Pulsed-dye laser found effective for erythematotelangiectatic rosacea

 

DALLAS – Use of a newly designed pulsed-dye laser with a 15-mm diameter beam was safe and effective for treating rosacea, in a single-center study of 20 patients.

“Recent advances in pulsed-dye laser technology enable 50% higher output energies and much longer dye life,” lead study author Eric F. Bernstein, MD, said at the annual conference of the American Society for Laser Medicine and Surgery. “A 15-mm treatment diameter is now possible, which makes treatment faster and possibly more effective due to increased penetration of laser energy. Compared with a 10-mm spot size, which most of us use, a 15 mm is a 125% larger beam diameter, so it’s a big difference in treatment area.”

In an effort to investigate use of the new 15-mm VBeam Prima pulsed-dye laser from Syneron Candela for treating rosacea, Dr. Bernstein, director of the Main Line Center for Laser Surgery in Ardmore, Pa., and his associates enrolled 20 patients with erythematotelangiectatic rosacea to receive four treatments every four weeks. Linear vessels were treated with a 3-mm by 10-mm elliptical beam with a 40-millisecond pulse duration, while diffuse redness was treated with a 15-mm circular beam with a 3-millisecond pulse duration. Cryogen spray cooling was used for comfort and epidermal protection.

Blinded assessment of digital and cross-polarized images taken 8 weeks following the last treatment was performed using an 11-point clearance scale. The Investigator Global Assessment Scale was used to evaluate inflammatory lesions, erythema, and telangiectasia, and safety was assessed by incidence and severity of side effects. The investigators and subjects assessed satisfaction with the treatment outcome on a 5-point Likert scale (–2, very dissatisfied; –1, dissatisfied; 0, no opinion; 1, satisfied; and 2, very satisfied). Dr. Bernstein also evaluated the patients for purpura, petechiae, edema, erythema, blistering, and crusting on a 0-3 point scale (0, absent; 1, mild; 2, moderate; and 3, severe).

Of the 20 subjects, 16 females and 3 males completed the study. All had Fitzpatrick skin types II-IV and 17 of 19 subjects received four treatments, while 2 received three treatments because of scheduling challenges. Between baseline and 8 weeks following the last treatment, mean Investigator Global Assessment scores improved significantly for overall score (from 4.3 to 1.8; P less than .0001), as well as for inflammatory lesions (from 1.7 to 1.0; P less than .005), erythema (from 4.5 to 1.6; P less than .0001), and for telangiectasia (from 4.2 to 1.1; P less than .0001).

Dr. Bernstein also reported that blinded evaluators correctly identified baseline images in 55 of 57 image pairs (96.5%), while the average score improvement in their rosacea was 52.5%, and ranged from 30.0% to 86.7%. In addition, 17 of 19 subjects (89%) showed a score improvement of more than 40%, while 57% of subjects had a score improvement of greater than 50%.

Patients and investigators both recorded a mean satisfaction score of 1.9, and 18 of 19 subjects reported being “very satisfied” with the treatment.

 

The average pain score was 5.6 on a 0-10 scale, while common side effects that resolved within 1-3 days without intervention included mild edema, mild to moderate erythema, and mild to moderate bruising. No cases of hyperpigmentation, hypopigmentation, blistering, or scarring occurred.

“The newly designed pulsed-dye laser is a major change in a device that has performed for over 10 years with wide acceptance,” Dr. Bernstein said. In addition to a longer-lasting dye kit, he said that new features include 50% more total energy enabling clinically relevant fluences to be delivered using a 15-mm diameter treatment beam, once-daily calibration instead of after every energy or spot size change, “both contact and dynamic spray cooling, and an Nd:YAG wavelength for treating larger vessels.”

Dr. Bernstein reported having received grant funding from Syneron Candela and Zeltiq. He also has received consulting fees from and holds ownership interest in Syneron Candela, and has served on the advisory board for Novoxel, Solta, Syneron Candela, and Zeltiq.

dbrunk@mdedge.com

 

DALLAS – Use of a newly designed pulsed-dye laser with a 15-mm diameter beam was safe and effective for treating rosacea, in a single-center study of 20 patients.

