Treatment of rosacea with long-pulsed Nd: YAG laser

Background and Design: Rosacea is a chronic inflammatory disorder of the face. There is no curative treatment for the disease. Facial flushing and vascular lesions due to rosacea may significantly affect a patient’s quality of life. Topical and oral antibiotics are not effective for treating rosacea. Currently, laser treatment of vascular lesions has been reported in the literature. We aimed to investigate the efficacy of long-pulse 1064-nm neodymium: YAG (Nd: YAG) laser in the treatment of vascular lesions (erythema and telangiectasia) in rosacea patients. Materials and Methods: Thirty-nine patients (29 women, 10 men) with erythematotelangiectatic rosacea (ETR) were recruited into the study. Severity of the disease (ETR-score: 0-3) was assessed for all patients. We used long-pulsed Nd: YAG laser for vascular lesions at 3-4 weeks intervals. The face was divided into seven anatomic regions for evaluation. Assessment was made by comparing pretreatment and posttreatment photographs by using ETR-scores. For evaluating patient satisfaction, a scale of 0 to 3 was used. Results: The patients were divided into three groups according to the ETR scores [ETR-1 (n=12), ETR-2 (n=9), ETR-3 (n=18)]. Following an average of 3.95 (2-8 sessions) laser treatments, the clinical improvement was statistically significant in all groups (p<0.05). The mean reduction of ETR-score was 91.70% in patients with ETR-1 and. the clinical improvement was to be decreased in severe forms of ETR. The most common sites for the lesions were the malar region, ala nasi and the nasal dorsum, respectively. The lesions on the ala nasi were more recalcitrant to the treatment than those on the other areas. Regarding to physician assessment of treatment’s success, 97% of the patients was associated with moderate and excellent improvement. According to physicians’ assessment, excellent improvement was noticed in 43.58% and, 61.5% of patients reported a high degree of satisfaction with this therapy. Only one patient developed hypopigmented atrophic scar as a complication. Discussion: Long-pulse Nd: YAG laser is a safe and effective treatment for vascular lesions in patients with rosacea.