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

Clinical Snapshot

Key Findings

• P Value: p < 0.001 for efficacy outcomes; p < 0.05 for edema difference; p < 0.001 for purpura difference

• Effect Size: Significant improvements in all erythema measures for both groups

• Primary Outcome: Both 6 ms and 10 ms pulse durations showed significant improvements in CEA, RASI, RIR, and PEA scores

• Nnt Or Sensitivity: Not calculable from available data - would require absolute risk differences

• Confidence Interval: Not reported in abstract

Clinical Application

Highly feasible - PDL is standard equipment in Australian dermatology practices, and pulse duration adjustment is a simple parameter modification PDL therapy for rosacea is well-established in Australian dermatology practice. Medicare item numbers cover laser treatment for vascular lesions. Results support using 10 ms pulse duration as standard practice to minimise adverse effects while maintaining efficacy Patients with erythematotelangiectatic rosacea suitable for laser therapy, particularly those concerned about post-treatment adverse effects

Abstract

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.

References

1. 1.Liu, T., Liu, Y., Meng, X., Chen, N., Yang, W., Li, D., & Xu, Y. (2026). Beyond efficacy: pulse duration is crucial for adverse events in pulsed dye laser therapy for rosacea. The Journal of Dermatological Treatment. https://doi.org/10.1080/09546634.2026.2665064