Meta-Analysis of the Efficacy of Intense Pulsed Light and Pulsed-Dye Laser Therapy in the Management of Rosacea

Objective: The primary aim of this systematic review and meta-analysis was to synthesize and compare the clinical efficacy of intense pulsed light (IPL) and pulsed-dye laser (PDL) therapies for the management of rosacea. Methods: The literatures were searched in the Web of Science, PubMed, Embase, and Cochrane Library databases to identify relevant studies investigating the use of IPL and PDL for the treatment of rosacea. Screening of the retrieved articles and data extraction were performed as per the pre-established inclusion and exclusion criteria. The primary outcome measures evaluated in this meta-analysis included clearance rates, erythema scores, and pain scores. Results: The meta-analysis incorporated data from four studies involving a total of 141 participants. The meta-analysis did not reveal a statistically significant difference between IPL and PDL in the rate of achieving greater than 50% clearance (RR = -0.07, 95% CI: -0.19, 0.05). However, the IPL group demonstrated a significantly higher rate of clearance exceeding 75% compared to the PDL group (RR = -0.13, 95% CI: -0.23, -0.04). The change in erythema index, a key measure of rosacea severity, was similar between the two treatment modalities (SMD = -0.15, 95% CI: -0.55, 0.26). Interestingly, the PDL group reported a notably lower VAS pain score than the IPL group (SMD = 1.54, 95% CI: 0.08, 3.00). Conclusion: Either PDL or IPL appears to be effective modalities for the management of rosacea. IPL exhibits a slight advantage in achieving a higher rate of substantial (>75%) clearance, while PDL may be preferable for patients with lower tolerance for post-treatment discomfort. However, the existing literature directly comparing these two laser/light-based therapies is limited, warranting further well-designed, large-scale studies to establish the optimal treatment algorithm for this chronic inflammatory skin condition.