Dual-Frequency Ultrasound Promising for Treatment-Refractory Rosacea

Ultrasound equipment
Ultrasound equipment
Additional large-scale, split-face prospective studies are warranted to evaluate the independent efficacy of DFU on rosacea.

The application of dual-frequency ultrasound (DFU) in patients with refractory rosacea is associated with improvement in persistent erythema, barrier dysfunction, and patient-reported symptoms, according to the results of a retrospective analysis published in Dermatologic Surgery.

The investigators sought to examine the effect of DFU on patients with refractory rosacea. They retrospectively analyzed the medical records of 42 patients with refractory rosacea (26 with erythematotelangiectatic rosacea, 14 with papulopustular rosacea, and 2 with a mixed type of rosacea.

Of the 42 participants, 40 were women. The mean patient age was 47.9 years (range, 20-65 years). All participants received treatment with DFU twice weekly for the first week and then once weekly thereafter. Efficacy was evaluated with the use of erythema index (EI), transepithelial water loss, and patient self-assessment.

The use of DFU treatment was associated with significant decreases in EI and transepithelial water loss. Mean EI values decreased from 16.3 at baseline to 15.3 at 4 weeks (P <.05), 14.6 at 8 weeks (P <.05), and 12.7 at 12 weeks (P <.01). With respect to transepithelial water loss, mean values decreased significantly from baseline to 4 weeks (P <.05), 8 weeks (P <.01), and 12 weeks (P <.01).

When assessing the efficacy of DFU on the basis of subtype of rosacea, the data in the erythematotelangiectatic rosacea and papulopustular rosacea groups were analyzed separately. Regarding EI, a slightly higher reduction was reported in the papulopustular rosacea group compared with the erythematotelangiectatic rosacea group, but it was not statistically significant.

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Moreover, after DFU treatment, the patient self-assessment grade for rosacea was improved significantly (P <.01). Between baseline and 12 weeks, patient-assessed erythema grade decreased from 2.6 to 1.1, and patient-assessed itching and burning sensation grades decreased from 2.4 to 0.3. The treatment was well tolerated by all patients.

The investigators concluded that on the basis of the study findings, DFU may be an additional therapeutic option for rosacea that is resistant to other treatments. Limitations of the study include the fact that it is a retrospective chart review and the sample size was small. Additional large-scale, split-face prospective studies are warranted to evaluate the independent efficacy of DFU on rosacea.


Park JY, Ahn MK, Cho EB, Park EJ, Kim KH. Dual-frequency ultrasound as a new Treatment modality for refractory rosacea: a retrospective study [published May 9, 2018]. Dermatol Surg. doi: 10.1097/DSS.0000000000001552