Treatment of Erythematotelangiectatic Rosacea With Pulsed-Dye Laser and Oxymetazoline 1.0% Cream: A Retrospective Study.


Journal

Lasers in surgery and medicine
ISSN: 1096-9101
Titre abrégé: Lasers Surg Med
Pays: United States
ID NLM: 8007168

Informations de publication

Date de publication:
01 2020
Historique:
accepted: 17 10 2019
pubmed: 12 11 2019
medline: 29 6 2021
entrez: 12 11 2019
Statut: ppublish

Résumé

Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce facial erythema and telangiectasias. Oxymetazoline 1.0% cream is an α adrenergic agonist, which has shown to reduce facial erythema. The aim of this study was to determine the degree of erythema improvement and telangiectasia clearance after combination treatment with PDL plus oxymetazoline 1.0% cream. This retrospective study was conducted at two sites. Pre- and post-treatment cross-polarized images from subjects on combination treatment with PDL and oxymetazoline 1.0% cream were graded by a board-certified dermatologist at each practice. Blinded images were analyzed using the Clinical Erythema Assessment (CEA) Scale (0 = clear and 4 = severe). Unblinded images were analyzed using the five-point Telangiectasia Scale to determine the degree of improvement post-treatment compared with baseline (1 = <5% clearance and 5 = 75-100% clearance). Thirty-one subjects (20 females, 11 males) of age 51 ± 13 years (mean ± standard deviation) were included in the study after an average of 4 months (range: 1-13) of daily oxymetazoline 1.0% cream and two (range: 1-4) PDL treatments. At baseline, 87% of subjects had CEA Grade 2 (mild erythema) or higher. For erythema, 55% of subjects improved by at least one CEA grade and 13% achieved two grades of improvement post-treatment. For telangiectasias, 90% of subjects achieved at least a two-point clearance (5-25%), 62% at least a three-point clearance (25-50%), and 41% at least a four-point clearance (50-75%) post-treatment. Compared with subjects with baseline CEA Grade 1-2 (almost clear to mild erythema), significantly more subjects with baseline CEA Grade 3-4 (moderate to severe erythema) achieved at least one CEA grade of improvement (P = 0.021) and two grades of CEA improvement (P = 0.041). A higher percentage of baseline CEA Grade 3-4 subjects achieved at least a two-point clearance in telangiectasias (P = 0.055). Combination treatment with PDL and daily oxymetazoline 1.0% cream can safely and effectively reduce erythema and telangiectasias. Limitations include the retrospective design of the study, small sample size, and lack of a control group. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Sections du résumé

BACKGROUND AND OBJECTIVES
Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce facial erythema and telangiectasias. Oxymetazoline 1.0% cream is an α adrenergic agonist, which has shown to reduce facial erythema. The aim of this study was to determine the degree of erythema improvement and telangiectasia clearance after combination treatment with PDL plus oxymetazoline 1.0% cream.
STUDY DESIGN/MATERIALS AND METHODS
This retrospective study was conducted at two sites. Pre- and post-treatment cross-polarized images from subjects on combination treatment with PDL and oxymetazoline 1.0% cream were graded by a board-certified dermatologist at each practice. Blinded images were analyzed using the Clinical Erythema Assessment (CEA) Scale (0 = clear and 4 = severe). Unblinded images were analyzed using the five-point Telangiectasia Scale to determine the degree of improvement post-treatment compared with baseline (1 = <5% clearance and 5 = 75-100% clearance).
RESULTS
Thirty-one subjects (20 females, 11 males) of age 51 ± 13 years (mean ± standard deviation) were included in the study after an average of 4 months (range: 1-13) of daily oxymetazoline 1.0% cream and two (range: 1-4) PDL treatments. At baseline, 87% of subjects had CEA Grade 2 (mild erythema) or higher. For erythema, 55% of subjects improved by at least one CEA grade and 13% achieved two grades of improvement post-treatment. For telangiectasias, 90% of subjects achieved at least a two-point clearance (5-25%), 62% at least a three-point clearance (25-50%), and 41% at least a four-point clearance (50-75%) post-treatment. Compared with subjects with baseline CEA Grade 1-2 (almost clear to mild erythema), significantly more subjects with baseline CEA Grade 3-4 (moderate to severe erythema) achieved at least one CEA grade of improvement (P = 0.021) and two grades of CEA improvement (P = 0.041). A higher percentage of baseline CEA Grade 3-4 subjects achieved at least a two-point clearance in telangiectasias (P = 0.055).
CONCLUSIONS
Combination treatment with PDL and daily oxymetazoline 1.0% cream can safely and effectively reduce erythema and telangiectasias. Limitations include the retrospective design of the study, small sample size, and lack of a control group. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Identifiants

pubmed: 31709571
doi: 10.1002/lsm.23176
doi:

