Improved telangiectasia and reduced recurrence rate of rosacea after treatment with 540�nm‑wavelength intense pulsed light: A prospective randomized controlled trial with a 2‑year follow‑up

Abstract

The aim of the present study was to evaluate the clinical efficacy and safety of 540 nm-wavelength intense pulsed light (IPL) for the treatment of telangiectasia in late-stage rosacea. Between July 2013 and January 2016, patients with rosacea who tested positive for Demodex folliculorum were recruited. Patients received anti-mite therapy and were then randomly apportioned to receive either three 540 nm-IPL treatments at 4-week intervals (IPL group), or no treatment (control group). Telangiectasia was assessed by the same clinician at baseline and at follow-up intervals over 2 years, where ≥90% clearance of telangiectasia was considered to indicate effective treatment. The rates of effective treatment, improvement (≥30% clearance) and recurrence (original or neo-location) were compared in both groups. After 33 patients were lost during follow-up, the IPL and control groups were comprised of 107 and 120 patients for the final analysis, respectively. The rates of effective treatment and total efficacy in the IPL group (66.36 and 95.33%, respectively) were found to be significantly higher compared with those of the control group (0 and 30.83%, respectively). By contrast, the rates of recurrence were found to be lower in the IPL group (8.41%) compared with the control group (48.33%). Redness-to-blisters associated with IPL treatment (9.7% of analyzed patients) subsided within one week and hyperpigmentation (1.9%) within 3 months. To conclude, treatment with 540 nm-IPL improved facial telangiectasia in late-stage rosacea that remained after sequential anti-mite therapy and effectively reduced the recurrence of rosacea. The present study was registered into the Chinese Clinical Trial Registry under the title 'Sequential therapy for mites folliculitis' (Trial registration number: ChiCTR-IPR-15006451; approved May 27, 2015).

The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?

“…Coagulation necrosis of the Demodex mites has been observed after IPL treatment; nevertheless, the mites recolonized the skin 1 month after the second treatment [ 179 ]. IPL reduced the risk of recurrence of PPR after oral acaricidal treatment [ 180 , 181 ], which also supports a facilitating role of the vascular background on the proliferation of mites.…”

“…Coagulation necrosis of the Demodex mites has been observed after IPL treatment; nevertheless, the mites recolonized the skin 1 month after the second treatment [179]. IPL reduced the risk of recurrence of PPR after oral acaricidal treatment [180,181], which also supports a facilitating role of the vascular background on the proliferation of mites. Paradoxically, if these light-based therapies are applied from the outset of treatment, they may cause an exacerbation of rosacea, probably related to the mass death of many Demodex mites, although not all, because some are still observed after treatment [182] (Fig.…”

Retrospective Study of Factors Affecting Efficacy of Therapy with Dye Pulsed Light for Erythematotelangiectatic Rosacea

“…Adverse effects such as skin flushing, edema and other reactions caused by DPL resolve completely within 4 weeks of the last treatment session. In addition, the recurrence rate, which was measured 4 weeks after the last session, was low [24]. However, the recurrence rate measured at the 6-month follow-up may reach 30% [6].…”

Intense pulsed light for the treatment of pigmented and vascular disorders and lesions: A review

“…Of the group treated with IPL, 66.36% showed greater than 90% clearance of their rosacea over a follow‐up period of at least 2 years while no subject from the control group achieved 90% clearance. The IPL‐treated group exhibited a recurrence rate of only 8.41% while the control group had a recurrence rate of 48.33% 99 . In another study of 102 patients with mild‐to‐severe rosacea, 80% experienced a reduction in erythema, 78% experienced a reduction in flushing and improved skin texture, and 72% experienced fewer acneiform outbreaks after treatment with NaturaLight IPL System (Focus Medical) at 1–3‐week intervals at 2.5/5‐ms pulses with an average of 7.2 treatments 100 .…”

“…The IPL-treated group exhibited a recurrence rate of only 8.41% while the control group had a recurrence rate of 48.33%. 99 In another study of 102 patients with mild-to-severe rosacea, 80% experienced a reduction in erythema, 78% experienced a reduction in flushing and improved skin texture, and 72% experienced fewer acneiform outbreaks after treatment with NaturaLight IPL System (Focus Medical) at 1-3-week intervals at 2.5/5-ms pulses with an average of 7.2 treatments. 100 Similar results were found in a smaller scale study of 32 patients that received 1-7 treatments of IPL after which 83% achieved reduced redness, 75% achieved reduced flushing and improved skin texture, and 64% had fewer acneiform breakouts.…”