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SAVANNAH, Ga. — Supramolecular salicylic acid (SSA) plus intense pulsed light (IPL) was both safe and effective for treating rosacea, a prospective, split-face trial suggested.

In the study, compared with the sides of the face that received IPL alone, the sides treated with IPL plus SSA were associated with greater reductions in erythema scores and in the erythema index at 12 weeks.

In addition, adverse events did not differ significantly between the treatment groups.

Study investigator Meifang Wang, PhD, Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, presented the results at The American Society for Laser Medicine and Surgery (ASLMS) 2026 Annual Meeting.

Overall, the findings show the superiority of SSA plus IPL over IPL monotherapy, as well as a favorable safety profile, Wang told meeting attendees, noting that this could provide “a promising therapeutic strategy” for rosacea.

Previous Research ‘Lacking’

Rosacea, a chronic skin disorder characterized by signs and symptoms that include persistent erythema, paroxysmal flushing, and inflammatory papules, affects approximately 5% of adults globally. Current treatments include topical medications and photoelectric therapies, but “each of these has its limitations,” Wang said.

Although the use of SSA and IPL separately have shown some efficacy for rosacea, prospective studies assessing the modalities together “are still lacking,” she noted.

Historically, there was concern that combining salicylic acid with an energy-based treatment could potentially lead to irritation and a compromised skin barrier. However, recent studies have challenged that hypothesis.

In the current prospective, randomized study, the investigators enrolled 36 patients in China aged 18-55 years with either facial erythematotelangiectatic (type I) or papulopustular (type II) rosacea.

All patients received once monthly IPL applied to both sides of the face for three sessions, along with a 30% SSA peel applied on the randomly assigned side. They were evaluated at baseline and at week 12.

The IPL device used was a Lumenis One, with a parameter of 7 mm, 1.5-3 ms, 6-10 J/cm². After a cleansing step, the IPL was applied, followed by a cold compress. The process for the 30% SSA treatment also included cleansing, application of the product, and then cooling.

Adverse outcomes assessed for IPL included redness, swelling, and purpura; and those for SSA included redness, stinging, and itching.

Efficacy outcome measures included the VISIA Complexion Analysis System for a quantitative analysis of the erythema area, the CK multiple probe adapter for erythema index, the Clinical Erythema Assessment (CEA), and patient-rated symptoms. To assess the skin barrier, transepidermal water loss (TEWL) and skin hydration were also evaluated.

Of the 36 participants enrolled, 33 completed the study.  At 12 weeks, 1 month after the last treatment, the side of the face that received combination therapy showed a greater reduction in clinician-rated erythema scores on the VISIA than the sides treated with IPL alone (-3.3 vs -1.9; P = .004), as well as a greater decrease in the erythema index (-36.1 vs -25.9; P = .001).

Both sides showed improvement from baseline on the CEA (P < .001 for all measures), patient scores (P < .05 for all), and VISIA pore and texture scores (P < .05 for all), and the results between the sides were not significantly different for any of these outcomes. Both sides also showed progressive increases in skin hydration and progressive decreases in TEWL with each successive session (P < .05 for all).

Adverse events occurred in 17% vs 8% of patients in the combination and single-treatment groups, respectively, but the difference was not statistically significant.

Generalizable Results?

Commenting for Medscape Medical News, session moderator Zakia Rahman, MD, clinical professor of dermatology at Stanford University School of Medicine, Stanford, California, noted that the study included a good-sized number of patients, and that the findings could be generalizable to other countries.

“Combination modalities, especially when done in the hands of experts, can lead to better outcomes than a single modality. And I think this was a good example of that,” Rahman said.

In addition, “salicylic acid is relatively inexpensive, and I was curious to see the effects that it would have here,” she said. Overall, “I think combination treatments can absolutely be used, including for rosacea,” Rahman added.

She reported having had patients who were surprised to learn they could have multiple treatments in one day. This process, known as stacking, can also be convenient for patients who travel long distances for treatment, Rahman said.

“If you can use more of the tools in your tool kit to optimize outcomes, it’s a win for the patient,” she said.

Rahman, who was not involved with the research, also directs the laser and aesthetic clinic at Stanford and is a member of the ASLMS national board of directors.

She noted that she welcomes hearing about research from all over the world, including in presentations at the meeting. In the case of the combination treatment used in the current study, “I do think this could be used in the US,” Rahman said.

Wang and Rahman reported having no relevant financial relationships.