Rosacea is a common skin disease characterized by transient flushing or persistent erythema and vasodilation symptoms on the face. In more severe cases, papules and pustules may appear in the central part of the face. Rosacea can be classified into four subtypes based on clinical manifestations: erythematotelangiectatic type, papulopustular type, rhinophyma type, and ocular rosacea type. Although the pathophysiology of rosacea is not fully understood, it has been found in previous studies that it is related to abnormal neurovascular and immune responses to various stimuli. Since rosacea is essentially chronic and recurrent, its treatment is difficult and usually requires lifelong management through lifestyle changes. The treatment methods vary depending on the severity and clinical subtype. Facial flushing and telangiectasia are common symptoms of rosacea, and they respond well to laser treatment with wavelengths that selectively absorb oxyhemoglobin, such as pulsed dye laser (PDL), intense pulsed light (IPL), and long-pulse Nd:YAG. Alexandrite laser is widely used for pigmented skin lesions and hair removal due to its absorption characteristics within the melanin spectrum. Recently, there has been increasing interest in using Alexandrite laser for treating vascular lesions, especially deeper ones, as it is relatively easily absorbed by deoxyhemoglobin and can penetrate deeper into the dermis than PDL. However, so far, there is little evidence regarding the effectiveness of Alexandrite laser in treating rosacea. In Kim et al.'s only available randomized clinical trial to date, the authors reported that the effect of dual-wavelength Alexandrite/Nd:YAG treatment for rosacea was comparable to that of PDL. The unique photothermal effect of the large-spot low-energy mode of 1064nm Q-switched Nd:YAG laser can enhance endogenous porphyrin activity, inhibit Propionibacterium acnes activity, penetrate deeper into the dermis to reach sebaceous glands, regulate sebum secretion, and promote inflammation absorption. Rosacea mainly presents as dilated capillaries and/or red patches, and this laser's wavelength is located in the peak absorption region of hemoglobin, which selectively absorbs oxyhemoglobin. According to the selective photothermal effect of light, it destroys capillaries and inhibits their formation, thereby promoting inflammation regression and achieving the purpose of preventing and treating post-inflammatory erythema after acne. In addition, its photothermal effect can also stimulate collagen regeneration, stimulate the rearrangement of collagen fibers and elastic fibers, repair the barrier, and reduce the formation of acne-induced depressed scars. DPL is a single narrow-band IPL device that combines the dual advantages of PDL and IPL. Its wavelength range is 500-600 nm, covering two absorption peaks of oxyhemoglobin including 542 nm and 577 nm, achieving higher energy concentration, higher vascular selectivity, and more precise treatment. This also makes it more precise and efficient in treating superficial vascular lesions. In this study, researchers conducted a randomized face-to-face comparison trial of large-spot low-energy 1064nm laser and DPL to explore their clinical efficacy and safety for rosacea and attempted to compare whether there are differences in clinical treatment between the two for rosacea. Participants were involved in the study to assess the outcomes.
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Timeframe: Baseline level, six weeks, twelve weeks