Is laser treatment right for your rosacea?
Dermatologists have been using lasers since the mid-1980s to treat
rosacea. Today, an ever-increasing number of lasers and a non-laser
light therapy called intense pulsed light (IPL) are available for
Despite years of use and significant technological advances, data on
the effectiveness and safety of these products is limited. The U.S.
Food and Drug Administration (FDA) classifies laser and light
therapies as procedures, so stringent, long-term studies are not
required. Most of what is known comes from observations made by
dermatologists while treating individual patients.
Recently, a few studies investigated the effectiveness and potential
side effects of using lasers and IPL to treat rosacea. Here are the
findings along with some general information about these devices.
Today, lasers are used to treat these signs of rosacea:
The pulsed dye laser (PDL) has
been used for years to treat the flushing and visible blood vessels
of rosacea. Recently, a study looked at the effects of treating 16
patients with one or more of these signs of rosacea — flushing,
persistent redness, and visible blood vessels.
After just one treatment, every patient in the study experienced
significant improvement. With two treatments, redness decreased by
40% to 60%. Patients also reported reductions in flushing, burning,
itching, dryness, swelling, and sensitivity, which they said
significantly improved their quality of life. Side effects included
crusting and spots of darkened skin on the treated areas. These side
effects were successfully treated. All improvements were maintained
from one treatment to the next.
This study also found that effectiveness increases when the pulsed
dye laser causes temporary bruising, which may last for 1 to 2
weeks. While bruise-free treatment is possible with some of the
newer pulsed dye lasers, researchers concluded that inducing
bruising leads to a consistent decrease in redness and other
symptoms, such as burning and itching. The researchers firmly
believe that inducing bruising increases effectiveness. They also
realize that this may not be acceptable for some patients.1
Other lasers used to treat visible blood vessels include the KTP
laser, diode laser, and Nd:YAG laser. These lasers are
less likely to cause bruising. Each is used to treat single, large,
visible blood vessels. Findings indicate that these lasers may not
be as effective in reducing redness as the pulsed dye laser.
Some patients with longstanding rosacea develop thickening skin on
the nose and cheeks, which is called rhinophyma. The CO2
laser and erbium:YAG laser can be used to remove this
thickening skin and improve the contour of the nose. Other surgical
procedures used to treat this condition include dermabrasion and
excision with a scalpel. Treatment options may be combined to obtain
Dermatologists recommend early treatment of rhinophyma to help
prevent the condition from progressing and becoming more difficult
to treat. In the advanced stages, rhinophyma can cause difficulty
breathing through the nose. It also is possible for the nostrils to
Intense Pulsed Light (IPL)
A newer form of therapy, IPL uses a non-laser light source. The
first IPL product received FDA approval in 1995 for treating fine
dilated blood vessels on the face. Since then several other products
have been approved. Recent studies conclude that IPL can safely and
effectively reduce the following signs of rosacea in some patients:
Dilated blood vessels
To investigate the safety and
effectiveness, four patients with dilated blood vessels and
persistent redness received five IPL treatments, which were given at
three-week intervals. Patients averaged a 30% drop in blood flow, a
29% reduction in visible blood vessels, and a 21% decrease in
redness.2 Since only four patients were evaluated,
these numbers cannot predict how people with rosacea in general will
respond. Some dermatologists believe, IPL is more effective than
these numbers indicate.
Another study looked at the effects of IPL treatment on the
persistent redness, flushing, and breakouts associated with rosacea.
In this study, 32 patients received between one and seven IPL
treatments. Following treatment, 83% experienced reduced redness,
75% said they had less flushing and improved skin texture, and 64%
reported fewer acne-like breakouts.3
As the above studies indicate, IPL is not effective for everyone.
However, most patients notice some reduction in dilated blood
vessels and redness after only one or two treatments. In one case, a
patient’s flush response returned to normal. Side effects from IPL
are temporary and include redness, swelling, bruising, and skin
Thinking about laser or light therapy?
If you are considering laser therapy or IPL to treat your rosacea,
it is important to keep the following points in mind:
Not a cure. While some patients experience dramatic results (such
as the return of a normal flushing response) and the results can be
long-lasting, neither laser nor light therapy cures rosacea. You
still need to continue to see your dermatologist for treatment and
avoid your personal rosacea triggers. To maintain results,
additional laser or light treatment may be needed at a later time.
Some patients not candidates. Do you have a suntan or any of the
following medical conditions?
Anyone with a suntan should not receive laser or light treatments.
If you have any of the medical conditions listed above, be sure to
tell your dermatologist because these conditions may increase your
risk of developing an infection or problems with wound healing.
Additionally, laser and light treatments are not recommended during
pregnancy as the effects on pregnancy are unknown.
Realistic expectations essential.
Most patients do see
improvement; however, with any medical procedure there is always the
possibility that you will only see a minor change or not see a
response. Rosacea also may worsen. Your dermatologist can determine
if you are a good candidate. To date, dermatologists have found that
people with lighter skin who limit their sun exposure after the
procedure tend to have better results.
Success depends on several factors.
Several factors — including
your skin type, condition of your skin, your lifestyle, and the
amount of sun exposure you get following the procedure — affect the
short- and long-term results. For example, not protecting your skin
from the sun after treatment can provoke a strong reaction, which
can make rosacea worse.
Experience required. As with any surgical technique, finding a
dermatologist who is skilled in using lasers or IPL is essential.
You should ask prospective doctors about their experience and
training in this area. Extensive experience in performing laser or
light procedures helps ensure the best possible results.
Not covered by insurance. Typically, the laser and light therapies
used to treat rosacea are not covered by medical insurance. If you
opt for laser or IPL therapy, you can expect to pay from $300 to
$600 per treatment session. Laser therapy usually requires one to
three treatment sessions to achieve the best results, and sessions
are generally spaced four to eight weeks apart. IPL may require one
to five sessions. IPL treatments are usually repeated every three
weeks. With both laser and IPL, follow-up treatment may be necessary
to maintain the results.
Looking to the Future
Laser and light therapy could become a preferred treatment option
for the redness, flushing, and dilated blood vessels of rosacea.
Benefits include few short-term side effects, no downtime with many
products, and some long-lasting results.
However, more research is needed to determine the long-term side
effects and optimal use of the different laser and light therapies.
If you believe that a laser or light therapy may be the right choice
for treating your rosacea, be sure to discuss this treatment option
with your dermatologist.
1 Tan SR and Tope WD. “Pulsed dye laser treatment of
rosacea improves erythema, symptomatology, and quality of life.”
Journal of the American Academy of Dermatology. 2004
2 Mark KA et al. “Objective and quantitative improvement
of rosacea-associated erythema after intense pulsed light
treatment.” Dermatologic Surgery. 2003 Jun;20(6):600-4.
3 Taub, AF. “Treatment of rosacea with intense pulsed
light.” Journal of Drugs in Dermatology. 2003 Jun;2(3):254-9.
content solely developed by the American Academy of Dermatology
While lasers have been used
since the mid-1980s to treat rosacea, topical and oral
medications are still the mainstay of rosacea treatment.