Multispectral Imaging and OCT-Guided Precision Treatment of Rhinophyma with CO2 and Dye Lasers: A Comprehensive Diagnostic and Therapeutic Approach

Background/Objectives: Rhinophyma, an advanced form of rosacea, is characterized by significant nasal tissue enlargement and deformation, leading to aesthetic and psychosocial challenges. Traditional treatments are often invasive with variable outcomes, emphasizing the need for improved therapeutic approaches. This study evaluates the efficacy of a dual-laser therapy (CO2 and dye lasers) in treating rhinophyma. An innovative diagnostic algorithm using multispectral imaging guided treatment decisions, while Optical Coherence Tomography (OCT) was utilized to analyze post-treatment vascular and collagen changes. Methods: A prospective study was conducted involving 20 patients with rhinophyma. Multispectral imaging was used to guide the tailored application of CO2 laser, dye laser, or both, depending on the predominant vascular or glandular components in the nasal tissue. Post-treatment analysis employed OCT to assess changes in vascular and collagen density, providing insights into the tissue modifications induced by laser therapy. Results: The treatment significantly reduced vascular density from 35,526.75 to 26,577.55 at 300 microns and from 46,916.25 to 35,509.25 at 500 microns. Collagen density decreased from 81.35 to 66.34. All reductions were statistically significant, with highly significant p-values. These findings highlight the dual-laser therapy’s effectiveness in addressing the pathological features of rhinophyma. Conclusions: Dual-laser therapy guided by multispectral imaging provides a targeted and effective treatment for rhinophyma, addressing its vascular and glandular components. The use of OCT enhances understanding of laser-induced tissue changes and confirms significant reductions in vascular and collagen density. This approach represents a significant advancement in the management of rhinophyma, offering improved precision and therapeutic outcomes.