Shedding a light on couperose
Millions of people worldwide suffer from couperose, a skin disorder causing the small vessels in the face to permanently dilate and become visible. Patients with this condition often seek help from specialists in cosmetic medicine and laser treatment. Couperose is mostly found in adults with one or more of the following predisposing factors:
1) Hereditary fair complexion
2) Fair complexion associated with rosacea, a systemic disease, intake of oestrogen or either topical or systemic corticosteroids
3) Frequent exposure to the sun
4) Habitual smoker
5) Exposure to sudden temperature changes
6) Sensitive skin and frequent skin rashes
7) Stress or trauma
Laser is currently the treatment of choice for couperose, as it enables dilated blood vessels to be selectively targeted with pinpoint precision, leaving the surrounding skin intact.
Laser devices emit a coherent, monochromatic light in unidirectional, collimated (i.e. parallel) beams that are able to travel long distances. For laser beams to have effects on the body, their light needs to be absorbed by body tissue.
The selective photothermolysis theory
In 1983, Rox Anderson and John Parrish postulated the selective photothermolysis theory. The term is a compound word from the Greek “phós” (light), “thermós” (hot, heat) and “lýsis” (loosening, dissolution) and refers to the processes of light absorption by haemoglobin, the transformation of light into heat, and destruction of chromophores by means of heat.
Intravascular oxyhaemoglobin absorbs the energy from the laser and converts it into heat, causing the targeted blood vessel to shrink.
For optimal results, the practitioner must keep specific parameters under control, including wavelength, pulse duration, power output and spot diameter.
It is therefore essential to choose the right type of laser (e.g. KTP, NdYag or blue light laser) based on the type of capillaries to be treated. Nowadays, fast-evolving medical laser technology is providing us with increasingly sophisticated tools which, coupled with personalised therapies, are proving very effective in the treatment of couperose.
MD Rossana Lo Monaco, Specialist in plastic surgery