after second Gemini laser, lots of problems

[rf11]

I'm hoping someone has had some experience with the Gemini laser and can help me understand a problem I am having.

I've had three laser treatments since January. The first was just v-beam, I had to stop the doctor before he added the gemini laser because it was too painful.

About 8 weeks later I had a second treatment with v-beam and gemini (I used topical anesthetic this time). This treatment gave me a lot of redness and flaring, but healed after 8 weeks and I was happy with the results. So I went back for the third laser treatment.

The third laser treatment did not go well from the beginning. I had a lot of painful swelling and ugly whiteheads on one side of the face, which didn't go away for a week. The healing has not been as good, my red marks where the laser was done are not gone yet and I am now having hypersensitivity on the side of the face that went crazy right after treatment. I now have to be extremely careful about taking showers, etc. I have days where the skin is bright bright red (with a clear mark between lasered and unlasered skin) and I get little red bumps. This is two months out! Has anyone had this experience? It looks much worse than before even my first v-beam.

I have an allergy to the antibiotics and cannot tolerate topicals at all (especially now). I'm hoping with time this will subside, but it's not looking good. Any pointers on what I can expect with this?

[Twickle Purple]

Perhaps your skin needed longer to recover between sessions. My laser treatments were months apart and that was too soon. I am waiting a year for the next one, if I do it again.

I still had extreme sensitivity and some discomfort 5 months after my last session, along pinspot blood vessel ruptures. 7 months now and things are much better. The skin is now more tolerant of external stimuli and I no longer have such fragile tissues that rupture and the least pressure.

Give your tissue and nerve endings time to heal, they've been assaulted and are letting you know it.

Best of luck with this.

[phlika29]

It sounds like they must have turned up the power abit and it may have been too much for your rosacea. It should calm down eventually. I have been having gemini yag/KTP combined and the last time it took a good four to six weeks for the red blotches to disappear and another few weeks for it to calm down.

I would leave it a few months before you go back and if you do go back discuss the last reaction and ask to go back to a previous settings.

I'm going to move this over to the laser/IPL section.

[rf11]

Maybe that's what is happening with me.

Thanks for the help and well wishes...hope the time to heal (whenever that is) passes quickly...

[SteveYork]

How many days post treatment are you? It usually takes 2-4 weeks for the face to calm down.

Are you taking any post treatment meds like Ibuprofen or prednisone or something like that to get the swelling down, or clonidine for the flushing? They are worth it for a short period until the face calms down.

I'm not a big pill person, especially considering my debacle with Darm a couple of years ago, but used wisely, for short periods, they can help a great deal.

[SteveYork]

I would also call your treater and find out if he up the energy, like someoneelse mentioned.

How many weeks between the second and third treatment? Everyone is different. I'm finding out that I'm one of those folks who likes a lot of time between treatments. Maybe you need more time.

But be reassured that it is not uncommon for folks to have problems for a period of time after treatment.

[SteveYork]

I see your two months out.

What does your doc say? Maybe you just need to break the cycle of inflamation.

I've read of folks having trouble for up to three months who have had problems post treatment, but then things calmed.

And again, its not uncommon for laser patients to take two steps foward, then a step back, ect. It happens. This type of treatment needs persistance.

But you got to find out why you had this reaction. Make sure there is no underlying problem like hives or vasculitis, ect. A lot of laser therapy is trail and error until you find the protocol that works for you.

Have you tried IPL instead of laser?

Definately, get a test patch before another full face treatment. Remember, conservative is probally better for most of us then aggressive treatment. That's something you have to constantly reiterate to the treaters.

[rf11]

Hi I am now 3 and a half months post-treatment.

One side of my face (the side that got less treatment) looks better. It's about where it was before i went in for the third treatment (which was improved over me pre-laser). The other side of my face is still red (with hard barriers between lasered and unlasered skin), and still prone to inflammation. It is less severe now but it is still markedly worse than before the 3rd treatment.

I am also more prone to get pustules on that side -- I had a drink on the weekend (first time I had been out socially in months) and the next day that side of my face was covered with pustules -- only where I had the laser.

I have seen improvement in blushing and tolerance to triggers. But I still have to be very very careful so I'm not sure how much of the improvement is due to the laser and how much is the monastic lifestyle I lead.

I have not been back to the laser guy I saw because he seems a bit careless to me -- a bit of a cowboy -- and I'm not sure how much experience he has treating a case like mine. Will wait before I go the laser avenue again...maybe with a different doctor in a year's time.

So what is happening now is I've been to a different dermatologist, recommended by my regular derm, who is a specialist in allergies.

I found out that I am allergic to fragrances. He feels that partly from the laser and partly from other things, I have a skin barrier problem that I need to deal with before I do anything as aggressive as laser. I've been to him twice and while my skin was better at the 3 month mark his reaction to the redness in my face is nothing short of shock, asking me who treated me, etc.

So the jury is still out on what to do next. I do find that antibiotics work great but unfortunately I get reactions to them when I take them more than sporadically (I currently take 1 erythromycin 500 mg 1 or 2 times a week which seems to be ok).

The allergy derm gave me a prescription for minocycline but I am really hesitant to take any antibiotics since I always react to them, have to get off, and then my skin gets much worse!

My skin is very damaged from the years of rosacea/topicals. So topicals are out of the question.

