Treatment of erythematotelangiectatic rosacea with the fractionation of high‐fluence, long‐pulsed 595‐nm pulsed dye laser

Abstract

Various lasers have been used for the treatment of erythematotelangiectatic rosacea (ETR) that does not respond to systemic or topical therapy. The pulsed dye lasers (PDLs) are an effective option for ETR, and the purpuragenic fluence proved to be superior until now. Given that purpura and subsequent possible postinflammatory hyperpigmentation (PIH) are occasionally unbearable in some patients, and several studies using the low nonpurpuragenic fluence were reported. To deliver the sufficient high fluence of a PDL without generating purpura, we designed the fractionation of high fluence using five passes and longer pulse duration (6 milliseconds) of a PDL in succession. A total of eight patients with ETR were enrolled in this study; all patients were treated with PDL 10 times at 2-week intervals. Erythema and telangiectasia scores, as well as improvement, were assessed by two physicians using the digital photographs. Moderate-to-marked improvement was achieved in most of the patients, and erythema and telangiectasia scores were significantly decreased. Purpura and PIH were not reported in all patients. The fractionation of high-fluence, long-pulsed 595 nm PDL is a very safe and effective treatment for ETR.

IPL vs PDL in treatment of facial erythema: A split‐face study

“…Pulsed dye laser has been the standard treatment for facial erythema since the 1980s . Purpuragenic energy levels are more efficacious than nonpurpuric; however, patients may develop a week of discomfort in addition to the facial bruising .…”

The Efficacy of Pulsed Dye Laser Pretreated With or Without Local Anesthetic on Patients Presenting With Erythema of Face, Neck, Chest, and Extremities

“…The PDL was the first laser using the concept of selective photothermolysis for the treatment of the vascular lesions. Current PDLs emit a wavelength of 595 nm, and have been shown to successfully and safely treat vascular lesions, such as hemangiomas , PWSs , telangiectasia , rosacea , poikiloderma of civatte . Occasionally, PDL is used as an adjunctive treatment for the difficult‐to‐treat skin conditions such as striae common warts with a variable degree of success.…”

Light‐based devices in the treatment of cutaneous vascular lesions: An updated review

“…However, there are still new methods and systems being reported. A recently reported method describes using a fractionation of high‐fluence 595 nm PDL for rosacea with greatly efficacious results and without purpura . Additionally, the combination of optical and radiofrequency (RF) energies has been introduced in the last few years in some platforms for the treatment of vascular lesions .…”

“…A recently reported method describes using a fractionation of high-fluence 595 nm PDL for rosacea with greatly efficacious results and without purpura. 55 Additionally, the combination of optical and radiofrequency (RF) energies has been introduced in the last few years in some platforms for the treatment of vascular lesions. 56,57 In fact, RF alone, without any light-energy, has newly been shown to be as effective as PDL in the treatment of rosacea in a small study.…”