“Recent advances in pulsed-dye laser technology enable 50% higher output energies and much longer dye life,” lead study author Eric F. Bernstein, MD, said at the annual conference of the American Society for Laser Medicine and Surgery. “A 15-mm treatment diameter is now possible, which makes treatment faster and possibly more effective due to increased penetration of laser energy. Compared with a 10-mm spot size, which most of us use, a 15 mm is a 125% larger beam diameter, so it’s a big difference in treatment area.”

In an effort to investigate use of the new 15-mm VBeam Prima pulsed-dye laser from Syneron Candela for treating rosacea, Dr. Bernstein, director of the Main Line Center for Laser Surgery in Ardmore, Pa., and his associates enrolled 20 patients with erythematotelangiectatic rosacea to receive four treatments every four weeks. Linear vessels were treated with a 3-mm by 10-mm elliptical beam with a 40-millisecond pulse duration, while diffuse redness was treated with a 15-mm circular beam with a 3-millisecond pulse duration. Cryogen spray cooling was used for comfort and epidermal protection.

Blinded assessment of digital and cross-polarized images taken 8 weeks following the last treatment was performed using an 11-point clearance scale. The Investigator Global Assessment Scale was used to evaluate inflammatory lesions, erythema, and telangiectasia, and safety was assessed by incidence and severity of side effects. The investigators and subjects assessed satisfaction with the treatment outcome on a 5-point Likert scale (–2, very dissatisfied; –1, dissatisfied; 0, no opinion; 1, satisfied; and 2, very satisfied). Dr. Bernstein also evaluated the patients for purpura, petechiae, edema, erythema, blistering, and crusting on a 0-3 point scale (0, absent; 1, mild; 2, moderate; and 3, severe).

Of the 20 subjects, 16 females and 3 males completed the study. All had Fitzpatrick skin types II-IV and 17 of 19 subjects received four treatments, while 2 received three treatments because of scheduling challenges. Between baseline and 8 weeks following the last treatment, mean Investigator Global Assessment scores improved significantly for overall score (from 4.3 to 1.8; P less than .0001), as well as for inflammatory lesions (from 1.7 to 1.0; P less than .005), erythema (from 4.5 to 1.6; P less than .0001), and for telangiectasia (from 4.2 to 1.1; P less than .0001).

Dr. Bernstein also reported that blinded evaluators correctly identified baseline images in 55 of 57 image pairs (96.5%), while the average score improvement in their rosacea was 52.5%, and ranged from 30.0% to 86.7%. In addition, 17 of 19 subjects (89%) showed a score improvement of more than 40%, while 57% of subjects had a score improvement of greater than 50%.

Patients and investigators both recorded a mean satisfaction score of 1.9, and 18 of 19 subjects reported being “very satisfied” with the treatment.

 

The average pain score was 5.6 on a 0-10 scale, while common side effects that resolved within 1-3 days without intervention included mild edema, mild to moderate erythema, and mild to moderate bruising. No cases of hyperpigmentation, hypopigmentation, blistering, or scarring occurred.

“The newly designed pulsed-dye laser is a major change in a device that has performed for over 10 years with wide acceptance,” Dr. Bernstein said. In addition to a longer-lasting dye kit, he said that new features include 50% more total energy enabling clinically relevant fluences to be delivered using a 15-mm diameter treatment beam, once-daily calibration instead of after every energy or spot size change, “both contact and dynamic spray cooling, and an Nd:YAG wavelength for treating larger vessels.”

Dr. Bernstein reported having received grant funding from Syneron Candela and Zeltiq. He also has received consulting fees from and holds ownership interest in Syneron Candela, and has served on the advisory board for Novoxel, Solta, Syneron Candela, and Zeltiq.

dbrunk@mdedge.com

 

DALLAS – Use of a newly designed pulsed-dye laser with a 15-mm diameter beam was safe and effective for treating rosacea, in a single-center study of 20 patients.

