Treatment of facial flushing by topical application of nicotinic acid cream followed by treatment with 595-nm pulsed-dye laser

Topical niacin cream‐assisted 595‐nm pulsed‐dye laser treatment for facial flushing: retrospective analysis of 25 Korean patients

“…By using non-purpuragenic fluencies to minimize the downtime associated with the laser treatments, most of the erythema induced by the topical agent as well as laser irradiation usually reduced spontaneously within 2 h. Topical application of niacin derivatives has been used for various purposes, including as a treatment for female pattern alopecia, a diagnostic tool (niacin skin flush test) in schizophrenia, and a provocative agent for facial flushing. 5,6,12 We believe that topical application of nicotinic acid cream may allow accurate demarcation of margins to be treated and may allow for the dilated vessels to be filled with abundant erythrocytes by enhancing vessel dilatation. 5 In our study, we also compared the photographs taken 20 min after provocation of facial flushing using topical niacin cream at baseline and 3 months after pulsed-dye laser treatment.…”

“…5,6,12 We believe that topical application of nicotinic acid cream may allow accurate demarcation of margins to be treated and may allow for the dilated vessels to be filled with abundant erythrocytes by enhancing vessel dilatation. 5 In our study, we also compared the photographs taken 20 min after provocation of facial flushing using topical niacin cream at baseline and 3 months after pulsed-dye laser treatment. We observed that the reactivity to topical niacin cream was markedly reduced in 64% of our patients after 595-nm pulsed-dye laser treatments.…”

“…The patients had three sessions of 595‐nm pulsed‐dye laser treatment (V beam™; Candela Corporation, Wayland, MA, USA) after the application of topical niacin cream (Litederm™ niacin laser prep cream; Beaute Pacifique, Hadsund, Denmark) were performed at 1‐month intervals. As described previously, 5 topical niacin cream was applied for 20 min prior to the treatment to induce vasodilation of the superficial cutaneous vasculature. After the application of the topical agent, patients complained of a mild to moderate burning sensation but no itching or prickling sensations.…”

“…Our study group previously described a 26‐year‐old Korean man with facial flushing who experienced satisfactory clinical improvement after three sessions of 595‐nm pulsed‐dye laser treatment after provocation of flushing with topical niacin cream 5 . The purpose of using topical nicotinic acid cream was to allow more definite margins to be treated by enhancing vessel dilatation and filling dilated vessels with erythrocytes containing haemoglobins, the primary target of vascular lasers 5,6 .…”

“…Our study group previously described a 26‐year‐old Korean man with facial flushing who experienced satisfactory clinical improvement after three sessions of 595‐nm pulsed‐dye laser treatment after provocation of flushing with topical niacin cream 5 . The purpose of using topical nicotinic acid cream was to allow more definite margins to be treated by enhancing vessel dilatation and filling dilated vessels with erythrocytes containing haemoglobins, the primary target of vascular lasers 5,6 . Topical niacin cream, which we used in this study, is commercially available and contains various compounds, including acrylate/C 10–30 alkyl acrylate crosspolymer, vitamin‐B, glyceryl, polymethacrylate, propylene glycol, methylparabens, propylparabens and imidazolidinyl urea 5 .…”