Many well-documented factors result in vascular dilatation, damage, and subsequent alterations to the connective tissues in a context of increased activity of reactive oxygen radicals. A chronic inflammatory reaction – with it’s accompanying flood of inflammatory cells and inflammatory mediators – then leads to the rosacea phenotype: erythema, papules, and pustules. Involvement of the lymphatic system results in edema. Enduring erythema characterizes the first stage of rosacea with telangiectasia of different severity.

The 1064 nm wavelength has been long used for various vascular treatments from port wine stains to a variety of vascular ectasia and pigment applications. Long pulse Nd:YAG lasers (5-60 msec) has given us the opportunity to extend the application of this wavelength to the removal of fine telangiectasia connected with rosacea. The deep penetration depth of the Nd: YAG wavelength combined with the pulse duration matching the thermal relaxation time of targeted vessels, could potentially allow the treatment of these vessels.