“Recent advances in pulsed-dye laser technology enable 50% higher output energies and much longer dye life,” lead study author Eric F. Bernstein, MD, said at the annual conference of the American Society for Laser Medicine and Surgery. “A 15-mm treatment diameter is now possible, which makes treatment faster and possibly more effective due to increased penetration of laser energy. Compared with a 10-mm spot size, which most of us use, a 15 mm is a 125% larger beam diameter, so it’s a big difference in treatment area.”

In an effort to investigate use of the new 15-mm VBeam Prima pulsed-dye laser from Syneron Candela for treating rosacea, Dr. Bernstein, director of the Main Line Center for Laser Surgery in Ardmore, Pa., and his associates enrolled 20 patients with erythematotelangiectatic rosacea to receive four treatments every four weeks. Linear vessels were treated with a 3-mm by 10-mm elliptical beam with a 40-millisecond pulse duration, while diffuse redness was treated with a 15-mm circular beam with a 3-millisecond pulse duration. Cryogen spray cooling was used for comfort and epidermal protection.

Blinded assessment of digital and cross-polarized images taken 8 weeks following the last treatment was performed using an 11-point clearance scale. The Investigator Global Assessment Scale was used to evaluate inflammatory lesions, erythema, and telangiectasia, and safety was assessed by incidence and severity of side effects. The investigators and subjects assessed satisfaction with the treatment outcome on a 5-point Likert scale (–2, very dissatisfied; –1, dissatisfied; 0, no opinion; 1, satisfied; and 2, very satisfied). Dr. Bernstein also evaluated the patients for purpura, petechiae, edema, erythema, blistering, and crusting on a 0-3 point scale (0, absent; 1, mild; 2, moderate; and 3, severe).

Of the 20 subjects, 16 females and 3 males completed the study. All had Fitzpatrick skin types II-IV and 17 of 19 subjects received four treatments, while 2 received three treatments because of scheduling challenges. Between baseline and 8 weeks following the last treatment, mean Investigator Global Assessment scores improved significantly for overall score (from 4.3 to 1.8; P less than .0001), as well as for inflammatory lesions (from 1.7 to 1.0; P less than .005), erythema (from 4.5 to 1.6; P less than .0001), and for telangiectasia (from 4.2 to 1.1; P less than .0001).

Dr. Bernstein also reported that blinded evaluators correctly identified baseline images in 55 of 57 image pairs (96.5%), while the average score improvement in their rosacea was 52.5%, and ranged from 30.0% to 86.7%. In addition, 17 of 19 subjects (89%) showed a score improvement of more than 40%, while 57% of subjects had a score improvement of greater than 50%.

Patients and investigators both recorded a mean satisfaction score of 1.9, and 18 of 19 subjects reported being “very satisfied” with the treatment.

 

The average pain score was 5.6 on a 0-10 scale, while common side effects that resolved within 1-3 days without intervention included mild edema, mild to moderate erythema, and mild to moderate bruising. No cases of hyperpigmentation, hypopigmentation, blistering, or scarring occurred.

“The newly designed pulsed-dye laser is a major change in a device that has performed for over 10 years with wide acceptance,” Dr. Bernstein said. In addition to a longer-lasting dye kit, he said that new features include 50% more total energy enabling clinically relevant fluences to be delivered using a 15-mm diameter treatment beam, once-daily calibration instead of after every energy or spot size change, “both contact and dynamic spray cooling, and an Nd:YAG wavelength for treating larger vessels.”

Dr. Bernstein reported having received grant funding from Syneron Candela and Zeltiq. He also has received consulting fees from and holds ownership interest in Syneron Candela, and has served on the advisory board for Novoxel, Solta, Syneron Candela, and Zeltiq.

dbrunk@mdedge.com