A study to determine the efficacy of intense pulse light in vascular mode for topical steroid damaged facies

Objectives: Misuse of topical corticosteroids on the face has gradually evolved over the years and has now reached phenomenal proportions on account of easy availability, widespread misinformation, and the fairness craze sweeping across the land. Topical steroid-damaged/dependent facies (TSDFs) may present with diffuse erythema, telangiectasia, papules, and atrophy. Current modalities used for the management of TSDF, such as topical tacrolimus and oral antibiotics, have shown a variable response. Intense pulsed light (IPL) systems are economical, have a higher safety margin, and are widely available. The goal of treating vascular lesions with IPL is to raise blood vessel temperature high enough to cause coagulation, leading to destruction and healing with fibrosis. In our study, we exploit these properties of IPL for the management of TSDF. Material and Methods: A total of 15 patients of TSDF were recruited and were treated with three sessions of IPL treatments (vascular mode) 3 weeks apart and were assessed based on a clinical score for TSDF, visual analog scale (VAS) for erythema assessed by the physician and patient at the end of 9 weeks. Results: There was a significant response with a reduction in clinical score of 5.4 points ( P > 0.001) and a reduction in physician and patient-assessed VAS for erythema of 3.47 and 3.73, respectively. Conclusion: There is a scarcity of data regarding the efficacy of various treatment modalities for TSDF. Our study establishes IPL (vascular mode) as an innovative emerging modality of treatment.