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Rosacea is primarily a facial vascular disorder in which blood vessels are functionally and structurally abnormal. Both Laser and IPL therapy are very effective at treating telangiectasia (broken blood vessels), generalized redness and flushing. IPL skin treatments are known by many names including Fotofacial, Photofacial, Photoderm and Photo rejuvenation.
Antibiotics have long been used to treat rosacea, however they work primarily through their anti-inflammatory properties rather than antibacterial.
Antihistamines are effective at reducing facial inflammation, swelling and burning associated with rosacea. UV rays can penetrate the skin and activate sensory nerves that release potent vasodilators, as well as creating heat in the skin causing facial flushing. Free radicals have been shown to cause structural damage to vascular walls and many free radicals are potent blood vessel dilators. Studies show that vitamin C can protect blood vessel walls from free radical damage and reverse existing vascular damage. Intense Pulsed Light (IPL) is used in photo-rejuvenation for the skin and hair removal treatments. The cut off for the wavelength at the deeper end is predetermined, but can vary with each devise.
The 515 filter would block out wavelengths above and below 515nm – 1200nm, while the 560 filter would block out wavelengths above and below 560 -1200nm.
There are many variables involved in aesthetic lasers, including the active laser medium, wavelength, and targeted chromophore. Generally, the active medium of a solid-state laser consists of a glass or crystalline material. Semiconductor-based lasers are also in the solid state, but are considered as a separate class. Lasers used in aesthetic treatments target a specific chromophore generally melanin, hemoglobin or water in the tissue. Melanin and hemoglobin in blood vessels have color that absorbs the light emitted by specific lasers. Water constitutes 80% or more of soft tissue, so lasers that target water are generly used for resurfacing.
Argon 488 and 515 nm, is a gas laser that emits a blue green light which is strongly absorbed by both hemoglobin and water,used for photocoagulation. KTP 532 nm, a brilliant green light well absorbed by hemoglobin and melanin used photoablation and photocoagulation. Ruby 694 nm, uses a synthetic ruby crystal that emits red light that is strongly absorbed by blue and black pigment, and by melanin in skin and hair. Ruby lasers are used for laser hair removal, tattoo removal and treating pigmented lesions including freckles, liver spots. Nd:YAG 1064nm, laser emits a near infrared beam that can be absorbed by all tissue chromophores, however it is strongly absorbed by hemoglobin. CO2 10,600nm, is a gas laser emitting a mid infrared beam which is strongly absorbed by water. Non-ablative lasers heat the layers of skin beneath the surface without removing the epidermis (top layer of skin). Fractional lasers can be ablative or non-ablative treatments, and target only a fraction of skin at a time, leaving the surrounding tissue intact.

