Treatment Of Erythematotelangiectatic Rosacea Research Articles

Novel technique for rosacea treatment using optimal pulse technology: In vivo and clinical studies.

Rosacea is a chronic inflammatory skin disease affecting the face, and the current treatment effect is not satisfactory. Based on the photomodulation of optimal pulse technology (OPT), we developed a novel treatment mode, namely, advanced OPT with low energy, three pulses, and long pulse width (AOPT-LTL). We aimed to explore the feasibility and underlying molecular mechanisms of AOPT-LTL treatment in a rosacea-like mouse model. Furthermore, we evaluated the safety and efficacy in patients with erythematotelangiectatic rosacea (ETR). Morphological, histological, and immunohistochemical analyses were used to investigate the efficacy and mechanisms of AOPT-LTL treatment in the LL-37-induced rosacea-like mouse model. Moreover, 23 patients with ETR were included and received different times of treatment at intervals of 2 weeks depending on the severity of their condition. The treatment effect was assessed by comparing clinical photographs at baseline, 1 week, and 3 months after treatment, combined with the red value, GFSS, and CEA scores. After the AOPT-LTL treatment of the mice, we observed that the rosacea-like phenotype, inflammatory cell infiltration, and vascular abnormalities were significantly ameliorated, and the expression of the core molecules of rosacea was significantly inhibited. In the clinical study, the AOPT-LTL treatment exerted satisfactory therapeutic effects on erythema and flushing of ETR patients. No serious adverse events were observed. AOPT-LTL is a safe and effective method for the treatment of ETR.

A randomized, controlled, split-face study of topical timolol maleate 0.5% eye drops for the treatment of erythematotelangiectatic rosacea.

Centrofacial erythema associated with telangiectasis is the most common presentation of rosacea, known as erythematotelangiectatic rosacea (ETR). However, successful management of these symptoms remains challenging. The purpose of this study was to evaluate the efficacy and safety of topical timolol maleate eye drops 0.5% for ETR. In this randomized, single-center, single-blind, placebo-controlled split-face study, 16 patients with mild-to-moderate ETR who presented at West China Hospital between January 2019 to September 2020 were randomized to receive either topical timolol maleate eye drops 0.5% to one side of their face daily for 28days and normal saline to the other side of the face. Patients were assessed with both the Clinician Erythema Assessment (CEA) and Patient Self-Assessment (PSA) at the 28-day follow-up appointment. Subjective assessment was performed by asking participants to grade their sensation of warmth and burning. The sides treated with timolol demonstrated a significant improvement in both the CEA and PSA at the 28-day assessment. Patients reported a significant difference in warmth and burning sensations. The only adverse reaction was worsened redness on both sides of the face at Day 1 in one patient. In this small study, the application of topical timolol maleate was safe and effective for the treatment of ETR.

600 Treatment of facial flushing and erythema by carvedilol in rosacea patients with anxiety, a prospective randomized controlled clinical study

Introduction: Treatment of erythematotelangiectatic rosacea (ETR) is extremely challenging, because of the severe facial flushing and anxiety, which form a vicious cycle of reciprocal causation in the pathogenesis. There are no known specific treatments available, some cases have reported that beta-blokers play a role in the treatment of rosacea, but there are not yet any randomized controlled prospective, with larger seriers, clinical studies to evaluate the effects of systemic betabloker therapy in treating ETR. Neither study assessed the effect of it in patients with only ETR or persistent centrofacial erythema with transient flushing. Objective: the aim of this study was to compare the efficacy and safety between the monotherapies of carvedilol and minocycline and identify which treatments is better on persistent centrofacial erythema with transient flushing and anxiety. Materials and Methods: This is a prospective, single-center, single-blind, randomized, controlled clinical study. 102 patients received carvedilol 5mg bid and 51 patients received minocycline 100mg qd for 3 months. The rosacea-specific Qol instrument (RosaQol ) ,Patientself assessment(PSA), Clinicians erythema assessment(CEA), Generalized anxiety disorderGAD-7) and Patient health questionnaire (PHQ-9) were performed by questonaires and take a picture of face every 2 weeks. Results: Long-term treatment of carvedilol showed a better controlling of the most common symptoms of rosacea than minocycline; No obvious side effects were found in rosacea patients with treatment of carvedilol; Long-term treatment of carvedilol improved the anxiety status of patients with rosacea. Conclusion: Our study found that compared to minocycline, carvedilol can significantly reduce erythema with flushing and anxiety of rosacea patient, also had a maintenance effect after drug withdrawal. The novel use of this drug could be an effective systematic treatment for flushing and erythema phenotype of rosacea(or ETR) .

Comparative effectiveness of purpuragenic 595 nm pulsed dye laser versus sequential emission of 595 nm pulsed dye laser and 1,064 nm Nd:YAG laser: a double-blind randomized controlled study

Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients.

