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Martignago CCS, Bonifacio M, Ascimann LT, Vassão PG, Parisi JR, Renno AP, Garcia LA, Ribeiro DA, Renno ACM. Efficacy and safety of intense pulsed light in rosacea: A systematic review. Indian J Dermatol Venereol Leprol 2024; 90:599-605. [PMID: 39152889 DOI: 10.25259/ijdvl_1029_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/25/2023] [Indexed: 08/19/2024]
Abstract
Background Rosacea is a chronic inflammatory disease of the skin characterised by facial erythema, oedema, telangiectasias, papules, pustules and nodules. There is a paucity of effective therapeutic modalities for the management of rosacea. Intense Pulsed Light (IPL), a modality in which flash lamps installed in an optical treatment device (head or tip) with mirrors to reflect light, has in recent times gained popularity in the management of this condition. Aim This systematic review aims to evaluate the efficacy, safety and adverse effects of IPL treatment for rosacea. Methods This systematic review was conducted in accordance with the Preferred Reporting Item for Systematic Reviews and Meta-Analysis. The electronic databases searched were Medline, PubMed and Scopus databases. The Risk of bias in non-randomised studies of interventions (ROBINS-I) and risk-of-bias tools for randomised trials (RoB-2) was employed to assess the risk of bias. Results Of a total of 233 articles retrieved from Medline, Scopus and PubMed databases, 14 studies qualified for final analysis. The studies included patients with Fitzpatrick skin types I to IV, with ages ranging from 15 to 78 years. Although the included studies showed heterogeneity between the parameters used, most studies demonstrated positive effects of IPL treatment on telangiectasia and erythema in rosacea and that the adverse effects presented were transitory. Limitation The methodological quality of the included studies was poor. Conclusion Although most studies showed the efficacy of IPL in the treatment of rosacea, the poor quality of the studies was of concern.
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Affiliation(s)
| | - Mirian Bonifacio
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Laura Takahashi Ascimann
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | | | - Julia Risso Parisi
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Ana Paula Renno
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Livia Assis Garcia
- Department of Biomedical Engineering, Institute of Science and Technology of Brazil University (UB), Rua Carolina Fonseca, São Paulo, Brazil
| | - Daniel Araki Ribeiro
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
| | - Ana Claudia Muniz Renno
- Department of Biosciences, Federal University of São Paulo - Unifesp, Silva Jardim, Santos, Brazil
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Arora G, Arora S. Medical Aesthetics - Current Trends and a Review of Its Applications. Indian Dermatol Online J 2023; 14:309-319. [PMID: 37266088 PMCID: PMC10231726 DOI: 10.4103/idoj.idoj_264_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 06/03/2023] Open
Abstract
Medical aesthetics is the use of a procedure or product for a therapeutic indication which is conventionally used for aesthetics. Several medical conditions are now being treated with products, procedures or equipment that are conventionally used for aesthetic indications. This has widened the scope of treatment modalities available for dermatologists to treat various indications that fall outside the purview of aesthetic dermatology. The authors present aesthetic treatment modalities and procedures which can be used for medical aesthetics, their present-day status and usefulness in field of therapeutics with a review of published literature from "Medline" (via "PubMed"), "Cochrane," the Virtual Health Library, and Google Scholar.
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Affiliation(s)
- Gulhima Arora
- Department of Dermatology Consultant Dermatologist, Mehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences, Delhi Cantt, India
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3
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Intense pulsed light treatment for inflammatory skin diseases: a review. Lasers Med Sci 2022; 37:3085-3105. [PMID: 35913536 DOI: 10.1007/s10103-022-03620-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/26/2022] [Indexed: 10/16/2022]
Abstract
Although intense pulsed light (IPL) has been commonly used in the field of medical cosmetics in recent years, the exact outcomes of IPL in the treatment of inflammatory skin diseases remain unclear. To assess the clinical evidence for the use of IPL in the treatment of various inflammatory skin diseases and propose evidence-based recommendations, we searched for relevant publications in the PubMed and Web of Science databases and provided updated information. The inflammatory skin diseases treated with IPL consisted of acne vulgaris, rosacea, psoriasis, hidradenitis suppurativa (HS), atopic dermatitis (AD), Riehl's melanosis, lupus erythematosus, cutaneous sarcoidosis, pilonidal cysts, and pigmented actinic lichen planus (PALP). The efficacy of IPL treatment for these inflammatory skin diseases was described and evaluated. Forty-two studies were included to provide this assessment. The evidence suggests that IPL can effectively and safely improve acne vulgaris and rosacea (recommendation grade B). For other described inflammatory skin diseases, IPL can be used as a tentative or supplementary treatment (recommendation grade C and D). The main complications include transitory erythema, edema, and pain, with the possibility of hyperpigmentation, blisters, and a burning sensation in some individuals.
