Lasers in Medical Science (2022) 37:3085–3105

https://doi.org/10.1007/s10103-022-03620-1

REVIEW ARTICLE

Intense pulsed light treatment for inflammatory skin diseases:

a review
Yujia Cai1 · Yuan Zhu1 · Yanqing Wang1 · Wenzhong Xiang2

Received: 11 March 2022 / Accepted: 26 July 2022 / Published online: 1 August 2022
© The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2022

Abstract
Although intense pulsed light (IPL) has been commonly used in the field of medical cosmetics in recent years, the exact
outcomes of IPL in the treatment of inflammatory skin diseases remain unclear. To assess the clinical evidence for the use
of IPL in the treatment of various inflammatory skin diseases and propose evidence-based recommendations, we searched
for relevant publications in the PubMed and Web of Science databases and provided updated information. The inflammatory
skin diseases treated with IPL consisted of acne vulgaris, rosacea, psoriasis, hidradenitis suppurativa (HS), atopic dermatitis
(AD), Riehl’s melanosis, lupus erythematosus, cutaneous sarcoidosis, pilonidal cysts, and pigmented actinic lichen planus
(PALP). The efficacy of IPL treatment for these inflammatory skin diseases was described and evaluated. Forty-two studies
were included to provide this assessment. The evidence suggests that IPL can effectively and safely improve acne vulgaris
and rosacea (recommendation grade B). For other described inflammatory skin diseases, IPL can be used as a tentative or
supplementary treatment (recommendation grade C and D). The main complications include transitory erythema, edema,
and pain, with the possibility of hyperpigmentation, blisters, and a burning sensation in some individuals.

Keywords Intense pulsed light · Treatment · Inflammatory skin diseases

Introduction circumstance, medical cosmetics have recently become a

With the development of social technology and people’s liv-
ing standards, people now pay more attention to skin prob-
lems, especially those on the face, after solving their basic
living needs. Appearance may be the first impression noted
when people meet, and defects in appearance can easily lead
to a lack of confidence. As facial scars have been shown
to impact psychosocial functioning [1], some light-based
diseases, such as skin aging, telangiectasis, freckles, and
melasma, can also cause increased anxiety and self-con-
sciousness, thus impacting their quality of life. Under this
* Wenzhong Xiang
xiangwenzhong@126.com
1
Department of Dermatology, Hangzhou Third People’s
Hospital, Zhejiang Chinese Medical University, West Lake
Road 38, Hangzhou 310009, People’s Republic of China
2 role in medical cosmetics.
Department of Dermatology, Hangzhou Third People’s
Hospital, Hangzhou Third Hospital Affiliated to Zhejiang
Chinese Medical University, Affiliated Hangzhou
Dermatology Hospital, Zhejiang University School
of Medicine, West Lake Road 38, Hangzhou 310009,
People’s Republic of China
popular method to improve the condition of skin.
As a part of medical cosmetology, different lasers and
light-based treatments have become popular for use in
patients worldwide, and the IPL system is one of them. In
1983, Anderson and Parrish [2] introduced the concept of
selective photothermolysis, clarifying that brief pulses of
selectively absorbed optical radiation can cause selective
damage to pigmented structures and cells. IPL is a noncoher-
ent polychromatic broadband filtered flashlamp that emits
light in the spectrum of approximately 400 to 1200 nm, with
a wide spectrum. IPL can be absorbed by water, hemoglobin,
and melanin in skin tissue, which makes IPL a versatile
therapy with various applications, such as skin rejuvenation,
irregular pigmentation, skin texture, rhytids, hair removal,
and vascular lesions [3]. Approximately 20 years ago, the
IPL system was introduced into medical practice, and with
its efficacy and safety, IPL has rapidly played an essential
However, this is far not enough that the IPL method is
used only for cosmetics purposes. Researchers are seeking
new applications of IPL to meet the increasingly different