Topical 0.5% brimonidine gel to camouflage redness of immature scars

Cutaneous scars develop as a result of a defective wound healing process. Scars are commonly visible as erythematous, sometimes disfiguring lesions which might be stigmatizing for the affected patient. Only a few therapies to improve the appearance of scars are available. Recently, brimonidine — a selective α2-receptor-agonist which causes vasoconstriction of small cutaneous vessels — was approved for the treatment of erythemato-telangiectatic rosacea. Topical brimonidine might also be helpful to improve redness of immature scars. Here we report on the effect of brimonidine 0.5% gel on a flat, erythematous scar in a 25-year-old female patient. Whitening of the scar could be observed immediately after application of brimonidine 0.5% gel and a good clinical result was observed within one hour. This effect lasted for up to three hours. We conclude that brimonidine 0.5% gel is a suitable topical therapy to reduce erythema in visible cutaneous scars. ( J Dermatol Case Rep . 2015; 9(3): 87-88)

Evaluation of the safety and effectiveness of microfocused ultrasound with visualization (MFU-V) for the treatment of erythematotelangiectatic rosacea

Evaluation of the safety and effectiveness of microfocused ultrasound with visualization (MFU-V) for the treatment of erythematotelangiectatic rosacea

Neodymium‐yttrium aluminum garnet laser versus pulsed dye laser in erythemato‐telangiectatic rosacea: comparison of clinical efficacy and effect on cutaneous substance (P) expression

Different laser systems are reported to be effective in treatment of telangiectasia and erythema, but comparative studies on 1064-nm neodymium-yttrium aluminum garnet (Nd-YAG) laser and pulsed dye laser (PDL) in treatment of erythemato-telangiectatic rosacea are lacking. Substance (P) is implicated in rosacea pathogenesis. To compare the effect of Nd-YAG laser and PDL on erythemato-telangiectatic rosacea, both clinically and immunohistochemically on cutaneous substance (P) expression. This split-face comparative study included 15 patients with erythemato-telangiectatic rosacea treated on the right side with Nd-YAG laser and on the left side with PDL: three sessions, 4weeks apart. Evaluation of the patients was done using erythema and telangiectasia grading scores, patient's self-assessment, physicians' clinical assessment of the patient, and immunohistochemical assessment of substance (P). One month after the three laser sessions, excellent response was achieved in 73.3% of patients after Nd-YAG and in 53.3% of patients after PDL with significantly lower substance (P) concentration after Nd-YAG laser than after PDL. Positive correlations were found between the decrease in erythema and telangiectasia grading scores and the decrease in substance (P) concentration. The use of Nd-YAG laser and PDL appears to be safe and effective measures in treatment of erythemato-telangiectatic rosacea. Both types of laser decrease the concentration of substance (P) in the skin. This effect is more pronounced with Nd-YAG laser.

Pronounced facial flushing and persistent erythema of rosacea effectively treated by carvedilol, a nonselective β-adrenergic blocker

To the Editor: Rosacea is a common facial disorder characterized by centrofacial erythema, flushing, telangiectasia, edema, papules, and pustules.1,2 Treatment of erythematotelangiectatic rosacea (ETR) with severe facial flushing and persistent erythema remains challenging despite some successes with β-adrenergic blockers,3 clonidine (α-adrenergic agonist), naloxone (opiate antagonist), ondansetron (serotonin antagonist), and endoscopic thoracic sympathectomy. Traditional β-blockers nadolol and propranolol (20-40 mg, 2-3 times a day)3 can suppress flushing reactions, but the side effects of hypotension and bradycardia may pose problems because most patients are normotensive.

Comparative Efficacy of Nonpurpuragenic Pulsed Dye Laser and Intense Pulsed Light for Erythematotelangiectatic Rosacea

Erythematotelangiectatic (ET) rosacea is commonly treated with a variety of laser and light-based systems. Although many have been used successfully, there are a limited number of comparative efficacy studies. To compare nonpurpuragenic pulsed dye laser (PDL) with intense pulsed light (IPL) treatment in the ability to reduce erythema, telangiectasia, and symptoms in patients with moderate facial ET rosacea. Twenty-nine patients were enrolled in a randomized, controlled, single-blind, split-face trial with nonpurpuragenic treatment with PDL and IPL and untreated control. Three monthly treatment sessions were performed with initial PDL settings of 10-mm spot size, 7 J/cm(2), 6-ms pulse duration and cryogen cooling, and initial IPL settings of 560-nm filter, a pulse train of 2.4 and 6.0 ms in duration separated by a 15-ms delay, and a starting fluence of 25 J/cm(2). Evaluation measures included spectrophotometric erythema scores, blinded investigator grading, and patient assessment of severity and associated symptoms. PDL and IPL resulted in significant reduction in cutaneous erythema, telangiectasia, and patient-reported associated symptoms. No significant difference was noted between PDL and IPL treatment. A series of nonpurpuragenic PDL and IPL treatments in ET rosacea was performed with similar efficacy and safety, and both modalities seem to be reasonable choices for the treatment of ET rosacea.