Jenni Thain talks about combining radio frequency microneedling with LED light therapy as an alternative treatment for rosacea.
In Aesthetic Medicine, we are currently seeing a shift away from heavy filler and filters to what I like to call a “skin-movement,” leading patients to seek treatments that improve their overall skin health.
A skin problem that I am increasingly seeing in clinic is Rosacea. These patients are looking
for alternatives to those offered within Primary Care.
Typically, Rosacea is often overlooked; however, it is a common skin problem, usually in
those over 30 years old. Symptoms vary among patients but often include facial flushing,
erythema, papules and pustules, and rhinopephyma. These symptoms are often
exacerbated by sun exposure, cold weather, certain foods such as spicy curries, and even
alcoholic beverages.
Whilst we often find that most patients respond well to topical therapies from their GP, some
patients are the exception to the rule and may require a different approach.
Energy devices and rosacea:
Light Emitting Diodes (LED) have proven clinical evidence of having anti-inflammatory
properties, especially when combined with other treatments. For example, patients with
diffuse type rosacea … as well as post intervention erythema (eg, IPL, CO2) can benefit from
a quicker recovery with complementary LED therapy Fractional Radio Frequency Microneedling (FRFM) has been used clinically to reduced Post Inflammatory Hyperpigmentation (PIH) in those with acne 2 Therefore, it begs the question, would it be suitable for inflammation caused by Rosacea?
As far as energy devices and rosacea are concerned, it has long been thought that laser is
the only treatment suitable, primarily for treating telangiectasia or rhinopehyma. But what about those patients presenting solely with erythema and/or pustules?
Radio frequency microneedling and rosacea:
In my practice, I was presented with two patients— Patient A - in her early twenties, was
originally diagnosed with acne vulgaris and prescribed several courses of oral antibiotics
(OABX) before being seen by a consultant Dermatologist and diagnosed with Rosacea. She
also trialled topical treatments but did not have any further treatments. Patient B - in her late
fifties had suffered with regular outbreaks of pustules and erythema to her cheeks, nose and
forehead since her mid thirties but did not seek any intervention until attending my clinic.
After lengthy consultations with both, we decided to explore the idea of Radio Frequency
Microneedling (RFM) using the Dermaforce by 3D Aesthetics as a treatment for their
Rosacea. We decided that an initial course of three treatments would be carried out, five
weeks apart, to allow for healing and collagen induction to take place, with all three
treatments followed by LED light treatment from Dermalux using their “redness” protocol
which utilises red and near infrared (NIR) on the Tri-Wave MD for 10 minutes post
treatment.
By carrying out the initial course of 3 treatments, we would be able to gage their responses
to the treatment and assess the next course of action.
Each treatment was carefully planned, ensuring that no pustules were punctured by the
needles, with an increase to the RF at each pass. By the final session, there were no active
pustules, and the whole face could be treated for both patients, who reported fewer
noticeable breakouts between each session.
Results:
Both patients were reviewed five weeks after their final treatment, and utilising the 3D
Aesthetics Visage Skin Scanner, we determined that both patients had a reduction in
inflammation and sensitivity of over 10%, with patient A having the reduction at 11% in both
categories. She also reported that she had not had any new or active pustules for eight
weeks and that her skin felt smoother to the touch. Patient A also had 40% reduction in pore
size/appearance. However, it may be argued the biggest difference is purely on visual
inspection of the skin, in Patient A’s case.
Patient B also reported she had not had any new pustules, her skin felt smoother and she
was no longer experiencing flushing of her skin as often as she was previously.
Conclusion:
Both Patient A and Patient B were extremely happy with their results, both reporting they
were more comfortable within their skin and it felt and looked healthier, with the added
benefit of a reduction in their symptoms.
However, due to the severity of her symptoms, Patient A will require further RFM treatments
to further improve the appearance of PIH following the eradication of pustules. But overall,
this is a very promising case study on two individuals with both differing presentations of
Rosacea and differing age brackets and I will be pursuing this treatment plan for my
Rosacea patients in the future.
