27. Another concern of mine was if there is any risk of developing cancer from the procedure?
Thanks for your help.
Hi Louise1980,
IPL is a great way to get rid of redness and broken capillaries. Just so you know, it may take several treatments to get rid of broken capillaries.
How long the treatment lasts depends on what caused the problem in the first place.
If you got broken capillaries from being outdoors in the wind, sun and cold, and you continue to do that, they'll come back pretty fast. If you avoid that exposure and protect your skin, the results of the treatment will last longer.
IPL treatments have been done for years and there has never been evidence of an increased occurrence of cancer afterwards.
With the modern equipment for IPL the UV rays are completely filtered out so you're only being exposed to the safe wavelengths of light in the visible spectrum.
I'm excited for you to being having an IPL. It is such a good feeling to get rid of broken capillaries. You'll feel liberated from needing concealer and foundation.
Good luck with your treatment!
Dr. Rose
I'm currently scheduled for my first IPL treatment in September and I'm unsure whether to do IPL or the blue chemical peel treatment. I'm blonde blue eyed female with light skin and have a ton of sun damage at 27 years of age particularly on my left check. I even have a more significant frown line on the left check. more than ever I want the left check brown spots to go away. Which option would work better for me? Thanks.
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