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Combining laser and light-based treatments for rosacea have a synergistic effect, and the combination works better than each does separately, an expert says.
Frequently, dermatologists now use pulsed-dye lasers (PDLs) or intense pulsed-light (IPLs) sources to treat rosacea, a common disease of unknown pathogenesis that often has a chronic intermittent course despite current treatment.
"Recently, we have started to look at trying to do something new that decreases the inflammation of rosacea in a totally different way. We have begun to combine the light-emitting diode (LED) devices - which have a totally different mechanism - with either PDL or IPL to optimize outcomes for treatment of rosacea," says Dr. Goldberg, also clinical professor of dermatology and director of laser research, Mount Sinai School of Medicine, New York.
"We have completed a six-month, 20-subject study looking at one side of the face treated with IPL and the other side treated with both IPL and 20 minutes of continuous-wave, 633 nm, red LED energy. The results were clearly better on the combined treatment side.
"These studies show this combination therapy has a synergistic effect which is even better," he says.
The process includes adding the use of the red LED lights to treatment, Dr. Goldberg says.
"There are other LED lights, such as yellow, but I deal with red because of its anti-inflammatory effect. Red and near-infrared LEDs have a major impact on many cells that cause inflammation.
"For this reason, red LED is often used for more inflamed rosacea, and a combination of red and near-infrared for inflammation and swelling," Dr. Goldberg tells Dermatology Times.
For example, some rosacea symptoms, such as flushing, burning and swelling, are treated with red LED, generally in combination with IPL (or laser) treatments. The IPL decreases erythema and decreases the number of vessels in the skin and, thus, the flushing of the skin.
"The effect of IPL and LED appears to be additive and, therefore, the combination works better than each one separately," he says.
The LED treatment is usually provided in a series of five to seven treatments, about two to four weeks apart.
"The treatments generally take about 20 minutes, and it is totally painless and nonthermal," Dr. Goldberg says. "Then, some people will come back once every six months for a follow-up treatment."
According to Dr. Goldberg, LED is very safe and can be used in all skin types, including ethnic skin. He says the addition of the LED laser has added benefits to the overall rosacea treatment.
These treatments also can be used along with medical therapy.
Disclosure: Dr. Goldberg reports no relevant financial disclosures.