I have a two-headed acnelamp which I used after the 2nd treatment to help with inflammation. It helped somewhat. So I am considering waiting some more time, using that lamp conservatively, continuing on my anti-allergy diet (I also found out I have food allergies) and waiting to see if the skin heals.

Any other suggestions? Has anyone seen improvement in flushing but backsliding in inflammation this far out after treatment? I'm very patient and will wait to see if I have results in some months if I can expect some, otherwise I will try another treatment modality (maybe accutane)?

Thanks for reading!

s

[banshee]

rf..so sorry for your troubles :(

I've never had V-Beam so can only speculate as to why the Gemini/V-Beam may have backfired on you after previous successful txs.

My hypothesis is while V-Beam is a newer generation Pulsed dye, it is in the same family none the less. Pulsed dye always requires more healing b/c in relation to other lasers, like the non-ablative infrared Yag for i.e., it's more traumatic to the epidermis.

Gemini as I understand, has a dual setting of a 1064 Yag & 532nm. I don't know which or if both you are getting.

A couple of key things to note;

-Visible light (KTP 532nm), like the Pulsed dye will always be more active on epidermal tissue.

-Always do the KTP & Yag with cooling gel (ultrasound gel). It helps keep the local temp in your epidermis down so to avoid overheating.

-If you find settings that work, stick with them. Don't let the doc juice them higher each tx.

It's possible that with this particular combo of lasers, V-Beam/Gemini, that over time your epidermis incurred too much insult.

Personally I think anytime anyone is having a V-Beam or PDL-those lasers should be done alone.

I favor the 1064 Yag/KTP for combo (laserscope Lyra/Aura). I've seen the best results I've ever had with that.

I'd allow yourself to heal for at least 6 weeks before attempting any more laser...And RLT should help calm inflammation down.

I hope something here was helpful.

Best of luck-
Kristen

[rf11]

Thanks Kristen, so the latest as of today is that I went to the laser doctor to tell him what the other doctor thinks. He looked at my face and told me that the hardlines of redness are from the rosacea, and if he were to continue treatment with me he'd FINALLY lower the settings (which is what I've been asking for since the disaster of a test patch that took 2 months to heal).

After all of this 'm pretty disgusted with this doctor and have decided that I need to go to someone who listens to me from the get-go. Right now what Im having is not much inflammation but red blotches where he did the laser when I flush -- i.e., he increased rather than decreased my vessels. I am five months post-op.

I truly don't know what to do at this point. I'm so fearful to get another cowboy doctor who won't listen to me when I express concern at the strength of the settings. And lastly, I think it's a shame, because the first treatment in particular worked brilliantly and if he had just stuck with that I wouldn't be in this situation.

Any suggestions? I don't know whether to just accept this state of affairs or to try to do something about it. What happens now is I get this obvious very deep red blotch on one side of my face when I blush or flush. It's a freaky thing, people notice, and ask me what my problem is...so it's not like it was before where I just had more redness in my cheeks, but evenly distributed.

Anyonr have any suggestions for a VERY conservative and brilliant rosacea laser guy who isn't going to make my situ worse?

Thanks!

s

[banshee]

Thanks Kristen, so the latest as of today is that I went to the laser doctor to tell him what the other doctor thinks. He looked at my face and told me that the hardlines of redness are from the rosacea, and if he were to continue treatment with me he'd FINALLY lower the settings (which is what I've been asking for since the disaster of a test patch that took 2 months to heal).

After all of this 'm pretty disgusted with this doctor and have decided that I need to go to someone who listens to me from the get-go. Right now what Im having is not much inflammation but red blotches where he did the laser when I flush -- i.e., he increased rather than decreased my vessels. I am five months post-op.

I truly don't know what to do at this point. I'm so fearful to get another cowboy doctor who won't listen to me when I express concern at the strength of the settings. And lastly, I think it's a shame, because the first treatment in particular worked brilliantly and if he had just stuck with that I wouldn't be in this situation.

Any suggestions? I don't know whether to just accept this state of affairs or to try to do something about it. What happens now is I get this obvious very deep red blotch on one side of my face when I blush or flush. It's a freaky thing, people notice, and ask me what my problem is...so it's not like it was before where I just had more redness in my cheeks, but evenly distributed.

Anyonr have any suggestions for a VERY conservative and brilliant rosacea laser guy who isn't going to make my situ worse?

Thanks!

s5 months post op definitely indicates the tx did more harm than good :\

While it's discouraging & scary, I take the advice I was given which is to persevere despite perceived setbacks. I too had a tx which made me worse (a gel-less Aura), but as I mentioned now the Lyra/Aura (1 pass w/each, done 10 min apart, gel each pass) combo is working well *knock on wood*. Previously I've also had 2 failed IPL's...My main symptom had been wicked flushing vs marked resting/diffuse redness, but the Aura addition has been good for scars, blotchyness, skin tone, & epidermal sensitivity.

I am very pro-laser/light obviously as I feel it's necessary to halt/reverse progression. It is a personal decision, however. In relatively mild-moderate cases, RLT in time may be enough.

Unfortunately, laser requires getting the right settings for a person. Imo too little energy-no effect, too much makes things worse. Asking the doc what settings he'd use, & asking/researching if the energy is low/moderate/high for that laser before tx helps. One Yag doesn't=another for i.e.

I'd let folks know where you're located so they can recommend doctors in your area. You can also do an archive search and see who ppl have had luck with.

best to you-
Kristen