Beyond efficacy: pulse duration is crucial for adverse events in pulsed dye laser therapy for rosacea.

BACKGROUND

Pulsed dye laser (PDL) is widely used for erythematotelangiectatic rosacea (ETR); however, the influence of pulse duration remains unclear.

OBJECTIVE

To compare the efficacy and tolerability of 6 and 10 ms PDL pulse durations for ETR.

METHODS

In this single-center, prospective, randomized controlled study, 80 patients with ETR received single PDL treatment using either a 6 or 10 ms pulse duration (9-11 J/cm2, 7 mm spot size). Erythema was assessed by blinded dermatologists using the Clinical Erythema Assessment (CEA) and telangiectasia scores, and Rosacea Area and Severity Index (RASI). ImageJ analysis measured the Relative Intensity of Redness (RIR) and Percentage of Erythema Area (PEA). Adverse events were recorded on days 3 and 7, and patient global assessment (PGA) and symptom improvement were evaluated at week 4.

RESULTS

Both groups showed significant improvements in CEA, RASI, RIR, and PEA (p < 0.001), with no significant between group differences. However, edema (p < 0.05) and purpura (p < 0.001) were more frequent with the 6 ms setting. No significant differences were observed between the groups on the PGA, erythema improvement scale, or symptom improvement scale.

CONCLUSION

Both pulse durations effectively reduced erythema, but 10 ms demonstrated more favorable tolerability.