Neodymium-yttrium aluminum garnet laser versus pulsed dye laser in erythemato-telangiectatic rosacea: comparison of clinical efficacy and effect on cutaneous substance ( P) expression.

Background Different laser systems are reported to be effective in treatment of telangiectasia and erythema, but comparative studies on 1064-nm neodymium-yttrium aluminum garnet ( Nd- YAG) laser and pulsed dye laser ( PDL) in treatment of erythemato-telangiectatic rosacea are lacking. Substance ( P) is implicated in rosacea pathogenesis. Objectives To compare the effect of Nd- YAG laser and PDL on erythemato-telangiectatic rosacea, both clinically and immunohistochemically on cutaneous substance ( P) expression. Methods This split-face comparative study included 15 patients with erythemato-telangiectatic rosacea treated on the right side with Nd- YAG laser and on the left side with PDL: three sessions, 4 weeks apart. Evaluation of the patients was done using erythema and telangiectasia grading scores, patient's self-assessment, physicians' clinical assessment of the patient, and immunohistochemical assessment of substance ( P). Results One month after the three laser sessions, excellent response was achieved in 73.3% of patients after Nd- YAG and in 53.3% of patients after PDL with significantly lower substance ( P) concentration after Nd- YAG laser than after PDL. Positive correlations were found between the decrease in erythema and telangiectasia grading scores and the decrease in substance ( P) concentration. Conclusions The use of Nd- YAG laser and PDL appears to be safe and effective measures in treatment of erythemato-telangiectatic rosacea. Both types of laser decrease the concentration of substance ( P) in the skin. This effect is more pronounced with Nd- YAG laser. [ABSTRACT FROM AUTHOR]