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3086
needs of patients, and inflammatory skin diseases are one
such target of treatment.
Inflammatory skin diseases
Inflammatory skin diseases include a variety of skin dis-
eases, and clinicians are familiar with rosacea, acne, atopic
dermatitis, and psoriasis. These disorders are characterized
by intense itch and recurrent cutaneous lesions such as telan-
giectasia, erythema, scales, and exudate, which can severely
affect patients’ quality of life, thus leading to physical or
psychological distress. As the outermost organ in the human
body, the skin is exposed to many environmental pathogens
[4]. These factors influence the balance of physiological skin
function; when faced with external environmental stimuli,
the skin can induce an inflammatory response to appropri-
ately adapt to these changes [5]. Meanwhile, some internal
environmental transformations of the human body, such as
skin microbiota, heredity, immunity, mental disorders [6],
and daily lifestyle, including eating habits, smoking, alcohol,
and sleep, can also play an essential role in the occurrence
and development of inflammatory skin diseases [7]. The
pathogenesis of inflammatory skin diseases has not been
clearly elucidated, and as each inflammatory skin disease has
its own characteristics, the mechanisms and therapy could
also be different. Over the last few decades, the treatment of
inflammatory skin diseases has mainly revolved around topi-
cal ointments and/or selected oral antibiotics, antihistamines,
corticosteroids, and retinoids to improve symptoms and bio-
logical drugs targeting key molecules of the immune sys-
tem [8]. However, long-term medication may result in some
systemic side effects and resistance. Although a matter of
controversy, an increasing number of studies have explored
the outcomes of IPL therapy in treating inflammatory skin
diseases. To learn more about the efficacy and safety of IPL
for the treatment of inflammatory skin diseases, we reviewed
several related studies and provided updated information on
the treatment of inflammatory skin diseases with IPL.
Methods
We searched for peer-reviewed publications in the PubMed
and Web of Science databases from their inception to Febru-
ary 10, 2022. Language was limited to English, and the key
terms used were “intense pulsed light.” The term “inflamma-
tory skin diseases” includes an extensive range of different
diagnoses. The reference lists of retrieved reviews and meta-
analyses were also searched manually to identify potentially
relevant articles. Meanwhile, studies were excluded accord-
ing to the following criteria: treatment of lesions other than
inflammatory skin diseases, the use of laser systems other
13
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Lasers in Medical Science (2022) 37:3085–3105
than IPL, the combination of more than one type of interven-
tion, and literature without useful information.
As the available literature about IPL for inflammatory
skin diseases is diversified, all retrieved articles, including
case reports, case series, retrospective studies, randomized
controlled trials (RCTs), and meta-analyses, were reviewed.
However, regarding studies included in a meta-analysis, we
would neither incorporate them into our study nor give an
extra description; instead, we chose to incorporate the meta-
analysis to give a unitive introduction. In addition, all the
articles were assigned a level of evidence (LOE) and then
graded according to Tables 1 and 2 based on the Oxford
Centre for Evidence-based Medicine Levels of Evidence
(available from: https://​www.​cebm.​ox.​ac.​uk/​resou​rces/​lev-
els-​of-​evide​nce/​oxford-​centre-​for-​evide​nce-​based-​medic​
ine-​levels-​of-​evide​nce-​march-​2009) [9].
Results
After screening the titles, abstracts, and full-text articles if
applicable, 42 articles were obtained in the review, and all
results are shown in Table 3. The publications consisted of
acne vulgaris (18), rosacea (9), psoriasis (1), HS (3), AD (1),
Riehl’s melanosis (2), lupus erythematosus (3), cutaneous
sarcoidosis (2), pilonidal cyst (2), and PALP (1). Because
of limited space, for diseases with more than 5 studies, not
all of the studies are discussed here in detail, but they are
listed in Table 3.
Acne vulgaris
A literature search revealed 18 studies on IPL treatment for
acne vulgaris with similar outcome measures.
Choi and colleagues [10] performed a randomized split-
face trial to evaluate the efficacy and safety of 530–750 nm
IPL and pulsed dye laser (PDL). Seventeen patients under-
went 4 treatments at intervals of 2 weeks. Outcome meas-
ures included lesion counts, acne severity, patients’ subjec-
tive self-assessments, and histopathological examinations,
Table 1  Level of evidence
1a Systematic review of RCTs
1b Individual RCT​
2a Systematic review of cohort studies
2b Individual cohort study (including low-quality RCT)
2c “Outcomes” research; ecological studies
3a Systematic review of case–control studies
3b Individual case–control study
4 Case series
5 Case report; expert opinion
Lasers in Medical Science (2022) 37:3085–3105
Table 2  Grades of
recommendation A Consistent level 1 studies
B Consistent level 2 or 3 studies or extrapolations from level 1 studies
C Level 4 studies or extrapolations from level 2 or 3 studies
D Level 5 evidence or troublingly inconsistent or inconclusive studies of any level
including immunohistochemical staining for transforming
growth factor-b (TGF-b). The results showed that inflam-
matory acne lesion counts and acne grades were markedly
reduced after IPL treatment, and the satisfaction scores
increased with time. In addition, histopathological examina-
tions showed amelioration of inflammatory reactions and an
increase in TGF-b expression. No significant adverse reac-
tions were observed except transient erythema and oedema.
Additionally, 5 studies [11–15] compared IPL treatment with
other light-based therapies, and 4 studies showed significant
improvement after IPL treatment, while 1 showed nonsig-
nificant improvement.
Patidar and Deshmukh [16] enrolled 45 Indian patients
with inflammatory facial acne vulgaris treated with two dif-
ferent fluences into their prospective study. The wavelength
was 550 nm, while the fluence used was 35 J/cm2 on the
right face and 20 J/cm2 on the left side. All patients were
given 4 IPL treatments at 2-week intervals and were fol-
lowed for 2 months. The results showed that on the right
side, excellent results were achieved in 10 (22%) patients;
good results, in 22 (49%) patients; and moderate results,
in 13 (29%) patients. On the left side, the reduction of
acne lesions was excellent in 7 (15%), good in 19 (42%),
and moderate in 16 (43%) patients. There was no statisti-
cally significant difference between the two fluences. Two
patients developed erythema, and two patients developed
milia. Three patients complained of a burning sensation.
Fortunately, all the adverse effects were transient. Similarly,
Kumaresan and Srinivas [17] compared burst-pulse and sin-
gle-pulse modes in IPL treatment of acne vulgaris, and all
patients revealed a reduction in the number of acne lesions.
Liu and colleagues [18] performed a controlled study
involving 19 healthy controls and 20 patients diagnosed with
mild-to-moderate acne vulgaris who underwent 6 sittings of
420-nm IPL every 2 weeks. They evaluated the epidermal
barrier function and skin microbiota, which suggested that
IPL could successfully improve the Global Acne Grading
System (GAGS) scores, as well as regulate the equilibrium
between Cutibacterium acnes and Staphylococcus epider-
midis. Meanwhile, the study indicated that IPL could also
inhibit sebum secretion.
In addition, 4 studies [19–22] compared IPL treatment
with oral or topical medications, and 5 studies [23–27] of
case reports and case series reported the efficacy of IPL
therapy for acne vulgaris. These studies are listed in Table 3
instead of being described in detail.
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3087
Rosacea
A literature search revealed 9 articles describing IPL treat-
ment for different types of rosacea, including a meta-anal-
ysis consisting of 4 RCTs, and outcome measures mainly
included the change in facial erythema and recurrence
rates.
Luo and colleagues [28] performed a prospective rand-
omized controlled trial to explore the clinical efficacy and
safety of 540-nm IPL for the treatment of telangiectasia in
late-stage rosacea. A total of 130 patients underwent three
IPL treatments at 4-week intervals with 10–16 J/cm2 flu-
ence, and 130 were included in the control group with no
treatment. Outcome measures included clinical photographs
and the physicians’ and patients’ global assessments. After
33 patients were lost during follow-up, the rates of effective
treatment and total efficacy in the IPL group were found to
be significantly higher than those in the control group. On
the other hand, the rates of recurrence were lower in the IPL
group. Regarding adverse reactions, there were 11, 8, 3, and
2 cases of facial burning, facial swelling, hyperpigmentation,
and facial blisters, but these side effects were only tempo-
rary; redness-to-blistering subsided within 1 week, while
hyperpigmentation resolved within 3 months.
To compare the efficacy of 540-nm IPL in treating dif-
ferent erythema associated with rosacea, Liu and colleagues
[29] performed a controlled trial recruiting 15 patients with
erythema to telangiectatic rosacea (ETR) and 15 with papu-
lopustular rosacea (PPR). Three treatments were adminis-
tered on the face at 3-week intervals with an energy density
of 10–12 J/cm2. Clinical improvement was assessed by a
quartile grading scale and a 10-point visual analog scale.
All patients showed improvement after the course of treat-
ment, but the erythema improvement score of the PPR group
was significantly higher than that of the ETR group, as was
the degree of satisfaction. None of the patients showed any
noticeable side effects except for transient erythema and
edema.
Recently, Chang [30] published a meta-analysis incorpo-
rating 4 RCTs conducted on IPL versus PDL for treating the
facial erythema of rosacea. It turned out that IPL treatment
could lessen the erythema of rosacea and tended to cause a
better reduction than PDL did, which was not related to the
spot sizes, pulse duration, fluence level, or other factors.
Moreover, 6 studies [31–36] consisting of case series
or case reports about IPL treatment for different types of
13
 Table 3  Characteristics of included studies
3088

