From:  gnas_@_.edu 
Date:  Sat May 15, 1999  2:51 am 
Subject:  [rosacea] photoderm ipl beard hair and ocular rosacea

Thor,

Concerning the effect of Photoderm on the beard area. Well, in theory,
photoderm is able to discriminate between hair and blood vessels. For blood
vessels, the target is the hemoglobin travelling in the blood. For hair, it is
the melanin of the follicle/hair shaft. In theory, the wavelength of light used
to treat blood vessels is vastly different from the wavelength used to treat
unwanted hair. However, in practice, this selectivity is not always attainable.
Right now, everything is extremely new to physicians. They are now finding
that a few treatments with photoderm (set to treat only blood vessels) causes
some minor insults to the hair papilla and follicle (blood supply and growth
center for hair). This causes the hair to go from the growth phase to loss
phase. There is a transient loss of hair from the area that was treated.
However, within a few weeks it usually grows back in with the same thickness,
color and same growth cycle. But, after 4 to 5 treatments, there is a greater
degree of insult -- sometimes too much for the hair to recover from. Hair can
take several months to grow back in and it may be slightly smaller. In most
cases, it is not noticeable, however, in others it is. Too much difference
between the individuals to speculate the chances of significant loss.

In my case, the first 4 times caused only a temporary (2 to 4 weeks) loss of
hair. This hair grew right back. After my 6th treatment, some of my hair
growth was stunted for several months. It has started growing back again --
some of the hairs are slightly smaller. So, for right now you should understand
that there is a chance for minor alterations in beard hair density. You should
discuss this very thoroughly with your physician and ask him to be an artist.
He should go down as far as possible into the cheek blush zone and then even out
the beard zone with the smaller crystal. In essence, he can create a new,
shallower beard line -- if this does not bother you. I have also seen hundreds
of male patients who after multiple treatments have had no effect. As
physicians learn more, they will be able to treat vascular lesions without any
insult to the hair.

I have spoken with Linda Sy twice this week. We discussed her post about the
pulsed dye laser and the physician who tried photoderm for approximately 6
months and then stopped. I explained to Linda that this early frustration is
normal. Several of the current Photoderm experts readily admit that they only
attained average results during the first couple years of use. It takes quite a
bit of learning and experimenting to understand the machine -- especially
pertaining to facial rosacea treatment. If you stop within 6 months, you are
only just getting to the heart of rosacea in the first series of patients.

Very soon, there will be an explosion in the knowledge and use of photoderm in
the treatment of rosacea. Currently, there are three medical articles going
through the publication process on the effectiveness of photoderm in the
treatment of rosacea redness, stinging, burning and blushing. All with great to
excellent results. In addition, I know of two grants that are being submitted
for funding. They will be examining the effect of multiple photoderm treatments
(5 to 8) on rosacea erythema, emotional blushing and flushing due to topical
vasodilators. There will also be a grant submitted to look at the long-term
effectiveness of this treatment for rosacea sufferers. Furthermore, my book
will be an excellent review source for physicians to ponder over and communicate
with each other over. If a physician has equal experience with a laser system
and photoderm system, the physician will have much greater results with the
photoderm, hands down!

Lastly, about my progress with an ocular rosacea report. I have had some time
to review all my notes and ocular articles. I have started to outline my
article. However, I need much more time to finish this in-depth report. I do
not have any free time now. I need to be able to make a story out of it so that
everyone can point to certain parts of the article and say AH HA, those are my
exact symptoms. There is a great deal of variation in the symptoms of ocular
rosacea between patients and also the methods of treatment for each individual
case. The report has to be complete before I post it. It has to be detailed so
that everyone can understand all of the latest findings and treatment
possibilities. There are several important techniques and treatment strategies
that the average physician does not use or does not know about -- so, I have to
word it just right. Dozens of ophthalmologists are treating ocular rosacea with
near cure rates, however, most do not publish their treatment methodology or
their actual results because they are in private practice. It is not a piece
meal attack, it is a very logical stepwise treatment for all phases of ocular
rosacea -- with very surprising suggestions and usually excellent results for
most forms of this disease. I have to be careful in my presentation of the
material though, because it can be taken out of context if it is not presented
perfectly. As a PhD (or an MD), we are held liable for any information or
suggestions that are given, even if it is just for informational purposes. I
will post this information as soon as I am able to. My goal is to be post the
article to this group sometime this summer -- before my book (goal of October
for book publication). I know that this is not soon enough for some, but please
be patient......

Geoffrey
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Dr. Geoffrey Nase, PhD