Laser treatment of rosacea

Abstract

Rosacea is a common condition often resulting in persistent erythema and telangiectasia as well as rhinophyma in a number of patients. Over the last two decades lasers have been increasingly used in the treatment of these permanent changes. The literature is reviewed in terms of the different laser systems, side-effects and comparison with other surgical techniques. Laser studies on rosacea-associated telangiectasia and erythema are limited. Copper-bromide, krypton and KTP lasers have been used with good to excellent results. However, the most commonly applied system is the flash lamp-pumped pulsed dye laser. Rhinophyma can be treated with a variety of different surgical methods, including laser resurfacing. CO(2) lasers are the most widely used lasers, others are the Er:YAG and Nd:YAG lasers. Cosmetic end results are comparable to partial excision with a scalpel or electrosurgery. There does not appear to be an increased risk of infection or scarring, but the conventional surgical methods are quicker to perform and more cost effective.

Gnatophyma and Otophyma

“…27 The most commonly applied system is the flash lamp-pumped pulsed dye laser. 28 Surgical management is well accepted as the best mode of therapy to treat rhinophyma and is becoming a first-line treatment for all phymas. 29,30 It is the only effective means to significantly reduce the nodular tissue hypertrophy associated with end-stage disease.…”

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

“…However, KTP laser was not as successful as lpNd:YAG laser in removing macular erythema and inflammatory rosacea lesions. In previous studies, controversial results have been reported concerning the comparative clinical efficacy of KTP and other vascular lasers; e.g., PDL (18)(19)(20)(21)(22). KTP laser has also been reported to be very safe when used in combination with topical retinaldehyde (21).…”

Update on the Management of Rosacea

“…The older generation of argon, copper bromide, and krypton lasers paved the way for new lasers and lights developed specifically for cutaneous vascular lesions with more precision to minimize such side effects as hypopigmentation, atrophic scars, and recovery time. 83,84 Laser settings used in major studies of the treatment of rosacea with prominent telangiectasia and erythema (Table 2) and phymatous rosacea (Table 3) are outlined in detail, with laser manufacturers listed when specified by the authors. An in-depth review of all the published studies using lasers and/or lights for the treatment of rosacea is beyond the scope of this current review.…”