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
Acne vulgaris
Choi et al., 2010 Split-face, RCT​ 17 Wavelength: PDL treatment, Inflammatory acne
4 treatments at inter- Transient erythema 1b
[10] 530–750 nm, pulse wavelength: vals of 2 weeks, lesion counts and and edema
duration: 2.5 ms, 585 nm, spot size: followed up for acne grades were
fluence: 7.5–8.3 J/ 10 mm, pulse 8 weeks reduced, and the
cm2 duration: 40 ms, satisfaction scores
fluence: 8–10 J/cm2 were increased,
histopathologi-
cal examinations
showed ameliora-
tion in inflam-
matory reactions
and an increase in
TGF-b expression
Mohamed et al., Prospective, split- 74 Wavelength: 550 nm, Nd:YAG laser, wave- 3 treatments with In the IPL-treated NM 2b
2016 [11] face comparative pulse width: 4 ms, length: 1064 nm, 4 week interval, side, acne grade
fluence: 10–15 J/ spot size: 15 mm, follow-up was was significantly
cm2 delay time 20 ms, scheduled at decreased to 1.2
fluence: 30–35 J/ 4-week intervals (68.4%) after treat-
cm2 after the final ses- ment, the mean
sion inflammatory
acne lesion counts
were significantly
reduced
Moftah et al., Split-face, RCT​ 35 Wavelength: 550 nm, Topical 0.1% lipo- 3 treatments at All patients experi- Mild tinging occur- 1b
2016 [12] pulse duration: somal methylene intervals of 1 week, enced a statistically ring after the
30 ms, spot size: blue gel hydrogel followed up for significant reduc- session for an hour,
8 ­cm2, fluence: applied on the ran- 1 month tion in the number and relieved by
13–16 J/cm2 domly selected one of inflammatory icepacks
side of the back, lesions and showed
and after 60 min significant satisfac-
the entire back was tion, but according
exposed to IPL to Burton’s acne
severity scale, one
patient showed
marked improve-

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ment and 12
patients showed no
change
Lasers in Medical Science (2022) 37:3085–3105
 Table 3  (continued)
Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

Ianosi et al., 2013 RCT​ 60 Wavelength: Group 1: 60 patients 5 treatments at inter- A significant reduc- Transient erythema, 1b
[13] 400–700 nm and treated with a com- vals of 1 week tion in the number painful sensation
870–1200 nm, two bination of vacuum of inflammatory during the treat-
passes: 100 ms and IPL with lesions, a statisti- ment
pulse width and wavelength 500– cally significant
10–12 J/cm2, flu- 1200 nm, pulse improvement in
ence for the first width: 3 ms and clinical appearance,
pass and 20 ms 25 ms, pulse delay: and patients were
pulse width and 750 ms. Group 2: also significantly
8–10 J/cm2, fluence 60 patients were more satisfied
Lasers in Medical Science (2022) 37:3085–3105

for the second. For placebo-controlled after the treatment

each visit, both compared with the
pulse width and flu- control group
ence were gradually
increased
Yeung et al., 2007 Split-face, RCT​ 30 Wavelength: 530– IPL combined with 4 treatments at inter- 4 weeks after treat- Temporary crusting 1b
[14] 750 nm, pulse dura- photodynamic vals of 3 weeks, ment, the mean and hyperpigmenta-
tion: 2.5 ms, spot therapy using followed up for reduction of lesion tion were observed
size: 10 × 48 mm, topical methyl 12 weeks counts was 22% in two subjects
fluence: 7–9 J/cm2 aminolevulinate in the IPL group, subsided within
12 weeks post- 1 week
treatment showed
decreases of 23% in
the IPL group
Monib and Hus- RCT​ 15 Wavelength: 15 patients treated by 3 treatments at inter- The improvement Edema, ery- 2b
sein, 2020 [15] 420–1200 nm, Nd:YAG laser vals of 2 weeks, score seemed to thema, scarring,
pulse width: 3 ms, Wavelength: followed up for be improved, but postinflam-matory
fluence: 7 J/cm2 1064 nm, pulse 1 month the improvement hyperpigme-ntation
duration: 40 ms, in total lesions was and crust
fluence: 40–50 J/ nonsignificant in
cm2 the IPL Group.
Three patients in
the IPL Group
showed exacerba-
tion after the first
and second sessions

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13
3089
 Table 3  (continued)
3090

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
Patidar et al., Prospective, split- 45 Wavelength: IPL treatment on the 4 treatments with Right side: excellent 2 patients reported 2b
2016 [16] face comparative 550 nm, spot size: left side, fluence: 2-week interval, in 10, good in 22, erythema and 2
40 × 8 mm, pulse 20 J/cm2 followed up for and moderate in 13 patients developed
duration: 5 ms, 2 months every patients milia. 3 patients
pulse interval: 2 weeks Left side: excellent in complained of
10 ms, fluence: 7, good in 19, mod- burning sensation
right side 35 J/cm2 erate in 16, mild in
2 patients. 1 patient
showed increase in
lesion count
Kumaresan and Prospective, split- 10 Right side: burst- Left side: single- 4 treatments with The mean baseline No adverse side 2b
Srinivas, 2010 face comparative pulse mode, wave- pulse mode, wave- 1-week interval score was 22.4 for effects were
[17] length: 420 nm, length: 420 nm, single-pulse mode, observed
pulse delay: 6 ms, pulse width: 12 ms, which showed
fluence: 15–21 J/ fluence: 15–21 J/ 40.17% reduction
cm2 cm2 after four sessions.
The mean acne
severity score at
baseline was 27 for
burst-pulse mode
and showed 56.66%
reduction after
four sessions. The
mean total score
was 49.4 at baseline
and showed 49.19%
reduction after four
sessions of IPL
Liu et al., 2021 Prospective cohort 20 Wavelength: 420 nm, 19 healthy controls 6 sittings every The GAGS scores, NM 2b
[18] study pulse width: 12 ms, 2 weeks sebum, sclereryth-
fluence: 10–13 J/ rin, and red area
cm2 of patients were
improved, the rela-
tive abundance of
Staphylococcus epi-
dermidis increased,
but Cutibacterium

