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J Cosmet Med 2023; 7(1): 38-41

Published online June 30, 2023

https://doi.org/10.25056/JCM.2023.7.1.38

Treatment of severe erythematotelangiectatic rosacea with intense pulsed light: a case report

Cheuk Hung Lee , MBBS (HK), FHKAM (MED), FHKCP, MScPD (Cardiff), MRCP (UK), DPD (Wales), DipDerm (Glasgow), PGDipClinDerm (London), MRCP (London), GradDipDerm (NUS), DipMed (CUHK), Kar Wai Alvin Lee , MBChB (CUHK), DCH (Sydney), Dip Derm (Glasgow), MScClinDerm (Cardiff), MScPD (Cardiff), DipMed (CUHK), DCH (Sydney), Kwin Wah Chan , MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney)

Ever Keen Medical Centre, Hong Kong

Correspondence to :
Kar Wai Alvin Lee
E-mail: alvin429@yahoo.com

Received: September 19, 2022; Revised: October 11, 2022; Accepted: October 17, 2022

© Korean Society of Korean Cosmetic Surgery & Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Erythematotelangiectatic rosacea is a common, long-standing inflammatory skin disorder of unclear origin. It is characterized by facial erythema involving mainly the central face (malar areas, chin, nasal area, and forehead region), with a range of clinical manifestations varying from blood vessels hyperactivity to sebaceous glands hyperplasia. These can have a considerable psychosocial impact on the patients. Intense pulsed light treatment can have significant effects on severe erythematotelangiectatic rosacea. We aimed to describe the treatment of severe erythematotelangiectatic rosacea with intense pulsed light. This article is a case report together with a literature review to explore the views of researchers on the treatment of erythematotelangiectatic rosacea with intense pulsed light. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on severe erythematotelangiectatic rosacea. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for patients with severe erythematotelangiectatic rosacea. Our case report revealed that intense pulsed light using multiple filters at certain energy levels can effectively treat severe erythematotelangiectatic rosacea. We believe that, with more treatment sessions, patients can enjoy longer and more persistent results. Intense pulsed light is an effective treatment for erythematotelangiectatic rosacea. However, more erythematotelangiectatic rosacea cases treated with intense pulsed light will be required to consolidate intense pulsed light as one of the best treatment options for erythematotelangiectatic rosacea. Potential complications with intense pulsed light include post-inflammatory hyperpigmentation, burns, and pain.

Keywords: intense pulsed light therapy, phototherapy, pigmentation disorders, rosacea

Figures

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Fig. 1.Patient’s frontal area before undergoing the first intense pulsed light treatment.