In Aesthetic Medicine, we are currently seeing a shift away from heavy filler and filters to what I like to call a “skin-movement,” leading patients to seek treatments that improve their overall skin health.
A skin problem that I am increasingly seeing in clinic is Rosacea. These patients are looking
for alternatives to those offered within Primary Care.
Typically, Rosacea is often overlooked; however, it is a common skin problem, usually in
those over 30 years old. Symptoms vary among patients but often include facial flushing,
erythema, papules and pustules, and rhinopephyma. These symptoms are often
exacerbated by sun exposure, cold weather, certain foods such as spicy curries, and even
alcoholic beverages.
Whilst we often find that most patients respond well to topical therapies from their GP, some
patients are the exception to the rule and may require a different approach.
Energy devices and rosacea:
Light Emitting Diodes (LED) have proven clinical evidence of having anti-inflammatory
properties, especially when combined with other treatments. For example, patients with
diffuse type rosacea … as well as post intervention erythema (eg, IPL, CO2) can benefit from
a quicker recovery with complementary LED therapy Fractional Radio Frequency Microneedling (FRFM) has been used clinically to reduced Post Inflammatory Hyperpigmentation (PIH) in those with acne 2 Therefore, it begs the question, would it be suitable for inflammation caused by Rosacea?
As far as energy devices and rosacea are concerned, it has long been thought that laser is
the only treatment suitable, primarily for treating telangiectasia or rhinopehyma. But what about those patients presenting solely with erythema and/or pustules?
Radio frequency microneedling and rosacea:
In my practice, I was presented with two patients— Patient A - in her early twenties, was
originally diagnosed with acne vulgaris and prescribed several courses of oral antibiotics
(OABX) before being seen by a consultant Dermatologist and diagnosed with Rosacea. She
also trialled topical treatments but did not have any further treatments. Patient B - in her late
fifties had suffered with regular outbreaks of pustules and erythema to her cheeks, nose and
forehead since her mid thirties but did not seek any intervention until attending my clinic.
After lengthy consultations with both, we decided to explore the idea of Radio Frequency
Microneedling (RFM) using the Dermaforce by 3D Aesthetics as a treatment for their
Rosacea. We decided that an initial course of three treatments would be carried out, five
weeks apart, to allow for healing and collagen induction to take place, with all three
treatments followed by LED light treatment from Dermalux using their “redness” protocol
which utilises red and near infrared (NIR) on the Tri-Wave MD for 10 minutes post
treatment.
By carrying out the initial course of 3 treatments, we would be able to gage their responses
to the treatment and assess the next course of action.
Each treatment was carefully planned, ensuring that no pustules were punctured by the
needles, with an increase to the RF at each pass. By the final session, there were no active
pustules, and the whole face could be treated for both patients, who reported fewer
noticeable breakouts between each session.
Results:
Both patients were reviewed five weeks after their final treatment, and utilising the 3D
Aesthetics Visage Skin Scanner, we determined that both patients had a reduction in
inflammation and sensitivity of over 10%, with patient A having the reduction at 11% in both
categories. She also reported that she had not had any new or active pustules for eight
weeks and that her skin felt smoother to the touch. Patient A also had 40% reduction in pore
size/appearance. However, it may be argued the biggest difference is purely on visual
inspection of the skin, in Patient A’s case.
Patient B also reported she had not had any new pustules, her skin felt smoother and she
was no longer experiencing flushing of her skin as often as she was previously.
Conclusion:
Both Patient A and Patient B were extremely happy with their results, both reporting they
were more comfortable within their skin and it felt and looked healthier, with the added
benefit of a reduction in their symptoms.
However, due to the severity of her symptoms, Patient A will require further RFM treatments
to further improve the appearance of PIH following the eradication of pustules. But overall,
this is a very promising case study on two individuals with both differing presentations of
Rosacea and differing age brackets and I will be pursuing this treatment plan for my
Rosacea patients in the future.