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acnes decreased,
and the sebum
secretion was
inhibited
Lasers in Medical Science (2022) 37:3085–3105
 Table 3  (continued)
Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

Abdullah and Prospective cohort 20 Wavelength: 400 nm 27 patients used 3 treatments with There is statically NM 2b
Mahdi, 2022 study benzoyl peroxide 3-week interval, significant differ-
[19] 2.5% gel followed up for ence before and
3 weeks after treatment
with improve-
ment in inflam-
matory lesions by
55.5%, as well as
patient satisfac-
tion. Improvement
Lasers in Medical Science (2022) 37:3085–3105

in skin texture
and skin getting
smoother were
noted in eight
patients
Ryu et al., 2022 Prospective cohort 8 Wavelength: 6 patients applied 5 treatments with All patients experi- One patient showed 2b
[20] study 400–600 nm and the contents of a 2-week interval, enced a decrease an erythematous
800–1200 nm, gold microparticle followed up for in the number patch with pain, the
pulse width: ampule before 2 weeks of inflammatory patient recovered in
4–5 ms, fluence: IPL treatment, 9 lesions. The mean 1 week and devel-
11–13 J/cm2 were taking oral number of papules, oped postinflam-
antibiotics pustules, and matory hyperpig-
comedones was sig- mentation, which
nificantly decreased disappeared after a
at the final visit. month
The melanin index
showed statisti-
cally significant
differences after
treatment, but the
erythema index
did not

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13
3091
 Table 3  (continued)
3092

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
El-Latif et al., Prospective cohort 25 Wavelength: 530 nm, 25 patients used 5 treatments with Severity showed One patient suffered 2b
2014 [21] study pulse duration: benzoyl peroxide 1 week interval significant reduc- from burning
35 ms, fluence: 5% gel applied as a tion from baseline sensation
35 J/cm2 thin film once daily to the end of the
at bed time study, the percent-
age of reduction
in the number of
lesions compared
to baseline after
the 3rd session was
42.40 ± 23.87%,
while in the 5th
session, it was
61.56 ± 26.14%
Rojanamatin and Prospective, split- 14 Wavelength: IPL combined with 3 treatments with All patients experi- Transient erythema, 2b
Choawawan-ich, face comparative 560–590 nm, pulse 20% topical 5-ami- 3–4 weeks interval, enced a reduction and crusting
2006 [22] delay: 20–40 ms, nolevulinic acid followed up for in numbers of
fluence: 25–30 J/ 12 weeks inflammatory acne
cm2 lesions, the patient
self-assessment
showed mild
improvement in
one patient, two
reported moderate
improvement, and
11 noticed signifi-
cant result

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Lasers in Medical Science (2022) 37:3085–3105
 Table 3  (continued)
Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

Chen et al., 2019 Case series 21 A filter of dual-band None 5 treatments with Investigators Transient burning 4
[23] spectral output. 4-week interval, determined that and pain. Two male
Wavelength: followed up for 14.29% patients patients developed
400–600 nm and 1 month demonstrated excel- postinflammatory
800–1200 nm, lent response, and pigmentation and
pulse width: 3.5– 61.90% had good one resolved within
4.0 ms, pulse delay: response. Totally, a week while the
30–40 ms, fluence: the effective rate other resolved
the first pulse 9 J/ of the patients was within a month
cm2, the second 76.19%. As for
Lasers in Medical Science (2022) 37:3085–3105

pulse 6 J/cm2 inflammatory acne

Taylor et al., 2014 Case series
[24]
lesion counts, there
was an improve-
ment at the final
1-month follow-up
visit compared to
before the treat-
ment. Patients’
self-assessment
generally paralleled
physicians’ evalu-
ations
21 Wavelength: 530 nm, None 4 treatments at Inflammatory lesions NM 4
fluence: 40–42 J/ 2-week intervals but not the global
cm2 acne severities
are significantly
reduced, a reduc-
tion in TNF-α
expression of 17.6%
weakly correlated
with the change
in lesion counts.
TLR2 expression
fell by 2.6% but did
not correlate with
lesion counts

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13
3093
 Table 3  (continued)
3094

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
Lee, 2012 [25] Case series 18 Wavelength: 420 nm, None 8 patients had only 1 All patients showed Transient erythema 4
pulse width: 30 ms, session, and 10 had some improvement,
fluence: 8–12 J/cm2 2 sessions, 2 weeks and 14 patients had
apart, followed up clearance of at least
for 1–8 months 60%. Most patients
felt their overall
skin condition had
improved, and all
patients would be
happy to return for
repeat treatments in
the future
Kawana et al., Case series 25 Wavelength: None 5 treatments at Inflammatory lesions 20 patients expe- 4
2010 [26] 400–700 nm and 1-week interval decreased to 43.0% rienced immedi-
870–1200 nm, flu- of pretreatment ate erythema, 19
ence: 13 J/cm2 values after the reported burn-
first exposure ing or stinging,
and to 11.7% of which disappeared
pretreatment values within a few days.
at the end of the Crusting, bulla,
study. Acne grade formation, and
improved sig- hyperpigme-ntation
nificantly over the were observed in
course of treatment. 4, 1, and 2 patients,
Improvements and resolved within
in numbers of 1 to 2 weeks
acne lesions were
observed for all
pretreatment grades
Deshpande, 2018 Case series 100 Wavelength: None 6 treatments at 74 patients noticed Transient erythema 4
[27] 530–1200 nm, 1-week interval, good-to-excellent and pain
pulse width: 3 ms, followed up for improvement, 10
fluence: 7 J/cm2 6 weeks patients reported
fair-to-good
improvement, and
7 showed poor
response. Sig-