References

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  1. Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol 2013;69(6 Suppl 1):S15-26.
    Pubmed CrossRef
  2. Abokwidir M, Feldman SR. Rosacea management. Skin Appendage Disord 2016;2:26-34.
    Pubmed KoreaMed CrossRef
  3. Vemuri RC, Gundamaraju R, Sekaran SD, Manikam R. Major pathophysiological correlations of rosacea: a complete clinical appraisal. Int J Med Sci 2015;12:387-96.
    Pubmed KoreaMed CrossRef
  4. Baldwin HE. Diagnosis and treatment of rosacea: state of the art. J Drugs Dermatol 2012;11:725-30.
  5. Coleman WP 3rd. Acne and rosacea: epidemiology, diagnosis, and treatment. Edited by: David J. Goldberg and Alexander L. Berlin published by: Manson Publishing Ltd., London; 2012. Dermatol Surg 2012;38:1729.
  6. Maier LE. Rosacea: advances in understanding pathogenesis and treatment. Clin Invest 2011;1:739-55.
    CrossRef
  7. Chee SN, Lowe P. Triggers and treatment of rosacea. Med Today 2015;16:34-40.
  8. Tan J, Berg M. Rosacea: current state of epidemiology. J Am Acad Dermatol 2013;69(6 Suppl 1):S27-35.
    Pubmed CrossRef
  9. Pernia S, DeMaagd G. The new pregnancy and lactation labeling rule. P T 2016;41:713-5.
  10. Jackson JM, Pelle M. Topical rosacea therapy: the importance of vehicles for efficacy, tolerability and compliance. J Drugs Dermatol 2011;10:627-33.
  11. Pelle MT, Crawford GH, James WD. Rosacea: II. Therapy. J Am Acad Dermatol 2004;51:499-512; quiz 513-4.
    Pubmed CrossRef
  12. van Zuuren EJ, Kramer SF, Carter BR, Graber MA, Fedorowicz Z. Effective and evidence-based management strategies for rosacea: summary of a Cochrane systematic review. Br J Dermatol 2011;165:760-81.
    Pubmed CrossRef
  13. Rohrer T, Geronemus R, Berlin A. Vascular lesions. In: Goldberg DJ, editors. Lasers and lights: vascular - pigmentation -hair - scars - medical applications. 2nd ed. Edinburgh: Saunders; 2009. p. 1-15.
  14. Babilas P, Schreml S, Szeimies RM, Landthaler M. Intense pulsed light (IPL): a review. Lasers Surg Med 2010;42:93-104.
    Pubmed CrossRef
  15. Lim HS, Lee SC, Won YH, Lee JB. The efficacy of intense pulsed light for treating erythematotelangiectatic rosacea is related to severity and age. Ann Dermatol 2014;26:491-5.
    Pubmed KoreaMed CrossRef
  16. Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Surg 2009;35:920-8.
    Pubmed CrossRef
  17. Kim BY, Moon HR, Ryu HJ. Comparative efficacy of shortpulsed intense pulsed light and pulsed dye laser to treat rosacea. J Cosmet Laser Ther 2019;21:291-6.
    Pubmed CrossRef
  18. Chang HC, Chang YS. Pulsed dye laser versus intense pulsed light for facial erythema of rosacea: a systematic review and meta-analysis. J Dermatolog Treat 2022;33:2394-6.
    Pubmed CrossRef

Article

Case Report

J Cosmet Med 2023; 7(1): 38-41

Published online June 30, 2023 https://doi.org/10.25056/JCM.2023.7.1.38

Copyright © Korean Society of Korean Cosmetic Surgery & Medicine.

Treatment of severe erythematotelangiectatic rosacea with intense pulsed light: a case report

Cheuk Hung Lee , MBBS (HK), FHKAM (MED), FHKCP, MScPD (Cardiff), MRCP (UK), DPD (Wales), DipDerm (Glasgow), PGDipClinDerm (London), MRCP (London), GradDipDerm (NUS), DipMed (CUHK), Kar Wai Alvin Lee , MBChB (CUHK), DCH (Sydney), Dip Derm (Glasgow), MScClinDerm (Cardiff), MScPD (Cardiff), DipMed (CUHK), DCH (Sydney), Kwin Wah Chan , MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney)

Ever Keen Medical Centre, Hong Kong

Correspondence to:Kar Wai Alvin Lee
E-mail: alvin429@yahoo.com

Received: September 19, 2022; Revised: October 11, 2022; Accepted: October 17, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Erythematotelangiectatic rosacea is a common, long-standing inflammatory skin disorder of unclear origin. It is characterized by facial erythema involving mainly the central face (malar areas, chin, nasal area, and forehead region), with a range of clinical manifestations varying from blood vessels hyperactivity to sebaceous glands hyperplasia. These can have a considerable psychosocial impact on the patients. Intense pulsed light treatment can have significant effects on severe erythematotelangiectatic rosacea. We aimed to describe the treatment of severe erythematotelangiectatic rosacea with intense pulsed light. This article is a case report together with a literature review to explore the views of researchers on the treatment of erythematotelangiectatic rosacea with intense pulsed light. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on severe erythematotelangiectatic rosacea. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for patients with severe erythematotelangiectatic rosacea. Our case report revealed that intense pulsed light using multiple filters at certain energy levels can effectively treat severe erythematotelangiectatic rosacea. We believe that, with more treatment sessions, patients can enjoy longer and more persistent results. Intense pulsed light is an effective treatment for erythematotelangiectatic rosacea. However, more erythematotelangiectatic rosacea cases treated with intense pulsed light will be required to consolidate intense pulsed light as one of the best treatment options for erythematotelangiectatic rosacea. Potential complications with intense pulsed light include post-inflammatory hyperpigmentation, burns, and pain.

