What is Rosacea?

It is a chronic, flare-up skin disease affecting the central areas of the face.

Primary findings: Erythema (redness), telangiectasia (widening of capillaries), papules and pustules.

Secondary findings: Burning, stinging, edema, dryness, ocular involvement, deformations such as physeal.

Subtypes:
Erythematotelangiectatic Rosacea (ETR) – permanent redness and vascular dilations

Papulopustular Rosacea (PPR) – acne-like lesions

Phymatous Rosacea (FR) – tissue thickening (the most common form of rhinophyma)

Ocular Rosacea – eye involvement

Laser and Light Therapies:
Laser treatments are especially effective against erythema and telangiectasia in the ETR subtype. Main systems used:

1. Pulsed Dye Laser (PDL, 585–595 nm)
Targets oxyhemoglobin.

Effective, but side effects such as purpura (bruising) are common.

These effects have been reduced with cryogenic cooling in newer devices.

It has been shown to improve the quality of life in patients with ETR.

2. Intense Pulsed Light (IPL)
Wide wavelength (560–1200 nm).

Uses non-coherent light, low risk of purpura.

Larger spot size provides more homogeneous application.

3. KTP Laser (532 nm)
Frequency-doubled version of Nd:YAG.

May be more effective than PDL, but erythema and edema are more common.

4. Nd:YAG Laser (1064 nm)
Targets deep vessels, does not cause purpura.

Similar efficacy compared to PDL, fewer side effects.

5. Copper Bromide and Krypton Laser
Older technologies; high risk of hypopigmentation and scarring.

Treatment of Phymatous Rosacea:
Isotretinoin may be effective in mild cases.

In advanced cases:

Laser ablation

CO₂, Er:YAG lasers

Surgical methods: electrosurgery, dermabrasion, tangential excision

Recommendations for Clinical Practice:
The use of broad-spectrum sunscreen is recommended in all rosacea cases.

Triggers (hot/cold weather, alcohol, spices, exercise, irritating cosmetics) should be avoided.

In ETR treatment:

If laser is to be preferred, pulse duration, energy level and cooling are important factors.

Combination treatments (e.g. IPL + RF) may be more effective.

It has been found effective in ETR and PPR.