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nificant reductions
were revealed in
total lesion count as
well as improve-
ments in erythema
Lasers in Medical Science (2022) 37:3085–3105
 Table 3  (continued)
Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

Rosacea
Luo et al., 2020 Prospective, RCT​ 130 Wavelength: 540 nm, 130 patients with no 3 treatments at The rates of effec- 11, 8, 3, and 2 cases 1b
[28] spot size: 1.5 × 4 treatment 4-week intervals, tive treatment and of temporary
­cm2, pulse width: followed up for total efficacy were burning, swelling,
12 ms, pulse 18 months significantly higher hyperpigmentation,
interval: 10–15 ms, than the control and blisters
fluence: 10–16 J/ group; the rates of
cm2 recurrence were
lower in the IPL
group
Lasers in Medical Science (2022) 37:3085–3105

Liu et al., 2014 Prospective cohort 15 with ETR Wavelength: 540 nm, 15 with PPR 3 treatments at All patients showed Transient erythema 2b
[29] study spot size: 6.4 c­ m2, 3-week intervals, improvement; the and edema
pulse width: 12 ms followed up for erythema improve-
3 weeks ment scores and the
degree of satisfac-
tion of PPR group
were higher than
ETR group
Chang et al., 2021 A meta-analysis of 28 Wavelength: 555 nm PDL treatment, 2–4 sessions with Both PDL and IPL NM 1a
[30] RCT​ and 560 nm, pulse wavelength: 21–42 days apart, treatment could
interval: 1.5 ms, 585–595 nm PDL, followed up for reduce facial
15 ms, 30 ms, flu- spot size: 7 mm, 21–60 days erythema; IPL
ence: 8 J/cm2, 20 J/ 10 mm, pulse dura- could cause a better
cm2, 25 J/cm2 tion: 1.5 ms, 6 ms, reduction than PDL
40 ms, fluence:
7–8 J/cm2
Tsunoda et al., Case report 13 Wavelength: None 3 times at Lesions of all NM 5
2018 [31] 590–1200 nm for 4–16 weeks patients got
the whole face and interval reduced, and 2
500–635 nm for cases recurred
dilated vessels, flu-
ence: 22–24 J/cm2
and 14–15 J/cm2

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13
3095
 Table 3  (continued)
3096

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
Kassir et al., 2011 Case series 102 Wavelength and None An average of 7.2 80% of patients No adverse effects 4
[32] fluence: 530 nm treatments at had reduction in
with 10–30 J/cm2 1–3 weeks intervals redness, 78% of
or 420 nm with patients reported
10–20 J/cm2, pulse reduced flush-
delay: 20–30 ms, ing and improved
spot size: skin texture, and
10 mm × 40 mm 72% noted fewer
acneiform break-
outs at 1–3 weeks
post treatment and
photodocumenta-
tion showed a
51% reduction in
telangiectasias
Lane and Case report 1 Wavelength: 550 nm, None 6 times at 4 weeks The lesions got sat- NM 5
Khachemou-ne, pulse duration: interval isfactory improve-
2016 [33] 20 ms, fluence: ment and accept-
34–40 J/cm2 able outcome
Papageorgi-ou Case series 34 Wavelength: 515– None 4 treatments at The erythema values, Occasional bruis- 4
et al., 2008 [34] 1200 nm, spot size: 3-week intervals, the global severity ing within 1 week,
34 × 8 mm, fluence: followed up for scores, and the or edema within
24–32 J/cm2 6 months scores of the photo- 5 days. One patient
graphic assessment went through
all fell significantly edema and crusting,
from baseline to which resolved
10 weeks, and this after 10 days
reduction was sus-
tained at 6 months
follow-up

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Lasers in Medical Science (2022) 37:3085–3105
 Table 3  (continued)
Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

Schroeter et al., Case series 60 Wavelength: 500– None Patients were treated The mean success 109 of 508 treatments 4
2005 [35] 1200 nm, mean for a mean duration rate in clearance showed erythema,
pulse duration: of 1.93 years, and was 77.8%, and 67 of 508 showed
4.8 ms, fluence: followed up for lesions on the fore- purpura, and in
25–35 J/cm2 2–99 months head showed the 5 of 508 treat-
best clearance ments, patients
complained of
pain. Three patients
showed edema, one
had blisters, five
Lasers in Medical Science (2022) 37:3085–3105

showed footprints,
and one had tran-
sient hyperpigme-
ntation
Mark et al., 2003 Case report 4 Wavelength: 515 nm, None 5 times at 3-week Outcome demon- NM 5
[36] pulse duration: intervals, followed strated an average
3 ms, fluence: up for at least of 30% decrease
22–25 J/cm2 6 months in blood flow, a
29% decrease in
the actual area
occupied by
telangiectasia, and
a 21% decrease
in the intensity
of erythema was
noted. One patient
reported “great”
improvement,
whereas three
reported somewhat
improvement

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13
3097
 Table 3  (continued)
3098

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
Psoriasis
Tawfik, 2014 [37] Nonrandomized 20 with nail psoriasis Wavelength: 550 nm, None Twice weekly for There was improve- NM 4
clinical trial spot size: 11.25 a maximum of ment in the nail
­cm2, pulse duration: 6 months, followed bed and matrix,
20 ms, fluence: up for a year and in the NAPSI
25 J/cm2 score. 11 patients
(55%) were very
satisfied, 7 patients
(35%) were satis-
fied, and 3 patients
(10%) were not
satisfied; relapse
was revealed in
3 patients after
6 months
Hidradenitis suppurativa
Highton et al., Split-face, RCT​ 17 Wavelength: 420 nm, Contralateral side Two times per There was a sig- NM 2b
2011 [38] pulse width: received no treat- week for 4 weeks, nificant improve-
30–50 ms, fluence: ment followed up for ment in the mean
7–10 J/cm2 12 months examination score,
patients reported
high levels of
satisfaction. There
was no concurrent
improvement on the
control side
Riis et al., 2018 Retrospective, case 25 Wavelength: 525 nm, None 1–10 times every A total of 13/25 Erythema and 4
[39] series fluence: 18–34 J/ 4–6 weeks patients reported a irritation of the
cm2 reduction in disease area after shav-
activity ing (n = 4), minor
infection (n = 1),
minor burn (n = 1),
worsening of HS
(n = 1). And all of
them were treated
with resorcinol