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Bennardo L, Patruno C, Zappia E, Tamburi F, Sannino M, Negosanti F, Nisticò SP, Cannarozzo G. Combination of Specific Vascular Lasers and Vascular Intense Pulsed Light Improves Facial Telangiectasias and Redness. Medicina (B Aires) 2022; 58:medicina58050651. [PMID: 35630068 PMCID: PMC9147706 DOI: 10.3390/medicina58050651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives: Facial telangiectasias are dilated blood vessels that can represent a cosmetic issue for patients. They may be associated with other conditions, such as rosacea. Laser and light treatments are nowadays becoming a cornerstone in the management of these lesions. Materials and Methods: In total, 68 patients seeking medical treatment for facial telangiectasias were enrolled from 1 March 2019 to 1 March 2020 at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). A protocol consisting of a 1064 Nd:YAG laser for darker blue telangiectasias and 532 nm Nd:YAG for red lesions followed by intense pulsed light with an optimized spectrum for vascular lesion 3 weeks after the first procedure was proposed. A three-month follow-up visit assessed patient’s satisfaction using a visual analog scale (VAS). Two dermatologists measured clinical results using a 4-point scale, comparing pictures before treatment and at follow-up. Results: A total of 68 patients (32 males and 36 females) completed the study, performing all requested treatments. No severe side effects were reported. Patient satisfaction was very high (8.15 ± 1.05 out of a 10-point VAS scale), as well as dermatologists’ clinical evaluations (2.19 ± 0.74 out of 3). Conclusions: The combination of vascular lasers and Vascular Intense Pulsed Light acting specifically on small blood vessels may help to improve the aesthetic outcome, reducing side effects. A prospective study with a larger number of participants will be necessary to confirm this study’s findings.
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Affiliation(s)
- Luigi Bennardo
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (L.B.); (C.P.); (E.Z.); (F.T.); (S.P.N.)
| | - Cataldo Patruno
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (L.B.); (C.P.); (E.Z.); (F.T.); (S.P.N.)
| | - Elena Zappia
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (L.B.); (C.P.); (E.Z.); (F.T.); (S.P.N.)
| | - Federica Tamburi
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (L.B.); (C.P.); (E.Z.); (F.T.); (S.P.N.)
| | - Mario Sannino
- Department of Systems Medicine, Tor Vergata University, 00100 Rome, Italy;
| | - Francesca Negosanti
- Dermatologic Center “Villa Bella-Antiaging Care Group”, 40126 Bologna, Italy;
| | - Steven Paul Nisticò
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (L.B.); (C.P.); (E.Z.); (F.T.); (S.P.N.)
| | - Giovanni Cannarozzo
- Department of Systems Medicine, Tor Vergata University, 00100 Rome, Italy;
- Correspondence:
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Yepuri V, Patil AD, Fritz K, Salavastru C, Kroumpouzos G, Nisticò SP, Piccolo D, Sadek A, Badawi A, Kassir M, Gold MH, Große-Büning S, Grabbe S, Goldust M. Light-Based Devices for the Treatment of Facial Erythema and Telangiectasia. Dermatol Ther (Heidelb) 2021; 11:1879-1887. [PMID: 34562267 PMCID: PMC8611125 DOI: 10.1007/s13555-021-00607-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Indexed: 10/26/2022] Open
Abstract
Facial erythema is one of the most common outpatient complaints in dermatology. There are various causes of facial erythema and several devices are available for its treatment. Pulsed dye laser (PDL) and intense pulsed light (IPL) are the two common light devices used for these conditions. In this review, we evaluated the literature to assess efficacy of IPL versus PDL in facial erythema and telangiectasia. We searched published articles including clinical trials or reviews articles, case series, and case reports. Electronic databases (MEDLINE and PubMed) were searched to retrieve the articles. Reference lists of selected articles were also considered for the review. Articles published in English language until June 2021 were considered for this review.
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Affiliation(s)
- Vani Yepuri
- Venkat Charmalaya, Centre for Advanced Dermatology and Post Graduate Training, Bangalore, Karnataka, India
| | - Anant D Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Klaus Fritz
- Dermatology and Laser Center, Reduitstr. 13, 76829, Landau, Germany.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
| | - Carmen Salavastru
- "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania.,"Colentina" Clinical Hospital, Pediatric Dermatology Discipline, Dermato-Oncology Research Facility, 19-21 Stefan cel Mare Str, Bucharest, Romania
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode, Island.,Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.,GK Dermatology, PC, South Weymouth, Massachusetts, USA
| | - Steven Paul Nisticò
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100, Catanzaro, Italy
| | | | - Ahmed Sadek
- Cairo Hospital for Dermatology and Venereology (Al-Haud Al-Marsoud) Manager, Cairo, Egypt
| | - Ashraf Badawi
- Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt.,Dermatology and Allergology Department, Faculty of Medicine, Szeged University, Szeged, Hungary.,, Oakville, Canada
| | | | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, TN, USA
| | | | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany.
