Successful treatment of erythematotelangiectatic rosacea with pulsed light and radiofrequency

Many laser and light devices have reported to be successful in the treatment of the flushing, background erythema, and telangiectasias that characterize erythematotelangiectatic rosacea including pulsed dye laser, potassium titanyl phosphate, intense pulsed light, and dual-wavelength lasers. A technology called ELOS (electro-optical synergy) combines pulsed light or laser with bipolar radiofrequency. This combination, developed in 2000, was based on the premise that these two forms of energy could be synergistic. One such device (Aurora SRA-skin-rejuvenation advanced handpiece, Syneron Medical Ltd., Yokneam, Israel) has a light spectrum of 470 to 980nm, energy up to 45J/cm(2), and a range of radiofrequency energy of 5 to 25J/cm(3) and is indicated for the treatment of vascular and pigmented lesions.

We attempted to quantify the improvement of moderate-to-severe type-1 rosacea after three and five full-face treatments with this modality. Twenty-one patients with moderate-to-severe rosacea underwent five monthly full-face treatments with this device. The patients were evaluated with high-resolution photographs (Canfield Visia CR, Canfield, Fairfield, New Jersey) and self-evaluated via the National Rosacea Society's official "Scorecard."

Erythema and telangiectasia (physician assessed) as well as flushing and global status (patient assessed) achieved improvement that was statistically significant. Five treatments were no more effective than three, although the photographs reveal subtle improvements. There were no significant adverse events.

The results of this study suggest that the combination of optical and RF energies is effective for the treatment of rosacea. ELOS, as well as other vascular-focused lasers and light sources, provides an important treatment option for patients who fail medical therapy, reach a plateau in their response to medical therapy, or wish to avoid chronic oral therapy.