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Laser et lampe pulsée rosacée

Laser and Pulsed Light: Alternatives Against Rosacea?

Rosacea is a chronic skin disease that causes redness, itching, or even papules. It is essential to manage it as early as possible to prevent its worsening. Several treatments exist to alleviate rosacea, among which are laser and pulsed light therapy. What is the principle of these techniques? Are they truly effective? We delve into these questions.

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What is the difference between laser and pulsed light?

Laser and pulsed light are two aesthetic dermatology methods with a mode of operation quite similar. Indeed, both are based on the principle of selective photothermolysis, which specifically targets dilated blood vessels responsible for the redness associated with rosacea. The difference lies in the type of light emitted : monochromatic for the laser and polychromatic for pulsed light.

From a technical standpoint, the laser uses a single type of wavelength, which allows it to selectively target dilated blood vessels without damaging the surrounding tissues. On the other hand, pulsed light emits a range of wavelengths between 500 and 1200 nm, which can lead to less specific absorption and adverse effects on the surrounding tissues. That's why the laser is generally preferred. Moreover, the laser can be used on all phototypes unlike pulsed light, which is only recommended for people with very fair to slightly tanned skin.

Note : Laser and pulsed light sessions are not recommended for pregnant women. The data regarding the effect of these techniques on fetal development is limited, which is why caution is advised. Furthermore, during pregnancy, women are more prone to pigmentation disorders (and the infamous pregnancy mask) due to the hormonal changes they experience. To avoid them, it is better to avoid laser and pulsed light sessions.

Using laser and pulsed light to reduce rosacea: good or bad idea?

Rosacea is a dermatosis that is a chronic and rather complex condition. The initial clinical signs of rosacea include the emergence of a widespread redness, typically in the center of the face, accompanied by tingling, hot flashes, and increased skin sensitivity. These symptoms are the result of the dilation of blood vessels on the skin's surface, also known as telangiectasias. The origins of rosacea are still not fully understood, but genetics, stress, heat, or even the consumption of spicy foods could play a role. This disease can worsen over time without appropriate management and can cause a skin rash or affect the eyes. That's why it's very important to consult a dermatologist at the first signs.

It is possible to improve rosacea, which corresponds to the first stage of rosacea, and to reduce redness with sessions of laser or pulsed light therapy. Painless and quick, several studies have demonstrated the effectiveness of these techniques in reducing symptoms and spacing out flare-ups. However, it is important to emphasize that a laser or pulsed light intervention does not guarantee a permanent cure and that a recurrence remains possible. The choice of laser used to manage rosacea depends on the diameter of the vessels and the size of the area concerned. It often proves useful to combine several devices during the same session. Furthermore, 2 to 6 sessions depending on the extent of the rosacea are necessary. The table below summarizes the main lasers used to treat rosacea.

LaserWavelengthUsage
KTPShort (532 nm)In the event of significant red telangiectasias, ranging in size from 1.2 to 10 mm
Pulsed DyeShort (595 nm)In the event of red telangiectasias, ranging from small to medium size
AlexandriteLarge (755 nm)In the event of deep, blue telangiectasias
DiodeLarge (800 nm)In the event of deep, blue telangiectasias
Nd-YagLarge (1064 nm)In the event of violet or bluish telangiectasias

Laser or Intense Pulsed Light sessions: precautions to be taken.

A session of laser or pulsed light treatment is not trivial and it is important to follow certain precautions before, during, and after the treatment.

  • How to prepare for a laser or pulsed light session?

    Before undergoing a laser or pulsed light session, it is crucial that the patient does not take any photosensitizing medication, meaning drugs that increase the skin's sensitivity to light. Indeed, certain antibiotics or anti-inflammatory drugs have this property and can heighten the risk of burns or hyperpigmentation during the session. Furthermore, it is advised not to expose oneself to the sun two weeks prior to the appointment.

  • What precautions should be taken during a laser or pulsed light session?

    During a laser or pulsed light session, it is essential to protect the patient's eyes. This is especially true if the redness to be treated is located on the face. Indeed, the rays from the laser or pulsed light can cause severe and irreversible damage to the cornea, retina, lens, and other ocular tissues. That's why protective pads or glasses are always provided to the patient. Furthermore, it is recommended that the patient does not wear makeup, in order not to decrease the effectiveness of the laser or pulsed light treatment.

  • What to do after a laser or pulsed light session?

    Following a session of laser or pulsed light treatment, the skin tends to be more sensitive and vulnerable. It is therefore important to hydrate and nourish it daily with a suitable skincare product. Opt for rich textures with humectants such as glycerin, aloe vera, or panthenol, and ensure that the cream is non-comedogenic, meaning it is not likely to cause the appearance of comedones. Finally, in the month following the laser or pulsed light session, it is necessary for the patient to avoid sun exposure and to protect their skin with a sun care product of SPF 50 during sunny periods.

Sources

  • SAURAT J.H., LIPSKER D., THOMAS L., BORRADORI L., LACHAPELLE J.M. Dermatology and Sexually Transmitted Infections. Elsevier Masson (2017).

  • STEINHOFF M. & al. Recent advances in understanding and managing rosacea. F1000 Research (2018).

  • TAN J. & al. Rosacea: New Concepts in Classification and Treatment. American Journal of Clinical Dermatology (2021).

  • ALI F. & et al. Rosacea. British Journal of Hospital Medicine.(2021).

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