Rosacea

J Cosmet Laser Ther.  2011 Oct;13(5):216-22.

Intense pulsed light for the treatment of rosacea and telangiectasias.

Kassir R, Kolluru A, Kassir M.

Source

Otolaryngology, St. Joseph’s Hospital, Wayne, NY, United States. drkassir@drkassir.com

Abstract

Abstract Background: Rosacea is a chronic disease that affects the aesthetic appearance of skin. The use of intense pulsed light (IPL) has shown significant clearing in erythema, telangiectasia, and papules in rosacea. We seek parameters for IPL that will achieve optimal reduction in the appearance of rosacea with minimal adverse effects. .

Objective: To investigate the use of IPL on 102 patients at various parameters (fluence and pulse duration) in the treatment of rosacea.

Methods: 102 patients with mild to severe rosacea were treated with IPL treatment using the NaturaLight IPL system (Focus Medical, Bethel, CT). Patients received treatments at 1-3 week intervals, with an average of 7.2 treatments. The Reveal Imager (Canfield Scientific, Fairfield, NJ) was used for photodocumentation and analyses.

Results: Treatments were given at 2.5/5 ms double, triple, or quadruple pulsed with 20-30 ms delay time. A 530 nm filter was used with fluences varying from 10-30 J/cm(2), or 10-20 J/cm(2) with a 420 nm filter for those patients with acneiform breakouts in addition to telangiectasias. 80% of patients had reduction in redness, 78% of patients reported reduced flushing and improved skin texture, and 72% noted fewer acneiform breakouts. There were no complications or adverse effects.

Conclusion: The use of IPL at specified parameters provides optimal therapy for the treatment of rosacea.

Br J Dermatol. 2008 Sep;159(3):628-32. Epub 2008 Jun 28.

Treatment of rosacea with intense pulsed light: significant improvement and long-lasting results.

Papageorgiou P, Clayton W, Norwood S, Chopra S, Rustin M.

Department of Dermatology, Royal Free Hampstead NHS Trust, London NW3 2QG, UK.

BACKGROUND: Rosacea is a common skin condition but the treatments currently available are not satisfactory. OBJECTIVES: To assess the efficacy of intense pulsed light (IPL) for treatment of stage I rosacea (flushing, erythema and telangiectasia). METHODS: Thirty-four patients were treated, 25 women and nine men, mean age 47 years. The treatment employed was IPL 515-1200 nm, with a 560 nm cut-off filter. The fluence range was 24-32 J cm(-2). Four treatments were administered on the face at 3-week intervals. Erythema values were measured at baseline and at the end of the treatment period on the cheeks and chin. Digital photographs were assessed by a consultant dermatologist on a 10-point visual analogue scale (VAS). Patients’ assessments were also made using a 10-point VAS. Outcome measures were repeated 6 months after treatment. RESULTS: After four treatments the mean reduction of the erythema values was 39% on the cheeks (P < 0.001) and 22% on the chin (P < 0.001). This was confirmed by photographic assessment where erythema improved by 46% and telangiectasia by 55% (P < 0.001). The severity of rosacea was reduced on average by 3.5 points on the 10-point VAS. Patients’ and physicians’ assessments of the overall improvement of rosacea were similar: more than 50% improvement was noticed in 73% and 83% of patients, respectively (P < 0.001). The results were sustained at 6 months. Side-effects were minimal and self-limiting. CONCLUSIONS: IPL significantly reduces erythema and telangiectasia of rosacea and this is sustained for at least 6 months.

Dermatol Surg. 2005 Oct;31(10):1285-9.

Effective treatment of rosacea using intense pulsed light systems.

Schroeter CA, Haaf-von Below S, Neumann HA.

Department of Lasertherapy, Medical Centre Maastricht, Becanusstraat 17 A05, 6216 BX Maastricht, the Netherlands. lasermed.schroeter@planet.nl

BACKGROUND: To date, a variety of lasers have been used for treating vascular skin lesions. Intense pulsed light (IPL) is a proven technology for vascular lesion management, such as rosacea. OBJECTIVES: The aim of this study was to test the effectiveness of IPL in treating vascular facial lesions in rosacea patients. METHODS: Sixty patients presenting with telangiectasia owing to facial rosacea were selected randomly from the patient population in the Department of Laser Therapy at the Medical Centre Maastricht, the Netherlands. Patients of various skin types (Fitzpatrick I-IV) were selected with an average age of 44.2 years. Five hundred eight sites were treated, with a mean of 4.1 treatments per site and an IPL spectrum ranging from 515 to 1,200 nm with different pulse durations between 4.3 and 6.5 milliseconds. The energy density varied from 25 to 35 J/cm2. RESULTS: Patients were assessed clinically and photographically. A mean clearance of 77.8% was achieved and was maintained for a follow-up period averaging 51.6 months (range 12-99 months). No correlation was found between the clearance of rosacea and patient-related or technical data. For approximately 3 years post-treatment, lesion recurrence was noted in 4 of the 508 treated facial sites. DISCUSSION: This study demonstrated that IPL treatment of facial rosacea is effective in obtaining clearance of 77.8%, with minimal side effects, and that treatment effects are maintained. CONCLUSION: The IPL system, with its broad range of technical variables, is an effective tool in achieving meaningful and lasting rosacea clearance.

J Drugs Dermatol. 2003 Jun;2(3):254-9

Treatment of rosacea with intense pulsed light.

Taub AF.

Advanced Dermatology, 275 Parkway Drive, Suite 521, Lincolnshire, IL 60069, USA. drtaub@skinfo.com

Rosacea is a chronic disease that affects millions of men and women. Topical and oral antibiotics are effective, yet often leave individuals with treatment plateau associated erythema and persistent flushing. We investigated the use of intense pulsed light for treatment of the redness, flushing, and breakouts associated with rosacea. Thirty-two consecutive patients of Fitzpatrick skin types I-III underwent 1 to 7 treatments with intense pulsed light. Patients were assessed clinically and photographically. In addition, patients completed a detailed questionnaire regarding their response to treatment. Following treatment, eighty-three percent of patients had reduced redness, 75% noted reduced flushing and improved skin texture, and 64% noted fewer acneiform breakouts. Complications were minimal and transitory. It appears that intense pulsed light is an effective treatment for the signs and symptoms of rosacea and represents a new category of therapeutic options for the rosacea patient.]

Semin Cutan Med Surg. 2002 Dec;21(4):280-7.

Intense pulsed-light photorejuvenation.

Sadick NS, Weiss R.

Department of Dermatology, Weill Medical College of Cornell University, New York, NY, USA. nssderm@sadickdermatology.com

Intense pulsed light photorejuvenation represents a novel mode of treatment of photodamaged skin. A broad-spectrum flashlamp (500-1200 nm) targets chromophores reversing pigmentation, vascular and pilosebaceous aberrations. Both cytokine mediated as well as thermally induced deep dermal remodeling may be achieved using the varied polychromatic wavelengths associated with this technology. Inflammatory dermatosis such as rosacea may also be addressed as well. A structural approach to non-ablative rejuvenation utilizing intense pulsed light is associated with high patient satisfaction and minimal adverse sequelae.