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Lasers in Medical Science (2022) 37:3085–3105
 Table 3  (continued)
Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

Piccolo et al., Case report 2 Wavelength: 550 nm, None 6 sessions of inter- HS was completely NM 5
2014 [40] pulse duration: vals of 15–20 days removed in both its
5–10 ms, fluence: inflammatory and
8–10 J/cm2 painful components
Atopic dermatitis
Oh et al., 2010 Nonrandomized 11 Wavelength: 590 nm, None 3 times at 2-week The ESS decreased Transient dryness, 4
[41] clinical trial pulse duration: intervals, followed significantly, the erythema, and
30 ms, fluence: up for 1 month eczema and ery- edema
12–13 J/cm2 thema also showed
Lasers in Medical Science (2022) 37:3085–3105

improvement, and
the mean DLQI
score was better
Riehl’s melanosis
Li et al., 2011 [42] Split-face, RCT​ 6 Wavelength: 590, The other side of face Followed up for Five exhibited good Transient erythema 2b
640, and 695 nm, with no treatment 6 months improvement, one and slight edema,
pulse width: showed excellent PIH occurred
3–4 ms, fluence: improvement, a in one case and
11–17 J/cm2 significant reduc- resolved in 1 month
tion in melanin
was observed, the
mean MI values
and EI values on
the treated side
decreasing more
quickly than control
side
Oiso et al., 2010 Case report 1 Wavelength: 500 nm, None 9 treatments at inter- The therapy achieved No obvious side 5
[43] fluence: 12 J/cm2 vals of 1 month remarkable effect
improvements
Lupus erythematosus
Ekbäck and Troil- Case report 4 (DLE and SCLE) Wavelength: None An average of 4 All the lesions got 1 patient got swol- 5
ius, 2013 [44] 530–750 nm, pulse treatments improved or cleared len around right
duration: 8–13 ms, eye and another
fluence: 8–13 J/cm2 one went through
blushing within few

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hours

13
3099
 Table 3  (continued)
3100

Author Study type No. of patients for Laser parameters Comparison Treatment and Major results of IPL Adverse effects LOE
IPL treatment follow-up treatment

13
Levy, 2000 [45] Case report 1 (SLE) Wavelength: 515 nm, None 2 sessions, followed The erythema No significant 5
fluence: 22 J/cm2 up for 18 months revealed approxi- adverse effects
mately 75%
improvement, the
overall flushing and
burning of the skin
were relieved
Byun et al., 2017 Case report 1 (DLE) Wavelength: None 3 treatments at These erythematous Mild erythema and 5
[46] 555–950 nm, pulse 3–5 weeks interval, and hyperpig- oozing
duration: 8 ms, followed up for mented lesions
fluence: 11–12 J/ 1 year showed marked
cm2, combined with improvement
Nd:YAG: wave-
length: 1064 nm,
spot size: 3 mm,
fluence: 6–6.5 J/
cm2
Cutaneous sarcoidosis
Rosende et al., Case report 1 Wavelength: 590 nm, None Treatment lasted The erythema was NM 5
2012 [47] pulse duration: for 2 years, and almost complete
8 ms, fluence: followed up for
37–45 J/cm2 2 years
Piccolo et al., Case report 1 Wavelength: 500 nm, None 4 treatments The vascular com- NM 5
2014 [40] pulse duration: ponent and the
5–10 ms, fluence: consistency of the
12–16 J/cm2 lesions achieved
significant reduc-
tion, with the pain
disappeared
Pilonidal cyst
Piccolo et al., Case report 3 Wavelength: 550 nm, 3 treatments, fol- By the third ses- NM 5
2014 [40] pulse duration: lowed up for sion, the lesions
5 ms, fluence: 2 years achieved complete
7–9 J/cm2 resolution, after a
follow-up visit of
5 years, for the first

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patient, and 1 year
for the other two;
no recurrence was
observed
Lasers in Medical Science (2022) 37:3085–3105
 Lasers in Medical Science (2022) 37:3085–3105 3101

rosacea, which also showed excellent outcomes, are shown

LOE in Table 3.

5
Psoriasis
Adverse effects

In 2014, Tawfik [37] performed a single-arm trial using

IPL therapy with a 550-nm filter for treating nail psoriasis.
NM

The patient showed a NM Twenty patients were involved, and the fluence was 25 J/
cm2. In addition, treatment was given twice weekly for a
DLQI achieved sig-
good improvement,
recurrence rate was
Major results of IPL

nificant reduction
improved and the

and the score of maximum of 6 months. It was reported that there was a sig-
The lesions got

nificant improvement in the nail bed and matrix and in the

decreased

Nail Psoriasis Severity Index (NAPSI) score. The nail bed

treatment

showed an improvement of 71.2%, whereas the nail matrix

improvement was only 32.2%. However, after 6 months,
relapse was revealed in 3 patients with pitting and crum-
4–6 weeks interval

bling of nails, and 2 of the cases were associated with dis-

seminated psoriasis.
6 treatments at
Treatment and

7 treatments
follow-up

Hidradenitis suppurativa

Highton and colleagues [38] involved 17 patients in a pro-

spective study to determine whether IPL is an effective treat-
ment for HS. The patients were randomized to the treatment
Comparison

of one axilla, groin, or inframammary area with IPL two

times per week for 4 weeks, while the contralateral side
None

None

received no treatment and acted as a control. In addition, the

wavelength of IPL was 420 nm, and the fluence was 7–10 J/
540–950 nm, pulse

cm2. The outcome was measured by a validated hidradenitis

width: 12 ms, spot
size: 40 × 16 mm,
fluence: 12–14 J/

suppurativa examination scoring system, and the patients

Laser parameters

rated their satisfaction on a Likert scale. The results showed

Wavelength:

that there was a significant improvement in the mean exami-

nation score, and patients reported high levels of satisfaction
cm2
NM

with the treatment. There was no concurrent improvement

on the control side.
In a case series of 25 patients performed by Riis and
No. of patients for

colleagues [39], patients were treated with IPL 1–10 times

IPL treatment

every 4–6 weeks, using a fluence between 18 and 34 J/cm2

depending on the area treated, pain response, and skin type.
The Hurley score and effect on HS (reduction in disease
30

activity) were recorded. After the treatment, a total of 13/25

patients reported a reduction in disease activity, and adverse
effects included erythema and irritation of the area after
shaving for the procedure (n = 4), minor infection (n = 1)
Juanes et al., 2010 Case report
Case series
Study type

and minor burn (n = 1), and worsening of HS the day after

Pigmented actinic lichen planus

treatment (n = 1). However, all patients who experienced

adverse effects were treated with resorcinol.
Piccolo and colleagues [40] reported two cases that
Table 3  (continued)

