Safety of Combination Laser or Intense Pulsed Light Therapies and Doxycycline for the Treatment of Rosacea

Abstract

BACKGROUND Current treatment options for rosacea include topical agents, oral therapies, phototherapy using lasers, or intense pulsed light (IPL). Combination therapy for rosacea often yields better results than monotherapy. The safety of laser/light treatments in combination with systemic doxycycline has been questioned because of the theoretical risk of photosensitivity. OBJECTIVE The purpose of this study was to assess the incidence of phototoxicity or photosensitivity in rosacea patients receiving concomitant laser or light treatments and systemic doxycycline. METHODS Treatment records of 36 patients receiving laser/light treatments while also being treated with standard dose or anti-inflammatory dose of doxycycline were retrospectively reviewed. RESULTS No adverse reactions related to doxycycline combined with laser/light therapy were reported. Specifically, no photosensitivity or sensitivity to wavelengths in the pulsed dye laser (PDL), or IPL range was observed in this cohort. All patients achieved some degree of clearance. CONCLUSION The results of this retrospective study demonstrate that doxycycline used in conjunction with laser or nonlaser light therapy is a valid combination therapy for improving signs and symptoms of rosacea. No photosensitivity reactions were observed to commonly used IPL or PDL devices.

Comparison of intense pulsed light and near‐infrared light in the treatment of dry eye disease: a prospective randomized study

“…It would also be interesting to investigate the influence of age and sex on the efficacy. More interestingly, IPL and NIL might be combined to gain an optimal response for treatment of DED, like for some other diseases (Jiang et al 2017;Schilling et al 2019). The different therapeutic mechanisms for IPL and NIL will be further aided by vitro studies of molecular biology.…”

“…2017; Schilling et al. 2019). The different therapeutic mechanisms for IPL and NIL will be further aided by vitro studies of molecular biology.…”

Lasers for cutaneous lesions: An update

“…Results of comparative studies between PDL and Intense Pulsed Light (IPL) for diffuse facial erythema and telangiectases are of vague results 48,50 . Inflammatory rosacea can deteriorate with laser treatment, henceforth, sufficient treatment with topical or oral medications such as oral tetracyclines, oxymetazoline 1.0% cream, and α adrenergic agonist prior to laser treatment are compulsory 51,52 . Rosacea and facial telangiectases can be an exhibition of photoaging and other situations such as scleroderma, post‐radiotherapy hereditary, and hemorrhagic telangiectasia.…”

“…48,50 Inflammatory rosacea can deteriorate with laser treatment, henceforth, sufficient treatment with topical or oral medications such as oral tetracyclines, oxymetazoline 1.0% cream, and α adrenergic agonist prior to laser treatment are compulsory. 51,52 Rosacea and facial telangiectases can be an exhibition of photoaging and other situations such as scleroderma, post-radiotherapy hereditary, and hemorrhagic telangiectasia. Such telangiectases are treatable with vascular lasers or IPL.…”

Efficacy Comparison of Pulsed Dye Laser vs. Microsecond 1064-nm Neodymium:Yttrium-Aluminum-Garnet Laser in the Treatment of Rosacea: A Meta-Analysis

“…The diversity of clinical manifestations of rosacea requires a variety of appropriate and targeted treatment methods, including skincare, local or systemic drug treatment, or physical and surgery therapies ( 10 , 11 ). However, telangiectatic (ET) and rhinophyma (RP) changes have limited therapeutic effects on drugs, and traditional methods ( 12 ).…”