This paper is promoting the use of a pre-flush to improve the outcome of Pulse Dye Laser (PDL)Rosacea Treatments.
The authors suggest that by increasing the number of `target chromophores’ in a treatment area, one can expect an enhanced treatment effect with a greater number of blood vessels destroyed.
The area being treated is heated with a standard hair dryer 6 – 10 inches from the skin. The patient is encouraged to heat the skin themselves to minimise the risk of burning.
The PDL treatment is then undertaken straight away while the maximum amount of target cells are present in the target vessels.
The authors say that a split face example from their clinic resulted in a a `greater response’ in rosacea patients. It isn’t clear from the online extract how this greater response is quantified.
Does Pre-Flushing Really Help?
Dr. Soldo, one of the most experienced Rosacea IPL practitioners, is not a fan of pre-flushing before treatment. Dr. Soldo’s arguments against pre-flushing include wanting to avoid new vessel growth, the lower fluences you subsequently end up using and the fact that it isn’t needed for a successful outcome.
Only in specific cases where the patient does not present with flushing does Dr. Soldo advocate gentle pre-flushing.
Indeed there is an argument that you ought to have a regime to try to actually limit flushing between IPL treatments.
Abstract
Hair Dryer Use to Optimize Pulsed Dye Laser Treatment in Rosacea Patients
J Clin Aesthet Dermatol. 2012 June; 5(6): 41–44.
Lana Kashlan, MD, Emmy M. Graber, MD, and Kenneth A. Arndt, MD
Rosacea is a common chronic inflammatory condition characterized by erythema, telangiectasias, papules, and pustules.
While there are many effective treatment options for the papulopustular type, laser therapy remains the most effective modality to treat erythematotelangiectatic rosacea.
Erythema and flushing associated with rosacea remains an uncomfortable and socially embarrassing problem for patients.
Unfortunately, patients often do not have significant erythema or flushing when they present for laser treatment.
With this in mind, we propose a novel technique aimed at enhancing the response of rosacea patients being treated for erythema with pulsed dye laser. Specifically, we present a split-face example of our clinical observation that pre-treatment with forced heated air prior to pulsed-dye laser leads to a greater response in rosacea patients with erythema and flushing.