NM, not mentioned

received four sessions of 550-nm IPL at intervals of

Shafigh et al.,
2014 [48]

15–20 days for treating HS and two additional sessions with

the aim of treating the inflammatory component. The fluence
[49]
Author

was 8–10 J/cm2. Ultimately, HS was completely removed in

both its inflammatory and painful components.

13

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3102
Atopic dermatitis
Eleven patients with mild to moderate refractory facial AD
were included in a study performed by Oh and colleagues
[41]. Patients underwent three separate sessions at 2-week
intervals, and the whole face was exposed to a 590-nm IPL
at a fluence of 12 to 13 J/cm2. Clinical response was exam-
ined using the Eczema Severity Score (ESS), Dermatology
Life Quality Index (DLQI), and two dermatologists’ evalu-
ations. The ESS in 11 patients decreased significantly from
20.8 at baseline to 9.1 4 weeks after the treatment, while the
clinical assessment of the severity of eczema and erythema
by two blinded dermatologists also showed improvement.
Meanwhile, the mean DLQI score was significantly better
after the therapy. All patients complained of dryness after
each IPL treatment, which was alleviated with the use of a
moisturizer. Erythema and edema were transient and disap-
peared within a few days.
Riehl’s melanosis
Li and colleagues [42] performed a pilot study of six patients
with Riehl’s melanosis. They randomly chose one side of the
face to receive IPL treatment, with the other side as a self-
control. Cutoff filters of 590, 640, and 695 nm were used in
serial treatment, and the fluences ranged from 11 to 17 J/
cm2. Outcome measures included standardized photographs,
the skin melanin index (MI), and the erythema index (EI),
as well as biopsy specimens. Five patients exhibited good
improvement, and one showed excellent improvement at the
6-month follow-up visit. In addition, a significant reduction
in melanin was observed in the epidermis and dermis on
the treated side compared with the control side. The mean
MI values and EI values on both sides showed a decreasing
trend, with the treated side decreasing more quickly. Regard-
ing side effects, transient erythema and slight edema were
observed and resolved within a few hours. Postinflammatory
hyperpigmentation (PIH) occurred in one case and resolved
in 1 month.
Oiso and colleagues [43] reported 1 case of IPL treat-
ment for Riehl’s melanosis. Nine treatments were performed
at intervals of 1 month with a wavelength of 500 nm. The
initial IPL dose was 12 J/cm2, and the outcome measures
included subjective clinical improvement and clinical
photography. After the treatments, the therapy achieved
remarkable improvements, and no obvious side effects were
reported.
Lupus erythematosus
Ekbäck and Troilius [44] reported 4 cases of discoid lupus
erythematosus (DLE) and subacute cutaneous lupus erythe-
matosus (SCLE) treated with a 530–750-nm IPL. Patients
13
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Lasers in Medical Science (2022) 37:3085–3105
received, on average, four IPL treatments with a fluence of
8–13 J/cm2, and the efficacy was mainly dependent on clini-
cal photographs. All patients showed improvements after the
treatments: one patient exhibited swelling around the right
eye for a short time, and another patient experienced facial
flushing within a few hours.
Levy [45] reported a case of IPL treatment for systemic
lupus erythematosus (SLE) resulting in chronic erythema
of the cheeks. The patient was treated with 515-nm IPL
and single pulses of 22 J/cm2. According to clinical pho-
tographs, no obvious improvement of the erythema was
noted at a 2-month follow-up after the first treatment, while
a 2-month follow-up visit after the second session revealed
approximately 75% improvement. Furthermore, the overall
flushing and burning of the skin were relieved. There were
no significant adverse effects with the treatment, and the
effect of the intense pulsed light treatment was noted to last
for 12 months.
In addition, Byun and colleagues [46] reported 1 case
of scarring lesions of DLE treated by IPL combined with a
Q-switched 1064-nm neodymium-doped yttrium aluminum
garnet laser (Nd:YAG). The light parameters of IPL were
555–950 nm with a fluence of 11–12 J/cm2. The authors
reported significant improvement of the erythematous
lesions through clinical photographs after three sessions of
treatment at 3- to 5-week intervals. During the treatment,
the patient had mild erythema and exudation but no serious
side effects. It is worth mentioning that the improvement was
maintained for 1 year of follow-up without relapse.
Cutaneous sarcoidosis
Rosende and colleagues [47] reported 1 case of cutaneous
sarcoidosis with lesions on the nose treated by IPL. The
590-nm cutoff filter was used, and a double pulse of 37 J/
cm2 was delivered. The sessions lasted for 2 years; in each
session, the energy was slightly increased up to a fluence
of 45 J/cm2. Clinical photographs were taken to observe
the efficacy of IPL. The results showed that erythema was
almost complete, and at the 2-year follow-up visit, the
patient remained asymptomatic without treatment.
Similarly, Piccolo and colleagues [40] reported 1 case of
500-nm IPL treatment for cutaneous sarcoidosis. The patient
received 4 IPL sessions with a fluence of 12–16 J/cm2. After
the treatments, the pain disappeared, while the vascular com-
ponent and the consistency of the lesions achieved a signifi-
cant reduction.
Pilonidal cyst
Piccolo and colleagues [40] reported 3 cases of recurrent
pilonidal cysts treated with 550-nm IPL. Patients under-
went 3 sessions of IPL treatments with 7–9 J/cm2 fluence.
Lasers in Medical Science (2022) 37:3085–3105
Clinical photographs showed complete resolution in 3
treated patients. Moreover, after a follow-up visit of 5 years
for the first patient treated and 1 year for the other two, no
recurrence was observed.
The same year, Shafigh and colleagues [48] published
a case series study involving 30 patients with pilonidal
cysts. All patients received 6 sitting treatments with IPL
hair removal at 4–6-week intervals, which was repeated
2.2–2.8 years after treatment. IPL significantly improved the
lesion, and the overall recurrence rate after IPL treatment
was observed in 4 (13.3%) patients.
Pigmented actinic lichen planus
