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Topical brimonidine reduces IPL-induced erythema without affecting efficacy: A randomized controlled trial in patients with facial telangiectasias.
Lasers Surg Med. 2018 12; 50(10):1002-1009.LS

Abstract

BACKGROUND

Laser and intense pulsed light (IPL) are standard symptomatic treatments for superficial telangiectasias, but postoperative erythema, oedema, and pain may prolong downtime.

OBJECTIVES

To investigate whether topical brimonidine reduces IPL-induced inflammation in patients with moderate to severe facial telangiectasias.

METHODS

A randomized, two-centre, single-blinded, split-face trial on adjuvant brimonidine and air-cooling versus air-cooling alone (control) in 19 patients treated in Denmark (n = 10 patients) and Belgium (n = 9). Brimonidine was applied to the allocated side after each of three facial IPL-treatments, given at 3-week intervals. Patients were assessed up to 1 month after the final treatment. Outcome measures included blinded clinical on-site evaluation of erythema and oedema (5-point-scales), objective erythema-scores (red-filter analysis), patient-evaluated pain (Visual Analogue Scale), IPL-efficacy (blinded photo-evaluation of telangiectasia clearance), and patient preference.

RESULTS

In total, 19 patients were enrolled and completed the study. IPL induced moderate to severe erythema after each treatment. Application of brimonidine, reduced erythema to baseline values compared to air-cooling alone and sustained efficacy 24 hours after treatment (median difference reduction: score 1 at each assessment, P ≤ 0.022). Objective erythema-scores supported clinical findings, demonstrating a median erythema reduction of 50-95% after application of brimonidine and air-cooling compared to 9-28% reduction after air-cooling alone (P ≥ 0.002). No difference in reduction of IPL-induced oedema was observed between facial sides (P ≥ 0.227). Brimonidine and air-cooling slightly and consistently reduced postoperative pain compared to air-cooling alone (VAS 1.0 after brimonidine versus VAS 1.5-2.0 after air-cooling alone at treatment 1-3, P ≤ 0.032). At 1-month follow-up, patients experienced excellent clearance of telangiectasias (75-100% clearance) on both facial sides (P = 1.000). Patient preference supported clinical data and 79% of patients preferred brimonidine to control (P = 0.019).

CONCLUSION

Compared to air-cooling alone, adjuvant brimonidine reduces IPL-induced erythema and associated pain while maintaining a high IPL-efficacy. Lasers Surg. Med. 50:1002-1009, 2018. © 2018 Wiley Periodicals, Inc.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Vissing AE
Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
Dierickx C
Skinperium Clinic, Boom, Beukenlaan 52, 2850, Belgium.
Karmisholt KE
Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
Haedersdal M
Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.

MeSH

Administration, TopicalAdrenergic alpha-2 Receptor AgonistsBrimonidine TartrateEdemaErythemaFaceFemaleHumansLaser TherapyMaleMiddle AgedPostoperative ComplicationsSingle-Blind MethodTelangiectasisTreatment Outcome

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29911352

Citation

Vissing, Anne-Cathrine E., et al. "Topical Brimonidine Reduces IPL-induced Erythema Without Affecting Efficacy: a Randomized Controlled Trial in Patients With Facial Telangiectasias." Lasers in Surgery and Medicine, vol. 50, no. 10, 2018, pp. 1002-1009.
Vissing AE, Dierickx C, Karmisholt KE, et al. Topical brimonidine reduces IPL-induced erythema without affecting efficacy: A randomized controlled trial in patients with facial telangiectasias. Lasers Surg Med. 2018;50(10):1002-1009.
Vissing, A. E., Dierickx, C., Karmisholt, K. E., & Haedersdal, M. (2018). Topical brimonidine reduces IPL-induced erythema without affecting efficacy: A randomized controlled trial in patients with facial telangiectasias. Lasers in Surgery and Medicine, 50(10), 1002-1009. https://doi.org/10.1002/lsm.22953
Vissing AE, et al. Topical Brimonidine Reduces IPL-induced Erythema Without Affecting Efficacy: a Randomized Controlled Trial in Patients With Facial Telangiectasias. Lasers Surg Med. 2018;50(10):1002-1009. PubMed PMID: 29911352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Topical brimonidine reduces IPL-induced erythema without affecting efficacy: A randomized controlled trial in patients with facial telangiectasias. AU - Vissing,Anne-Cathrine E, AU - Dierickx,Christine, AU - Karmisholt,Katrine E, AU - Haedersdal,Merete, Y1 - 2018/06/17/ PY - 2018/06/04/accepted PY - 2018/6/19/pubmed PY - 2019/9/7/medline PY - 2018/6/19/entrez KW - oedema KW - redness KW - rosacea KW - satisfaction KW - side effects KW - vascular lesions SP - 1002 EP - 1009 JF - Lasers in surgery and medicine JO - Lasers Surg Med VL - 50 IS - 10 N2 - BACKGROUND: Laser and intense pulsed light (IPL) are standard symptomatic treatments for superficial telangiectasias, but postoperative erythema, oedema, and pain may prolong downtime. OBJECTIVES: To investigate whether topical brimonidine reduces IPL-induced inflammation in patients with moderate to severe facial telangiectasias. METHODS: A randomized, two-centre, single-blinded, split-face trial on adjuvant brimonidine and air-cooling versus air-cooling alone (control) in 19 patients treated in Denmark (n = 10 patients) and Belgium (n = 9). Brimonidine was applied to the allocated side after each of three facial IPL-treatments, given at 3-week intervals. Patients were assessed up to 1 month after the final treatment. Outcome measures included blinded clinical on-site evaluation of erythema and oedema (5-point-scales), objective erythema-scores (red-filter analysis), patient-evaluated pain (Visual Analogue Scale), IPL-efficacy (blinded photo-evaluation of telangiectasia clearance), and patient preference. RESULTS: In total, 19 patients were enrolled and completed the study. IPL induced moderate to severe erythema after each treatment. Application of brimonidine, reduced erythema to baseline values compared to air-cooling alone and sustained efficacy 24 hours after treatment (median difference reduction: score 1 at each assessment, P ≤ 0.022). Objective erythema-scores supported clinical findings, demonstrating a median erythema reduction of 50-95% after application of brimonidine and air-cooling compared to 9-28% reduction after air-cooling alone (P ≥ 0.002). No difference in reduction of IPL-induced oedema was observed between facial sides (P ≥ 0.227). Brimonidine and air-cooling slightly and consistently reduced postoperative pain compared to air-cooling alone (VAS 1.0 after brimonidine versus VAS 1.5-2.0 after air-cooling alone at treatment 1-3, P ≤ 0.032). At 1-month follow-up, patients experienced excellent clearance of telangiectasias (75-100% clearance) on both facial sides (P = 1.000). Patient preference supported clinical data and 79% of patients preferred brimonidine to control (P = 0.019). CONCLUSION: Compared to air-cooling alone, adjuvant brimonidine reduces IPL-induced erythema and associated pain while maintaining a high IPL-efficacy. Lasers Surg. Med. 50:1002-1009, 2018. © 2018 Wiley Periodicals, Inc. SN - 1096-9101 UR - https://www.unboundmedicine.com/medline/citation/29911352/Topical_brimonidine_reduces_IPL_induced_erythema_without_affecting_efficacy:_A_randomized_controlled_trial_in_patients_with_facial_telangiectasias_ DB - PRIME DP - Unbound Medicine ER -