Keywords: intense pulsed light therapy, phototherapy, pigmentation disorders, rosacea

Fig 1.

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Figure 1.Patient’s frontal area before undergoing the first intense pulsed light treatment.
Journal of Cosmetic Medicine 2023; 7: 38-41https://doi.org/10.25056/JCM.2023.7.1.38

References

  1. Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol 2013;69(6 Suppl 1):S15-26.
    Pubmed CrossRef
  2. Abokwidir M, Feldman SR. Rosacea management. Skin Appendage Disord 2016;2:26-34.
    Pubmed KoreaMed CrossRef
  3. Vemuri RC, Gundamaraju R, Sekaran SD, Manikam R. Major pathophysiological correlations of rosacea: a complete clinical appraisal. Int J Med Sci 2015;12:387-96.
    Pubmed KoreaMed CrossRef
  4. Baldwin HE. Diagnosis and treatment of rosacea: state of the art. J Drugs Dermatol 2012;11:725-30.
  5. Coleman WP 3rd. Acne and rosacea: epidemiology, diagnosis, and treatment. Edited by: David J. Goldberg and Alexander L. Berlin published by: Manson Publishing Ltd., London; 2012. Dermatol Surg 2012;38:1729.
  6. Maier LE. Rosacea: advances in understanding pathogenesis and treatment. Clin Invest 2011;1:739-55.
    CrossRef
  7. Chee SN, Lowe P. Triggers and treatment of rosacea. Med Today 2015;16:34-40.
  8. Tan J, Berg M. Rosacea: current state of epidemiology. J Am Acad Dermatol 2013;69(6 Suppl 1):S27-35.
    Pubmed CrossRef
  9. Pernia S, DeMaagd G. The new pregnancy and lactation labeling rule. P T 2016;41:713-5.
  10. Jackson JM, Pelle M. Topical rosacea therapy: the importance of vehicles for efficacy, tolerability and compliance. J Drugs Dermatol 2011;10:627-33.
  11. Pelle MT, Crawford GH, James WD. Rosacea: II. Therapy. J Am Acad Dermatol 2004;51:499-512; quiz 513-4.
    Pubmed CrossRef
  12. van Zuuren EJ, Kramer SF, Carter BR, Graber MA, Fedorowicz Z. Effective and evidence-based management strategies for rosacea: summary of a Cochrane systematic review. Br J Dermatol 2011;165:760-81.
    Pubmed CrossRef
  13. Rohrer T, Geronemus R, Berlin A. Vascular lesions. In: Goldberg DJ, editors. Lasers and lights: vascular - pigmentation -hair - scars - medical applications. 2nd ed. Edinburgh: Saunders; 2009. p. 1-15.
  14. Babilas P, Schreml S, Szeimies RM, Landthaler M. Intense pulsed light (IPL): a review. Lasers Surg Med 2010;42:93-104.
    Pubmed CrossRef
  15. Lim HS, Lee SC, Won YH, Lee JB. The efficacy of intense pulsed light for treating erythematotelangiectatic rosacea is related to severity and age. Ann Dermatol 2014;26:491-5.
    Pubmed KoreaMed CrossRef
  16. Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Surg 2009;35:920-8.
    Pubmed CrossRef
  17. Kim BY, Moon HR, Ryu HJ. Comparative efficacy of shortpulsed intense pulsed light and pulsed dye laser to treat rosacea. J Cosmet Laser Ther 2019;21:291-6.
    Pubmed CrossRef
  18. Chang HC, Chang YS. Pulsed dye laser versus intense pulsed light for facial erythema of rosacea: a systematic review and meta-analysis. J Dermatolog Treat 2022;33:2394-6.
    Pubmed CrossRef

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