Juanes and colleagues [49] reported a case of PALP success-
fully treated with IPL. The patient went through 7 sittings
of 540- to 950-nm IPL, and the fluence was 12 J/cm2 for the
first three sessions and 14 J/cm2 for the last four sessions.
Outcome measures included clinical photographs and the
DLQI score. After the treatment, the patient showed a good
improvement, with the DLQI decreasing significantly from
27 at baseline to 6.
Discussion
With the emergence of laser and light-based treatments in
dermatology in the past decade, a variety of methods have
been studied as potential treatments for inflammatory skin
diseases. The characteristics of a wide spectrum determine
the diverse applications of IPL, especially in pigmentation
and vascular lesions, according to manifestations of most
inflammatory skin diseases. Meanwhile, the function of reg-
ulating the equilibrium between epidermal bacteria might
also play an important role in improving lesions.
In Table 3, 42 studies were included with their main char-
acteristics. In sum, 1 study was level 1a, 5 were level 1b,
12 were level 2b, 12 were level 4, and 12 studies were level
5. After being carefully evaluated by 3 dermatologists, we
finally decided to give a recommendation grade B for acne
vulgaris (4 studies with LOE 1b, 9 studies with LOE 2b, and
5 with LOE 4), which indicated that IPL could be an effec-
tive method for acne vulgaris. However, it is worth noting
that Lu and colleagues [50] published a meta-analysis com-
paring the efficacy of IPL treatment with other therapies;
they found that IPL is not as efficient as other supplemen-
tary therapies. Thus, we believe that although IPL treatment
might not be the best treatment for acne vulgaris, it could
still be a primary or supplementary choice to improve acne
lesions. Similarly, rosacea also received grade B for recom-
mendation (3 studies with LOE 1a, 1b, and 2b; 6 studies
with LOE 4 and 5), as one of the articles was a meta-analysis
that maintained 4 RCTs with higher quality than others and
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3103
showed positive outcomes. We believed that patients can
take IPL treatment into consideration when facing rosacea,
especially cases involving perilesional erythema. In addi-
tion, the recommendation grade C was for psoriasis, HS,
AD, and Riehl’s melanosis. IPL treatment of these four
inflammatory skin diseases seems to be promising, but it
was hard to draw a firm conclusion, as the articles were
mainly case series and low-quality clinical trials. Although
an RCT with LOE 2b showed good improvement of Riehl’s
melanosis, we thought that it lacked convincing results, as
the total number of patients was only six. Grade D included
lupus erythematosus, cutaneous sarcoidosis, pilonidal cyst,
and PALP, while most studies were case reports. IPL seems
to be an effective treatment, as those case reports all sug-
gested positive results; however, a solid conclusion could
not be drawn based on the small number of patients without
controls.
Literature concerning the efficacy and safety of IPL for
inflammatory skin diseases is diverse, and most studies have
shown limitations in terms of small patient numbers, lack
of a control group, and inconsistent treatment parameters.
Meanwhile, as the lesions could be located in different areas
of the body, we also considered whether treatment in differ-
ent parts of the body could bring out different results. For
example, the study of psoriasis only observed nail psoriasis,
and the efficacy of other parts remains unknown. Therefore,
large RCTs or prospective cohort studies are still needed.
In the above investigations, acne vulgaris and rosacea
were the most investigated inflammatory skin diseases. With
comparative studies of higher LOE and grade than other
diseases, we can hypothesize that IPL treatment could be an
elective therapy combined with oral medicine and ointment
for acne vulgaris and rosacea or used when topical therapies
have failed.
In contrast, evidence for psoriasis, HS, AD, Riehl’s mela-
nosis, lupus erythematosus, cutaneous sarcoidosis, pilonidal
cyst, and PALP is of a low level with grade C and D. As the
incidence of these skin diseases, except for psoriasis and
AD, is quite low, it might be unlikely that large RCTs will
be performed soon. Hence, despite the low level of recom-
mendation, treatment with IPL is still worth consideration
when conventional therapies have failed or as a supplemen-
tary treatment to decrease recurrence rates, as IPL is well
tolerated.
Regarding the side effects reported by the included stud-
ies, except for transitory erythema, edema, and pain, there
were no obvious adverse effects in most people. However,
we will not exclude the possibility of hyperpigmentation,
blisters, and a burning sensation in some individual cases,
especially in patients with darker phototypes. In addition,
some suspected side effects, such as phototoxicity and the
phenomenon of Koebnerization, have not been reported,
which may be related to the small number of studies and
13
3104
participants. Therefore, for patients with severe symptoms
or diseases prone to having a Koebner phenomenon, such
as lupus erythematosus and psoriasis, IPL treatment should
be used prudently.
Conclusions
In addition to pigment and vascular diseases, IPL can also
be used in some inflammatory skin diseases. IPL applied
for such diseases can effectively and safely improve acne
vulgaris and rosacea (recommendation grade B). For other
described inflammatory skin diseases, the level of recom-
mendation is low, and IPL could be used as a tentative or
supplementary treatment. The main side effects include
transitory erythema, edema, and pain, with the possibility
of hyperpigmentation, blisters, and a burning sensation in
some individuals. For diseases prone to elicit photosensitive
responses or the Koebner phenomenon, IPL therapy should
be used prudently. Further prospective studies and high-
quality research are still needed.
Acknowledgements This study was supported by Hangzhou health
science and technology key project (No 20220054). This work was
supported by Hangzhou medical key discipline construction project
(No [2021]21-3).
Declarations
Ethical approval None.
Consent to participate None.
Conflict of interest The authors declare no competing interests.
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