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

Summary 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 ( N d‐ 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 N d‐ 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 N d‐ 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 N d‐ YAG and in 53.3% of patients after PDL with significantly lower substance ( P ) concentration after N d‐ 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 N d‐ 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 N d‐ YAG laser.