Photodynamic therapy (PDT) may be efficient and safe treatment for patients with rosacea, according to study findings published in Photodiagnosis and Photodynamic Therapy.

PDT has been a successfully applied treatment of acne vulgaris which overlaps rosacea in its manner of development and potential therapies, the researchers noted. They sought to investigate the efficacy and safety of PDT in treatment of rosacea. The primary endpoints were the effective rate and improvement of rosacea symptoms. Secondary endpoints included side effects and the rate of recurrence.

To accomplish this, they conducted a systematic review of the PubMed, Embase, and Cochrane Library databases that included 9 studies (case reports, case series, controlled clinical trials, and randomized control trials published in English) using PDT to treat rosacea published through the beginning of February, 2022, with as many as 30 adult patients (18-76 years of age) in each study. Researchers had used methyl aminolevulinate and aminolevulinic acid as the photosensitizer, and pulsed dye laser, long-pulsed dye laser, intense pulsed light, red light, blue light, and tungsten lamp as the laser source or light. Follow-ups varied from 1 to 25 months.


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Most of the studies resulted in acceptable therapeutic efficacy. Side effects (pain, stinging, burning, edema, erythema, swelling, itching, acne outbreaks, pustules, exudation, superficial erosions, desquamation, and hyperpigmentation) were bearable and transitory.

Study limitations include most of the 9 studies used descriptive evaluations and not qualitative and quantitative measurements, and all 9 studies were underpowered and lacked randomization resulting in a high risk of bias. Only studies published in English were considered.

Researchers concluded that, “Current studies provide evidence showing that PDT had an overall excellent efficacy and safety in treating rosacea, and PDT was more efficient at treating papulapustular rosacea.” They point out that the studies examined lacked sufficient sample size, control groups, long follow-up, and acceptable outcome measurement methods, and the variation in photosensitizers and light or laser sources made determination of efficient treatment problematic.

Reference

Li A, Fang R, Mao X, Sun Q. Photodynamic therapy in the treatment of rosacea: A systematic review. Photodiagnosis Photodyn Ther. June, 2022;38:102875. doi:10.1016/j.pdpdt.2022.102875