Surgical Intervention
Surgical/Laser and Light Therapy
- Telangiectasias are best treated with light-based and laser therapies
- Laser and light-based therapies are also used to manage facial erythema secondary to rosacea
- Indicated in patients with clinically noninflamed phyma
- Some reports show that moderate to severe rhinophyma respond well initially to surgical excision, electrocautery, cryosurgery or carbon dioxide-laser therapy
- Side effects: Temporary bruising, redness, swelling, darker or lighter spots on the skin and scarring
- Pulsed Dye Laser (PDL)
- Targets the visible blood vessels and reduces flushing and erythema
- Considered as one of the 1st-line modalities in patients with persistent erythema
- Indicated in patients with telangiectasia
- Improvement is not permanent and may cause some temporary bruising
- Intense Pulsed Light Therapy (IPL)
- Preferred for larger areas of diffuse redness and may improve flushing
- Considered as one of the 1st-line modalities in patients with persistent erythema
- Indicated in patients with telangiectasia
- A field effect is suggested by the improvement of ocular rosacea when IPL is used to treat cutaneous rosacea
- Potassium-titanyl Phosphate Laser (KTP)
- Ideally used for linear, arborizing and discrete telangiectasia; may also improve flushing
- Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) Laser
- Efficacy found in the treatment of large deep vessels with blue tones
- Used in the treatment of facial telangiectasia
- Erbium Laser and Fractional Photothermolysis
- Used to smoothen the nose in rhinophyma without significant removal of the top layer of skin
- Dermabrasion
- Surgical resurfacing technique to remove thickened skin
- Electrocautery
- The top layers of excess skin are scraped off using the hot tip of an electrode