Adding recombinant human type III collagen dressings to advanced optimal pulse technology, an advanced form of intense pulsed light, was associated with greater improvements in erythema, lesion severity, skin barrier measures, and quality of life among patients with rosacea, according to findings from a randomized controlled trial published in International Wound Journal. The combination therapy was also associated with lower recurrence at 24 weeks.
Researchers prospectively enrolled 150 patients with rosacea at The First Affiliated Hospital of Soochow University in Suzhou, China, between May 2022 and May 2023. Eligible patients were aged 18 to 50 years and had congestive erythema of the central face or nose with telangiectasia and/or papulopustular lesions.
Patients were randomly assigned to receive advanced optimal pulse technology (AOPT) alone or AOPT plus recombinant human type III collagen dressing. Both groups underwent 3 treatment sessions at 4-week intervals. In the combination group, patients applied the collagen dressing beginning 6 to 24 hours following each session and continued once daily for 1 week.
At 12 weeks, the overall response rate was 89.3% in the combination group compared with 77.3% in the AOPT-alone group, a difference that narrowly met statistical significance (p = 0.049). Combination therapy was also associated with greater reductions in clinician-rated erythema and lesion color, number, and pain scores.
Quality-of-life scores improved more with combination therapy across self-perception, emotional function, symptom, and social function domains. The researchers used the Acne-Specific Quality of Life questionnaire rather than a rosacea-specific instrument, noting that some enrolled patients had papulopustular features overlapping with acne manifestations.
Skin barrier measures also favored the combination group. Transepidermal water loss and sebum levels decreased more, while stratum corneum hydration increased more, compared with AOPT alone. Serum tumor necrosis factor alpha, hypersensitive C-reactive protein, and procalcitonin levels also decreased more in the combination group, although these biomarker findings should be interpreted as supportive rather than mechanistic proof.
Adverse events were uncommon and did not differ statistically between groups, occurring in 6.7% of patients receiving AOPT alone and 2.7% of those receiving combination therapy. During 24 weeks of follow-up, recurrence occurred in 14.7% of patients in the AOPT-alone group vs 2.7% of patients in the combination group.
The researchers noted several limitations, including the modest sample size, single-center design, relatively short follow-up period, and lack of histopathologic or molecular validation. Because the intervention was visible, patients and treatment operators could not be fully blinded, although treatment delivery, outcome evaluation, and statistical analysis were conducted by separate personnel.
The findings suggest that collagen dressings may provide additional short-term benefit when combined with AOPT in selected patients with rosacea, though larger multicenter trials with longer follow-up and comparisons against established rosacea therapies are needed to clarify durability and generalizability.
“The combination of AOPT with collagen dressing offers superior benefits over AOPT alone,” wrote Jinzhu Mao and Mengyao Yang, of The First Affiliated Hospital of Soochow University.
Although the study appeared in International Wound Journal—a publication more commonly associated with wound care research than rosacea therapeutics—the trial adds to growing interest in multimodal approaches targeting both vascular dysfunction and skin barrier impairment in rosacea.
The researchers reported no funding and no conflicts of interest.
Source: International Wound Journal