Increased blood circulation - Thermographic measuring charts show the increase of circulation under a magnetic field.  This leads to better nutrition and rejuvenation of cells.
Improved oxygen supply - The PEMF ensures increased oxygen extraction (deoxygenation) and enriches the tissue with oxygen. Overall it can be stated that magnetic field therapy supports the metabolism and increases blood circulation throughout the whole body.  It intensifies the oxygen supply in the cells and speeds the transportation of metabolic waste products.
Currently rosacea can’t be cured, however it can be effectively treated and controlled. IPL therapy can also be enhanced with Levulan to get the added benefit of treating acne, rosacea papules and pustuals. The laser energy is absorbed by the blood vessel and creates heat within the vessel which damages the vessel wall and permenatly closes that vessel. Intense Pulsed Light (IPL) differs from lasers because IPL uses a wide spectrum of wavelengths at the same time (for example: 500nm — 1200nm) that can target any chromophore in that range, while lasers have a single wavelength.
IPL and Laser treatments can be done independently, however combining technologies at the same treatment time will provide a better result. Dimethicone is also a protective ingredient that has been shown to reduce flushing caused by skin irritants.
People with rosacea should get plenty of vitamin-C in their diet, and may want to consider a vitamin-C supplement. A dye can usually be used for a much wider range of wavelengths which makes them suitable pulsed lasers. A laser technician adjusts the energy of each treatment, based on factors such as skin type and condition. Lasers that target color are usually used for hair removal, treating vascular issues such as rosacea and broken blood vessels, and skin discolorations such as freckels.
The Iredex DioLite 532 nm KTP that is Diode Pumped, it is used to treat vascular lesions and hyperpigmentation. Pulsed Dye Lasers (PDL) are especially useful for the treatment of vascular lesions, including spider veins, strawberry birthmarks and port wine stains. Alexandrite permits deeper penetration into skin than the ruby, and is used for Laser Hair Reduction. Nd:YAG lasers are used for photocoagulation and photoablation, commonly used to treat broken blood vessels.
Co2 lasers are capable of cutting or vaporizing tissue, and are used for deep laser resurfacing. You can think of the laser like a sniper that can precisely hit a single target with one shot, and IPL is like a grenade that hits several targets at once. This type of treatment is fairly aggressive and should only be done by someone that is very experienced in combining these technologies. Metronidazole is effective at reducing papules and pustules and has a fairly minimal effect at reducing inflammation.
The limitation with antibiotics is that they are not effective at treating telangiectasia or flushing.
Topical zinc oxide also has significant healing properties when applied to damaged skin and has been shown to decrease inflammation in both the epidermis and dermis. In addition to being a great antioxidant, topical vitamin-C has anti-inflammatory qualities. The filter used in treatment is decided based on the depth of a desired target and the color of skin.

There are also other (non-laser) technology based treatments used in aesthetics such as Intense Pulsed Light (IPL) and Radio Frequency (RF).
The laser technician can also control other factors such as spot size and the length and duration of the pulse.
Tanning is contraindicated with laser treatments that target color, tan skin will absorb more heat, increasing the probability of a burn.
The Smoothbeam laser is a 1450nm diode laser that targets water in the skin and is used to treat acne by shrinking the oil gland. The Smoothbeam uses a diode with a 1450nm, it targets water in the skin and is used to treat acne and build collagen. Treatment should be aimed at treating the underlying vascular issues associated with rosacea.
Although there isn’t a cure for rosacea, studies show that laser treatment can permantly remove damaged facial blood vessels and with repeated treatment blood vessels will not always be created to replace the old vessel.
IPL uses special cut-off filters that can be selected to target chromophors in a certain range within the skin. IPL emits a non coherent, broad spectrum light, rather than a monochromatic single wavelength like a laser. A deeper cut off filter would be used for hair removal, while a shallow filter would be used when treating vascular issues such as rosacea. For example hemoglobin in the blood is best absorbed at a shallow wavelength and water is best absorbed at deep wavelengths. Tanning can also interfer with the desired results of treatment, because there is less contrast between the intended target and the surrounding tissue. Vascular Lasers and IPL treatments are extremely effective at treating existing redness and broken blood vessels. It is important to remember that IPL targets color in the skin, so tanning must be avoided before treatment. Melanin is best absorbed somewhere in the middle (500nm-1064nm), the exact depth can vary, depending on the desired target. Lasers that are used for hair removal target the color in the hair, so grey or blond hair will not respond well.
In addition to avoiding rosacea triggers, topical products can be used to prevent flushing and further damage that can accelerate the progression of the disorder.
This is good news, because this will permently reduce the number of blood vessels in the face, near to the level of vessels found in healthy skin. The advantage IPL treatments have over laser treatments is that IPL can target vessels at different depths. Patients with darker skin should seek treatment from someone experienced in treating their skin type, to avoid complications. For example if you are targeting pigment in the hair follicle a deeper wavelength (640nm-1064nm) would be used, however most lasers used for hair removal are Diodes (800nm-900nm). It is the patients responsibility to choose an experienced professional, be honest about sun exposure and follow all pre and post treatment instructions.

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