Laser treatment is a medical procedure that can help reduce the appearance of rosacea by decreasing the number of visible blood vessels under the skin.
In people with lighter skin, rosacea is red. In people with darker skin tones, it may appear as a dusky brown discoloration, dry swollen patches of darker skin, or yellowish-brown hard bumps.
Keep reading to learn more about how laser treatment for rosacea works, what the procedure involves, and who is eligible.
Laser treatment involves directing a light beam of a certain wavelength at areas on a person’s body. Dermatologists use it for a variety of conditions. For rosacea, they typically recommend it in combination with other treatments to manage the symptoms.
Longer wavelengths of light are effective against deeper blood vessels, while shorter wavelengths target more superficial vessels.
According to the American Academy of Dermatology (AAD), in general, sessions occur every 3–4 weeks, although this may vary from person to person.
The AAD also states that most patients see a 50–75% reduction in visible blood vessels after up to first three treatments. Some people even see a 100% reduction.
However, the benefits of laser treatment are not lifelong. They tend to last for 3–5 years before requiring follow-up appointments.
There are several types of laser and light therapy that may help with rosacea. The type a dermatologist recommends will depend on the goal of treatment.
Pulsed dye laser
Erythematotelangiectatic rosacea is the most common form of rosacea and has the most evidence supporting the use of laser therapy for its treatment. Doctors usually recommend pulsed dye laser (PDL) treatment for this type of the condition.
PDLs target the protein hemoglobin in red blood cells, which converts light energy into heat energy. This heat then destroys the problematic blood vessels under the skin’s surface. PDLs use light wavelengths that range between 585 nanometers (nm) and 595 nm.
Carbon dioxide laser
Carbon dioxide (CO2) lasers are a type of “shaping” laser. They work by reshaping certain parts of the face that are inflamed or bruised from rosacea.
Doctors use this laser to treat rhinophyma, a progressive condition that affects the appearance of the nose. It is still unclear how rhinophyma develops, but scientists consider it an advanced type of rosacea.
Erbium lasers promote collagen remodeling, which means they rearrange the connective tissue of the skin.
According to the American Board of Cosmetic Surgery, this type of laser is popular for treating:
It is also a potential treatment for the symptoms of rosacea.
Erbium lasers can be ablative or non-ablative. An ablative laser removes the top layer of the skin, while non-ablative lasers heat up the underlying skin tissue, keeping the surface layer intact. Both encourage the skin to make new tissue.
Intense pulsed light therapy
Unlike other laser treatments, intense pulsed light (IPL) therapy uses many wavelengths to treat the skin. IPL works to reduce pigmentation and address uneven skin tone.
In a 2020 study, researchers administered a 540 nm-wavelength IPL to 227 people with advanced rosacea. They found a significant improvement in facial redness and a reduced rate of recurrence of symptoms over a 2-year period.
An older, smaller study from 2008 tested the effects of IPL therapy in 34 people with rosacea. By the end of the study, the participants and the doctors noted more than a 50% improvement in symptoms. However, these results were short-lived, lasting for about 6 months in most of the participants.
This type of laser is an improved version of the dual yellow/combination laser that dermatologists use to treat pigmentation, blemishes, and facial redness.
In 2019, researchers published a
Dermatologists consider this laser an effective and safe treatment for most forms of rosacea, including:
- erythematotelangiectatic rosacea
- facial erythema
- facial telangiectasia
However, there is not much research on this type of laser, and so fewer data on its effects are available.
For some people, laser therapy may not be a suitable type of treatment. This includes individuals who:
- tend to develop cold sores, as laser treatment could exacerbate them
- have light sensitivity
- take aspirin medication or other blood thinners, as this increases the risk of post-procedure bruising
- take acne medicines containing isotretinoin, as this may lead to scarring and poor healing
It is important to tell a dermatologist about this and any other medical conditions a person has or any other medications they are taking.
A dermatologist can determine whether laser therapy is suitable for an individual by assessing their physical symptoms, skin sensitivity, and family and personal medical history. If it is, the doctor will also decide which type of laser is likely to be the most beneficial.
Before laser treatment can begin, a person will need a patch test to ensure that the laser is suitable for their skin.
This involves using the laser on a small area of skin and monitoring for any side effects. If there are none, a dermatologist will schedule the first full session.
To start off, the dermatologist cleans the skin with a gentle cleanser. The healthcare team may take photographs at this stage to compare and monitor progress after every session.
The initial procedure depends on the type of laser. In the case of ablative lasers, doctors administer a local anesthetic via injection to ensure a comfortable and painless procedure.
For non-ablative laser treatment, the doctor may prescribe a numbing gel or cream for topical application.
Next, the dermatologist will direct the laser device to areas of skin affected by rosacea. The laser emits pulses of energy, which some people describe as the feeling of a rubber band snapping on the skin. Others experience skin tightening, itching, or mild pain.
The dermatologist may apply ice after the session to cool and soothe the skin. They will then apply sunscreen.
For non-ablative laser treatment, there is no recovery time after treatments. However, for ablative lasers, it takes roughly 2–3 weeks for the skin to heal.
During this time, the skin will be raw and sore. It may scab as it heals. A person undergoing this type of treatment will need to avoid potential sources of infection, such as swimming pools, until the skin has recovered.
All laser-treated skin is hypersensitive to sun exposure for up to 1 year following some procedures. This is why many cosmetic surgeons recommend laser therapy during the fall or winter months, when days are shorter, and people tend to spend most time indoors.
Between appointments, a person will need to wear a suitable SPF product on the face whenever they are outside, to prevent burns.
Generally, laser therapy is a safe and effective way to treat rosacea symptoms. As with every medical procedure, however, there are a few potential side effects, including:
- mild pain during and after treatment
- skin that feels tight or itchy
- temporary redness, which typically fades in 2 weeks
- a rash of purple or red spots, which usually clears in 1–2 weeks
Rarely, people can develop small scars, but this is unlikely if the dermatologist is experienced.
Keeping out of the sun and wearing adequate SPF is important for reducing the risk of side effects and skin damage.
In many places, laser treatment for rosacea is expensive, particularly over the course of multiple sessions. The cost depends on the extent of the rosacea and the number of sessions that are necessary.
In the United States, health insurance does not cover laser therapy. Prices tend to vary based on the location of the treatment clinic and the specialist’s experience.
Laser treatment for rosacea is a safe and effective way to reduce the symptoms of the condition, such as discoloration, inflammation, and visible blood vessels. Some types of laser can also help with rhinophyma, which affects the shape of the nose.
Several types of laser treatment are available, and the results can vary. People may need additional treatments over the course of their life to maintain the results.
The type of laser, length of treatment, and cost of laser or light therapy will depend on a person’s unique circumstances.
A dermatologist can advise whether laser treatment is suitable for someone and if so, what the next steps are.