A dermatological disease affecting the blood capillaries, rosacea is relatively widespread. Although it is a mild form of rosacea, it still causes several sensations of discomfort and can greatly affect the quality of life of those affected. Discover here the existing treatments against rosacea.
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What are the available treatments for rosacea?
Summary
- Rosacea: What are the available medicinal treatments?
- A closer look at laser treatments for rosacea
- Sources
Published October 10, 2024,
updated on October 10, 2024,
by
Marie, Scientific Editor
—
6 min read
Rosacea: What are the available medicinal treatments?
The first form of rosacea, couperose is characterized by diffuse and widespread redness on the face caused by a significant dilation of the blood vessels in this area. The redness can also be accompanied by increased skin sensitivity and hot flashes. The causes of couperose are numerous: they can notably include a genetic predisposition, exposure to heat and sun, stress, spicy food, and parasitic colonization. The prevalence of couperose is about 15% in women and 5% in men.
Rosacea is a chronic disease. The available treatments can only help to manage the symptoms.
One of the primary medications prescribed for rosacea is brimonidine. Brimonidine causes a constriction of the blood vessels, which are dilated in cases of rosacea, thus allowing a reduction in redness in about half an hour. From a mechanistic perspective, it triggers a stimulation of post-synaptic α-2 adrenergic receptors belonging to the sympathetic nervous system and involved in the processes of vasoconstriction/vasodilation. However, like any medication, the application of brimonidine can sometimes lead to side effects such as burning sensations or itching.
There are alternatives in the event that brimonidine, prescribed as a first-line treatment, proves not to be effective enough or when it is poorly tolerated. Creams based on metronidazole or azelaic acid, molecules known for their anti-inflammatory and antibacterial actions, can be recommended as a second-line treatment. However, like brimonidine, these medications can only temporarily alleviate the symptoms of rosacea and are not capable of completely curing the dermatosis.
A closer look at laser treatments for rosacea.
The use of laser treatments in the context of rosacea can help todiminish redness and the visibility of telangiectasias while reducing the risk of disease recurrence. There are several types of lasers that can treat rosacea, which can sometimes be used in conjunction. However, maintenance sessions are necessary at regular intervals to maintain the results obtained.
It's important to know that laser treatments are not covered by Health Insurance, as they are considered to be performed for aesthetic purposes.
Treating Rosacea: The Benefits of Nd-YAG Laser.
The Nd-YAG laser is among the more recent discoveries in the treatment of rosacea. It is capable of emitting light at a specific wavelength of 1064 nm. This laser utilizes the principle of thermocoagulation. A current is applied at the level of the blood vessels, producing intense heat that causes the blood within the vessels to coagulate. Given the blue color that blood vessels can present, they are particularly receptive to the Nd-YAG laser, whose wavelength absorbs this color and penetrates deeply into the dermis. The Nd-YAG laser generally requires two to four sessions to achieve optimal results. It is especially beneficial for vessels with a significant diameter.
How does the KTP laser work in the case of rosacea?
The KTP laser is a part of a subclass of YAG lasers often used in the treatment of rosacea. Its light emits a wavelength of 532 nm and its beam is green in color. The rays of the KTP laser tend to be absorbed less deeply due to their shorter wavelength compared to that of the Nd-YAG laser. This is why the KTP laser is more suitable for treating small superficial vessels.
Unlike the Nd-YAG laser, the KTP laser utilizes the principle of photocoagulation. It operates by selectively targeting pigments. Most of the time, it targets hemoglobin, which is present in the blood. The KTP laser thus induces the coagulation of vessels by sealing them: this is referred to as controlled coagulation. Generally, three to four sessions are required for an optimal result.
The effects of Pulsed Dye Laser on rosacea.
This type of laser is commonly used in the treatment of rosacea. It emits light pulses at a modifiable wavelength of 585 to 595 nm. The pulsed dye laser operates in two distinct modes: thermocoagulation and photothermolysis. Similar to the Nd-YAG laser, thermocoagulation requires three to four sessions for optimal effectiveness.
Photothermolysis, on the other hand, involves the bursting and destruction of blood vessels through the application of light that transforms into intense heat. It is used for severe forms of rosacea as it is a fairly aggressive technique. Generally, one to two sessions are required. Photothermolysis can sometimes cause the appearance of purplish spots, which can persist for up to three weeks. The two modes used by pulsed dye lasers can be combined within a single session.
Laser sessions are preferably conducted in winter, during periods of low sunlight. Proper skin hydration is necessary, as is the daily application of sunscreen in the weeks following the sessions.
Sources
DAHAN S. Prise en charge par laser et lampes pulsées de la couperose et de la rosacée. Annales de Dermatologie (2011).
BELASCO K. & al. The role of brimonidine tartrate gel in the treatment of rosacea. Clinical, Cosmetic and Investigational Dermatology (2015).
KERROUCHE N. & al. Brimonidine gel 0.33% rapidly improves patient-reported outcomes by controlling facial erythema of rosacea: a randomized, double-blind, vehicle-controlled study. Journal of the European Academy of Dermatology and Venereology (2015).
SCHÄFER G. & al. Improving treatment of erythematotelangiectatic rosacea with laser and/or topical therapy through enhanced discrimination of its clinical features. Journal of Clinical and Aesthetic Dermatology (2016).
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