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The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea? Dermatol Ther (Heidelb) 2020; 10:1229-1253. [PMID: 33095403 PMCID: PMC7649190 DOI: 10.1007/s13555-020-00458-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 12/15/2022] Open
Abstract
Rosacea is a common facial dermatosis but its definition and classification are still unclear, especially in terms of its links with demodicosis. Triggers of rosacea (ultraviolet light, heat, spicy foods, alcohol, stress, microbes) are currently considered to induce a cascading innate and then adaptive immune response that gets out of control. Recent histological and biochemical studies support the concept that this inflammatory response is a continuum, already present from the onset of the disease, even when no clinical signs of inflammation are visible. The Demodex mite is beginning to be accepted as one of the triggers of this inflammatory cascade, and its proliferation as a marker of rosacea; moreover, the papulopustules of rosacea can be effectively treated with topical acaricidal agents. Demodex proliferation appears to be a continuum process in rosacea, and may not be clinically visible at the onset of the disease. Molecular studies suggest that Demodex may induce tolerogenic dendritic cells and collaborate with vascular endothelial growth factor (VEGF) to induce T cell exhaustion and favor its own proliferation. These interactions among VEGF, Demodex, and immunity need to be explored further and the nosology of rosacea adapted accordingly. However, treating early rosacea, with only clinically visible vascular symptoms, with an acaricide may decrease early inflammation, limit potential flare-ups following laser treatment, and prevent the ultimate development of the papulopustules of rosacea. The effectiveness of this approach needs to be confirmed by prospective controlled clinical trials with long-term follow-up. Currently, the evidence suggests that patients with only vascular symptoms of rosacea should be carefully examined for the presence of follicular scales as signs of Demodex overgrowth or pityriasis folliculorum so that these patients, at least, can be treated early with an acaricidal cream.
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Zhao L, You C, Chen H, Wang J, Cao J, Qi M, Hou S, Zheng X, Shao L, Liu Q. Retrospective Study of Factors Affecting Efficacy of Therapy with Dye Pulsed Light for Erythematotelangiectatic Rosacea. Dermatol Ther (Heidelb) 2020; 10:1273-1283. [PMID: 32865718 PMCID: PMC7649186 DOI: 10.1007/s13555-020-00440-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Dye pulsed light (DPL) was proven to be effective at treating erythematous and telangiectatic skin disorders. However, there are limited data on the efficacy of DPL treatment for erythematotelangiectatic rosacea (ETR), and researchers do not fully understand the factors that may affect the efficacy. Here, we performed a study to investigate the efficacy of DPL treatment for ETR and determine the factors affecting that efficacy. METHODS Sixty-five patients with ETR underwent three treatment sessions with DPL at 4-week intervals and were followed up at 4 weeks after the last treatment session. Skin type, sex, age, lesion site, severity of erythema and telangiectasia, VISIA percentile ranking, clinical photographs and red area images were recorded at baseline. The post-treatment erythematous and telangiectatic scores and VISIA percentile rankings were recorded, and the effects of different personal and clinical factors on the efficacy were statistically analysed. RESULTS The erythema and telangiectasia scores and VISIA percentile rankings showed significant improvement after the DPL procedures (p < 0.01). With regard to erythema, treatment efficacy was not affected by any of the investigated variables, including pre-treatment erythema scores, skin type, pre-treatment VISIA percentile ranking, sex, age and lesion site (p > 0.05). With regard to telangiectasia, the treatment efficacy was greater for mild telangiectasia than for severe telangiectasia (odds ratio = 4.14, p < 0.05). There was no significant difference in treatment efficacy between the moderate and severe categories (odds ratio = 4.00, p > 0.05). CONCLUSION DPL is not the optimal procedure for treating severe telangiectasia in patients with ETR, whereas the efficacy of the treatment for erythema was not affected by the severity of the condition.
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Affiliation(s)
- Leran Zhao
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Cong You
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Han Chen
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Jiangyi Wang
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Junya Cao
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Manli Qi
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Shuping Hou
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Xin Zheng
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Lili Shao
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Quanzhong Liu
- Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.
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