Substances chimiques

Adrenergic alpha-Agonists 0
Oxymetazoline 8VLN5B44ZY

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

38-43

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Références

Wilkin J, Dahl M, Detmar M, et al. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol 2002;46(4):584-587.
Bernstein EF, Kligman A. Rosacea treatment using the new-generation high-energy, 595 nm, long pulse-duration pulsed-dye laser. Lasers Surg Med 2008;40(4):233-239.
Bernstein EF, Schomacker K, Paranjape A, Jones CJ. Pulsed dye laser treatment of rosacea using a novel 15 mm diameter treatment beam. Lasers Surg Med 2018;50(8):808-812.
Bulbul Baskan E, Akin Belli A. Evaluation of long-term efficacy, safety, and effect on life quality of pulsed dye laser in rosacea patients. J Cosmet Laser Ther 2018;24:1-5.
Draelos ZD, Gold MH, Weiss RA, et al. Efficacy and safety of oxymetazoline cream 1.0% for treatment of persistent facial erythema associated with rosacea: Findings from the 52-week open label REVEAL trial. J Am Acad Dermatol 2018;78(6):1156-1163.
DuBois J, Dover JS, Jones TM, et al. Phase 2 randomized, dose-ranging study of oxymetazoline cream for treatment of persistent facial erythema associated with rosacea. J Drugs Dermatol 2018;17(3):308-316.
Stein-Gold L, Kircik L, Draelos ZD, et al. Topical oxymetazoline cream 1.0% for persistent facial erythema associated with rosacea: pooled analysis of the two phase 3, 29-day, randomized, controlled REVEAL trials. J Drugs Dermatol 2018;17(11):1201-1208.
Tanghetti EA, Dover JS, Goldberg DJ, et al. Clinically relevant reduction in persistent facial erythema of rosacea on the first day of treatment with oxymetazoline cream 1.0%. J Drugs Dermatol 2018;17(6):621-626.
Baumann L, Goldberg DJ, Stein Gold L, et al. Pivotal trial of the efficacy and safety of oxymetazoline cream 1.0% for the treatment of persistent facial erythema associated with rosacea: Findings from the second REVEAL trial. J Drugs Dermatol 2018;17(3):290-298.
Hoover RM, Erramousepe J. Role of topical oxymetazoline for management of erythematotelangiectatic rosacea. Ann Pharmacother 2018;52(3):263-267.
Ryan H, Woods D, Holmes J, McDaniel D. Pilot study shows optical coherence tomography aids clinical evaluation of oxymetazoline hydrochloride as effective treatment for rosacea. ASLMS 2017. San Diego, CA.
Tan J, Liu H, Leyden JJ, et al. Reliability of Clinician Erythema Assessment grading scale. J Am Acad Dermatol 2014;71(4):760-763.
Friedman PM, Tolkachjov SN, Geddes ER, et al. TRASER: An innovative device for the treatment of nasal telangiectasias. Lasers Surg Med 2017;49:625-631.
Geddes-Bruce E, Hamill SS, Zachary CB, Friedman PM. One-year follow-up of a TRASER clinical trial for the treatment of nasal telangiectasias. Lasers Surg Med 2018;50:61-63.
Kelly A, Lertsakdadet B, Choi B, Kelly KM. Preclinical in vivo evaluation of vascular effects of pulsed dye laser in combination with oxymetazoline (abstract). Denver, CO: ASLMS; 2019.
Kusari J, Padillo E, Zhou SX, et al. Effect of brimonidine on retinal and choroidal neovascularization in a mouse model of retinopathy of prematurity and laser-treated rats. Invest Ophthalmol Vis Sci 2011;52(8):5424-5431.
Vissing AE, Dierickx C, Karmisholt KE, Haedersdal M. Topical brimonidine reduces IPL-induced erythema without affecting efficacy: A randomized controlled trial in patients with facial telangiectasias. Lasers Surg Med 2018;50(10):1002-1009.
Zeichner JA, Eichenfield LF, Feldman SR, Kasteler JS, Ferrusi IL. Quality of life in individuals with erythrotelangiectatic and papulopustular rosacea: Findings from a web-based survey. J Clin Aesthet Dermatol 2018;11(2):47-52.
Haber R, El Gemayel M. Comorbidities in rosacea: A systemic review and update. J Am Acad Dermatol 2018;78(4):786-792.
Strand M, Bergqvist G, Griffith S, Bergqvist E. The effect of recurrent pulsed dye laser treatments in rosacea patients. J Cosmet Laser Ther 2017;19(3):160-164.
Biesman BS. Evaluation of a novel topical agent in conjunction with long pulsed 532nm laser for the treatment of facial erythema associated with erythrotelangiectatic rosacea. Denver, CO: ASLMS; 2019.

Auteurs

Amanda K Suggs (AK)

Dermatology & Laser Surgery Center, 6400 Fannin St Suite 2720, Houston, Texas, 77030.

Angela Macri (A)

Dermatology, Laser & Vein Specialists of the Carolinas, 1918 Randolph Rd #550, Charlotte, North Carolina, 28207.

Heather Richmond (H)

Dermatology & Laser Surgery Center, 6400 Fannin St Suite 2720, Houston, Texas, 77030.

Gilly Munavalli (G)

Dermatology, Laser & Vein Specialists of the Carolinas, 1918 Randolph Rd #550, Charlotte, North Carolina, 28207.

Paul M Friedman (PM)

Dermatology & Laser Surgery Center, 6400 Fannin St Suite 2720, Houston, Texas, 77030.

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