Treatment of rhinophyma using a copper vapor laser

Abstract

Background.Rhinophyma is considered to be the most severe stage of rosacea, associated with the proliferation of the nose skin epithelium, hyperproduction of the sebaceous glands and telangiectasia.The treatment of rhinophyma remains a difficult task. One of the problems associated with rhinophyma is thickened and lumpy skin, penetrated with telangiectasias. The use of laser radiation in the treatment of rhinophyma seems to be promising, since this method allows blood vessels to be selectively heated.For the first time, we describe the treatment of rhinophyma using a copper vapour laser (CVL) equipped with a computerized scanner.Patient description.A 63-year-old male with Fitzpatrick skin type II was treated using an CVL (‘Yakhroma-med' model, RaS P. N. Lebedev Physical Institute). The clinical manifestations of the disease were typical of the phymatous or hypertrophic rhinophyma type, including significant thickening of the tissues and an uneven roughness of the skin surface. The treatment was carried out using a radiation wavelength of 578 nm, exposure duration of 0.2 s and energy exposure (fluence) of 15-30 J/cm2. Operational parameters used for the CVL in the scanner mode were the average power of 0.6-1.2 W and the focusing size of the light spot on the skin of 0.6 mm. The hexagonal mode of the scanning head was used with a maximum size of 12 mm and 1 mm distance between the centres of the laser spots. The treatment resulted in the restoration of the natural nose shape without redness. No side effects were noted.Conclusion:CVL radiation provided a selective photodisruption of the vessels with increased diameter.Due to the remodelling of the vasculature, the described method showed excellent results in the treatment of rhinophyma without side effects.