Can Phototherapy Treat Rosacea? A Comprehensive Overview Based on Current Research

Rosacea is a chronic inflammatory skin condition characterized by facial redness, visible blood vessels, and acne-like bumps. While its exact cause remains unclear, factors like genetic predisposition, immune system overactivity, and environmental triggers contribute to its development . Traditional treatments include topical creams (e.g., metronidazole, azelaic acid) and oral antibiotics, but many patients seek alternative or complementary therapies. This article explores whether phototherapy—using specific wavelengths of light—can effectively treat rosacea, drawing insights from five key studies.

Understanding Rosacea: Classification and Pathophysiology

Rosacea is classified into four subtypes based on symptoms: erythematotelangiectatic (redness and visible blood vessels), papulopustular (pimples and bumps), phymatous (thickened skin, often on the nose), and ocular (eye involvement) . Recent research emphasizes the role of neurovascular dysregulation and inflammatory pathways in its progression. For example, van Zuuren et al. (2021) note that abnormal immune responses to microbes like Demodex mites and excess sebum production can exacerbate inflammation .

The Role of Phototherapy in Rosacea Treatment

Phototherapy, including lasers and light-based devices, targets two primary issues in rosacea: vascular abnormalities (e.g., telangiectasia) and inflammation. Unlike traditional medications, which often focus on suppressing symptoms, phototherapy addresses structural and physiological root causes. Below, we examine specific light-based techniques and their clinical outcomes.

1. Laser Therapy

Lasers emit concentrated light to target specific skin structures. Two commonly used types for rosacea are:

• Pulsed Dye Laser (PDL)

PDL targets hemoglobin in blood vessels, reducing redness and visible veins. Goldberg (2005) reports that PDL effectively treats telangiectasia and erythema, with minimal side effects like temporary swelling or bruising . However, multiple sessions (typically 3–5) are often needed for optimal results.

• KTP Laser

The 532 nm KTP laser, combined with cryogen spray cooling, has shown promise in recent studies. Bernstein (2023) tested a dual-wavelength KTP laser on 21 patients with erythematotelangiectatic rosacea. After three monthly treatments, blinded observers noted an average 39% improvement in redness and visible vessels, with minimal side effects like short-term erythema . The cooling mechanism protects the skin surface while the laser targets deeper blood vessels, making it safe for sensitive skin.

2. Intense Pulsed Light (IPL)

IPL uses broad-spectrum light to address both vascular and inflammatory components. Goldberg (2005) highlights IPL’s effectiveness in reducing erythema and telangiectasia, particularly in early-stage rosacea . Kennedy Carney et al. (2009) further note that IPL can improve papulopustular symptoms by targeting inflammatory cells and reducing sebaceous gland activity . However, IPL may require more sessions than lasers and carries a slightly higher risk of post-treatment hyperpigmentation.

3. Low-Level Laser Therapy (LLLT) and Photobiomodulation

Low-level laser therapy (LLLT), also known as photobiomodulation (PBM), uses low-intensity red or near-infrared light to stimulate cellular repair. Boaretto Netto et al. (2025) investigated PBM’s role in rosacea, finding that it reduces inflammation by modulating cytokine production and improving mitochondrial function in skin cells . Key benefits include:

• Reduced redness: PBM calms blood vessel dilation.

• Collagen production: Improved skin elasticity and thickness.

• Mite reduction: Red light at 633 nm disrupts Demodex mite activity .

PBM is non-invasive and well-tolerated, making it suitable for patients with sensitive skin or those avoiding more aggressive treatments.

Comparing Light-Based Therapies

Each phototherapy technique has unique advantages and limitations. Below is a summary of their efficacy and practical considerations:

Clinical Outcomes and Patient Experiences

• Bernstein’s Study (2023): The dual-wavelength KTP laser demonstrated significant improvement in patients with persistent erythema. Over 89% of post-treatment images were correctly identified as improved by blinded observers .

• Goldberg’s Review (2005): Laser and light therapies are often used alongside topical medications for synergistic effects. For example, combining PDL with metronidazole cream may reduce both redness and papules .

• Patient Testimonials: Many users report visible results within 1–2 weeks of PBM or IPL sessions, with long-term benefits when combined with skincare routines .

Safety and Considerations

Phototherapy is generally safe when administered by trained professionals. However:

• Skin Type: Darker skin tones may require lower energy settings to avoid pigmentation issues.

• Side Effects: Temporary redness, swelling, or mild discomfort are common but resolve within days.

• Maintenance: Rosacea is chronic, so periodic touch-up sessions may be needed to sustain results .

Conclusion

Phototherapy offers a viable and effective treatment for rosacea, particularly for reducing redness, visible blood vessels, and inflammation. Laser therapies like PDL and KTP target vascular abnormalities, while PBM and IPL address both vascular and inflammatory components. These techniques are well-tolerated, minimally invasive, and often complement traditional medications.

However, no single treatment suits everyone. The choice of phototherapy depends on the rosacea subtype, skin sensitivity, and individual goals. Patients should consult a dermatologist to develop a personalized plan. As research evolves—such as Bernstein’s innovative KTP laser technology —phototherapy continues to advance as a cornerstone in rosacea management.

References

1. van Zuuren EJ, et al. (2021). Rosacea: New Concepts in Classification and Treatment. Am J Clin Dermatol. doi:10.1007/s40257-021-00595-7

2. Boaretto Netto JC, et al. (2025). Could photobiomodulation be used for treatment of rosacea? Lasers Med Sci. doi:10.1007/s10103-025-04503-x

3. Goldberg DJ. (2005). Lasers and light sources for rosacea. Cutis. PMID: 15810807

4. Kennedy Carney C, et al. (2009). Rosacea: a review of current topical, systemic and light-based therapies. G Ital Dermatol Venereol. PMID: 19907406

5. Bernstein EF. (2023). A new 532 nm KTP laser incorporating cryogen spray cooling effectively treats rosacea. Lasers Surg Med. doi:10.1002/lsm.23700