Physical modalities for the treatment of rosacea

Abstract

SummaryRosacea is characterised by a wide variety of vascular changes. Apart from telangiectasia and erythema, often so-called flushing occurs. These vascular abnormalities can be targeted with specific light and laser devices. In addition to KTP laser, pulsed dye laser (PDL) and Nd:YAG laser, also intense pulsed light devices (IPLs) are used. The described therapeutic effects include the reduction of vascular abnormalities and even improvement of papulopustular changes. While the KTP laser shows very good results in telangiectasia, the dye laser and IPL devices are used preferably in erythema. The Nd:YAG laser is also a possibility for patients with telangiectasia and erythema. However, compared to the other laser and light devices the Nd:YAG laser carries the highest risk of unpredictable scarring. Phymatous changes are another clinical manifestation of rosacea, mostly affecting the nose (rhinophyma). Moderate and severe cases are commonly treated with ablation modalities. Traditional surgery is a treatment option, but is often associated with major intraoperative bleeding. Alternative methods include electrosurgery and dermabrasion, although both methods can cause scarring. Newer methods such as CO 2 laser ablation, possibly in combination with the erbium:YAG laser, are safe alternatives with a lower risk of complications.

The Comparison of the Efficacy and Safety of Q-Switched Potassium Titanyl Phosphate Laser and Long-Pulsed Neodymium-Doped Yttrium Aluminum Garnet Laser in the Treatment of Erythematotelangiectatic and Papulopustular Rosacea

“…KTP laser has also been reported to be very safe when used in combination with topical retinaldehyde (21). Previous studies have similarly reported the scar risk of KTP laser to be lower than lpNd:YAG laser (23). However, contrary to previous studies that reported no undesirable adverse effects such as purpura and crusting, we observed transient purpura accompanied with mild crusting in six patients on the side treated with Q-switched KTP (585 nm) laser, probably due to the higher wavelength of the laser mode.…”

“…It has been reported that lpNd:YAG laser has advantages in the treatment of inflammatory lesions (2,7,14,15,23,24). In this study, the decrease in the number of pustules following lpNd:YAG laser treatment was remarkable.…”

“…The clinician's assessment, adverse effects, and follow-up records demonstrated similar results. Thus, we recommend the use of lpNd:YAG laser predominantly for facial erythema and Q-switched KTP laser for thin and superficial telangiectasias (7,17,23 Informed Consent: Informed consent was obtained from all participants included in the study.…”

Procedural management of rhinophyma: A comprehensive review

“…Rhinophyma is a disfiguring disease of the nose characterized by sebaceous gland hypertrophy and proliferation of blood vessels and connective tissue. Phymatous changes are considered the end stage of acne rosacea and classically affect the lower 2/3 of the nose (rhinophyma), though involvement of the chin (gnathophyma), forehead (metophyma), or ear (otophyma) has also been described . The obvious cosmetic deformity and social stigmatization have motivated patients to seek curative treatments, with destructive methods preferred to medical intervention.…”

Effect of pulsed dye laser therapy on dermatology quality of life in patients with rosacea

“…Rozasea için farklı tedavi seçenekleri vardır. Eritematelenjiektazik rozaseada 595 nm pulsed dye lazer (PDL) iyi bir seçenek olarak bildirilmektedir3 . Rozasea, yaşam kalitesini olumsuz yönde etkilemektedir.…”