Comparison of the efficacy and safety of pulsed dye laser, narrow-band intense pulsed light, and broad-band intense pulsed light in the treatment of erythematotelangiectatic rosacea

Erythematotelangiectatic rosacea (ETR) is a chronic dermatological condition characterized by persistent facial erythema and visible telangiectasia. This study aims to compare the efficacy, safety, and patient satisfaction associated with pulsed dye laser (PDL), narrow-band intense pulsed light (NB-IPL), and broad-band IPL (BB-IPL) in the treatment of ETR. A total of 112 patients diagnosed with ETR between May 2021 and April 2024 were retrospectively analyzed. Patients were divided into three treatment groups: PDL (n = 36), NB-IPL (n = 38), and BB-IPL (n = 38). Treatment outcomes were assessed via VISIA imaging, the Clinical Erythema Assessment (CEA), the Rosacea Quality of Life scale (RosaQoL), and recurrence rates. Pain intensity was measured using the Visual Analogue Scale (VAS), and skin parameters were analyzed pre- and post-treatment. Correlation analyses were performed to assess associations between treatment modalities, efficacy, and safety profiles. NB-IPL significantly reduced erythema and porphyrin levels compared to PDL and BB-IPL (P < 0.05). BB-IPL showed the most pronounced reduction in sebum levels but was associated with a higher incidence of pigmentation changes. PDL demonstrated comparable efficacy to NB-IPL in reducing erythema while presenting fewer adverse effects. Recurrence rates were low and showed no significant differences among the three groups. Both PDL and NB-IPL demonstrated negative correlations with CEA scores and energy density, whereas NB-IPL showed stronger positive correlations with treatment outcomes and negative associations with sebum levels when compared to BB-IPL. While IPL improves emotional and symptomatic domains in RosaQoL, no significant differences in functional domains were observed. NB-IPL demonstrated superior efficacy in erythema reduction, while BB-IPL effectively reduced sebum production but carried a higher risk of pigmentation. PDL provided a balanced therapeutic profile, combining satisfactory efficacy with fewer adverse events.