Standardized Application of Advanced Optimal Pulse Technology for Erythromelanosis Follicularis of Faciei and Colli: A Split-face Method.

Erythromelanosis follicularis of faciei and colli (EFFC) is a chronic dermatological disorder characterized by hyperpigmentation, erythema, and follicular papules. Management remains challenging, as conventional treatments such as pulsed dye lasers can induce purpura and pose a risk of post-inflammatory hyperpigmentation, particularly in individuals with darker skin types. This article presents a standardized and reproducible clinical protocol using Advanced Optimal Pulse Technology (AOPT), a tunable intense pulsed light system, to target the vascular and pigmentary components of EFFC. A randomized, split-face clinical study involving 14 patients is described. Specific parameter settings, including dual-band vascular filters and adjustable pulse structures, were applied to the intervention side and compared with standard Optimal Pulse Technology (OPT) on the contralateral side. Quantitative assessments were performed using a skin colorimetric probe and a digital skin analysis imaging system to objectively evaluate lesion clearance. All 14 patients completed follow-up without attrition. The AOPT-treated side showed statistically significant reductions in erythema and melanin indices compared with the OPT control, with substantial inter-rater reproducibility for clinical evaluations. Additionally, the procedure was generally well tolerated, with few adverse events and limited downtime. Methodological limitations of this study include the small sample size, the absence of long-term follow-up (>6 months) to assess recurrence rates, and the lack of prospective clinical trial registration. This protocol provides clinicians with a standardized approach for applying AOPT to EFFC and may help address some limitations of traditional laser modalities in selected patients.