Hardware technologies in rosacea treatment

Rosacea is a chronic inflammatory disease with a recurrent course, clinically characterized by facial erythema, papulopustular elements and telangiectasia with the rash predominantly localized in the trigeminal nerve’s innervation zone. Genetic predisposition of patient to the disease development, impaired neurovascular regulation and inflammatory immune response activation play an important role in the rosacea pathogenesis. The cascade of inflammatory reactions mediated by toll-like receptors 2 (TLR2) is an important mechanism associated with increased sensitivity of patients to exogenous and endogenous trigger factors: ultraviolet radiation, high and low temperatures, spicy food and alcohol, emotional stress, etc. The main challenges in rosacea treatment are to relieve or reduce the disease’s symptoms severity, prolong the remission period and prevent relapses. Currently, a number of pharmacological and hardware methods of the rosacea treatment are used in clinical practice. Hardware therapy technologies deserve a special attention. A dermatovenerologist has several treatment methods at his arsenal with the use of physical factors: laser, photodynamic, cryo- and radiofrequency therapy. Laser technologies are successfully used as a treatment method in vascular disorders and phymatous lesions. In addition to targeted action on pathologically dilated vessels, laser therapy helps inhibit the release of inflammatory mediators and remodel the dermal structures of the skin. Photodynamic therapy with the use of drugs based on 5-aminolevulinic acid causes the activation of photochemical reactions contributing to a local coagulation of vessels and regeneration of tissues. Cryotherapy has been shown to be effective in treating patients with ocular rosacea. The inflammatory response was relieved and regeneration mechanisms were enhanced after cryotherapy of the eyelids.