Long-Pulsed (6-ms) Pulsed Dye Laser Treatment of Rosacea-Associated Telangiectasia Using Subpurpuric Clinical Threshold

BACKGROUND: The pulsed dye laser (PDL), especially the 585-nm short-pulse width (450 micros) laser, has been extensively used in the treatment of facial telangiectasias. However, the resultant posttreatment purpura lasts for days and may not be cosmetically acceptable. OBJECTIVE: To examine the effect of long-pulsed (6 ms) PDL at subpurpuric clinical threshold in the treatment of rosacea-associated telangiectasia. METHODS: Twelve patients with rosacea-associated telangiectasia were recruited into the study. We used the 595-nm PDL at a pulse duration of 6 ms and titrated the fluence between 7 and 9 J/cm2 to produce immediate purpura lasting only a few seconds. Pretreatment cooling was achieved by cryogen spray. Assessment was made by comparing pretreatment and posttreatment photographs. Patients were evaluated 6 to 8 weeks after one PDL treatment. Results were reported as the percentage of reduction in the number of telangiectasias. Patients were asked for their own evaluation of improvement after treatment in terms of excellent, moderate, or poor outcome. Side effects such as pigmentary disturbance and scarring were also documented. RESULTS: Two of 12 patients had more than 75% improvement. Another two had 50% to 75% improvement, and five had 25% to 50% improvement. Overall, 9 (75%) of 12 patients had more than 25% improvement after a single treatment of PDL. None of the patients reported any lasting posttreatment purpura or complications. CONCLUSION: The long-pulsed 595-nm PDL using subpurpuric clinical threshold was effective for treatment of rosacea associated telangiectasia.