Clinical Studies On The Treatment Of Facial Telangiectasia By Pulsed Dye Laser And Intense Pulsed Light

Part Ⅰ Clinical study on the treatment of facial telangiectasia by pulsed dye laser and intense pulsed light of different typesObjcetive: To investigate the efficacy and safety differences between subpurpura dose pulsed dye laser and intense pulsed light of different types in the treatment of facial telangiectasia with Fitzpatrick Ⅲ-Ⅴ skin types.Methods: A prospective randomized controlled study of 42 patients with facial telangiectasias,who were treated with pulsed dye laser and intense pulsed light on both cheeks,will receive three consecutive treatments with an interval of 4 weeks.Among them,the intense pulsed light is further divided into three subgroups,which receive the treatment of narrow-spectrum intense pulsed light(DPL),dual-band intense pulsed light(MaxG)or optimal intense pulsed light(AOPT).The efficacy was evaluated by photos of patients before treatment and at each return visit(4th,8th,12 th,20th,and 32 nd weeks after enrollment).The patient satisfaction,the degree of pain during treatment and the occurrence of adverse reactions after treatment were recorded through follow-up.Repeated measures analysis of variance was used to evaluate the efficacy of each instrument within and between groups;the non-parametric rank sum test was used to compare patients’ satisfaction;the t test was used to analyze the difference of pain degrees.Results: Among the 42 patients,only 1 patient had no improvement,the effective rate was 97.62% after 3 PDL treatments,and 71.43% achieved ≥50% clearance;in 24 weeks after 3 treatments,61.90% achieved ≥50% clearance.In the DPL treatment subgroup,all patients showed improvement,69.23% achieved ≥50% clearance after 3 treatments;their TGS score,patient satisfaction and pain score were not statistically different from the PDL treatment group.In the MaxG treatment subgroup,the effective rate after 3 treatments was 92.86%,50.00% achieved ≥50% clearance;their TGS score and patient satisfaction were not statistically different from the PDL,while pain score was significantly higher than PDL(P = 0.018).In the AOPT treatment subgroup,all patients showed improvement,73.33% achieved ≥ 50% clearance after 3 treatments;their TGS score was significantly lower than PDL(P<0.05),while patient satisfaction and pain score were no statistical difference with PDL.Conclusion: Facial telangiectasia with Fitzpatrick III-V skin types was treated by subpurpura dose PDL safely and effectively,and long-term efficacy is stable.Among them,DPL are equivalent to PDL in the treatment;MaxG is equivalent to PDL in the treatment efficacy,but the pain degrees are significantly higher than PDL;the treatment efficacy of AOPT is weaker than PDL,but the pain degrees are similar.Part Ⅱ Efficacy analysis of intense pulsed light for treating facial telangiectasiaObjcetive: To investigate the association between clinical factors and the efficacy of intense pulsed light in the treatment of facial telangiectasia patients,and to analyze related factors influencing the efficacy.Methods: We enrolled 406 facial telangiectasia patients who consecutively received the therapy of dual-band spectral intense pulsed light,and retrospectively analyzed the clinical dates and efficacy by photos before and 4~8 weeks after treatment.Rank sum test was used to evaluate the difference between clinical dates and patients with different response,and multivariable ordinal logistic regression analysis to identify the influencing factors of different therapeutic effects.Results: Among the 406 patients,9 patients had no improvement,298 achieved ≥25% clearance,and the effective rate was 73.40%.There was a positive linear correlation between the treatment session and(G=0.154,P=0.001),whereas the treatment interval was negatively correlated with the efficacy(G=-0.108,P=0.018).When a slight curative effect is obtained,there are significant differences in primary diseases and treatment sessions(P=0.006);among them,there is a significant difference in the number of treatments required for facial telangiectasia and acne(P=0.009).In patients with acne and facial telangiectasia,there are significant differences of vascular clearance rate in the different group of treatment sessions(P<0.05).Multivariate ordinal logistic regression analysis found that the efficacy of patients with acne and rosacea is better than that of primary telangiectasia patients;patients with 4 consecutive treatment sessions and above is better than 1 treatment;treatment interval ≤4 weeks is better than > 6 weeks(P<0.05).Conclusion: The treatment frequency and primary disease may influence the treatment efficacy.In the study,patients who received the more treatment sessions and the shorter treatment intervals would achieve the better effect,especially received 4 or more consecutive treatments and each treatment interval ≤4 weeks.Compared with acne and rosacea,patients with primary telangiectasia need continuous treatment to obtain a similar degree of improvement.