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ORLANDO, Fla. — Treatments of the face with fully ablative carbon dioxide lasers and nonablative fractional lasers (NAFLs) have in recent years been shown to be associated with a reduced risk of developing keratinocyte-derived carcinomas (KCs) on treated areas of skin.

At The American Society for Laser Medicine and Surgery (ASLMS) 2025 Annual Meeting, researchers presented evidence that pulsed-dye laser (PDL) facial treatments, used since 1987 to treat erythema, rosacea, and other skin conditions, may also reduce the risk for these common skin cancers, which include basal cell and squamous carcinomas.

At the meeting, Jamie K. Hu, MD, a research fellow in dermatology at Massachusetts General Hospital (MGH) in Boston, the study’s lead investigator, presented results from a retrospective chart review from a cosmetic dermatology practice at the hospital of 59 patients (61% women) with a history of facial KCs who received at least one facial treatment with PDL and no other type of laser. These patients were matched with non–laser-treated control individuals from the same cosmetic practice for sex, age, and Fitzpatrick skin type.

After a mean follow-up of 8.6 years, 27.1% of the PDL-treated patients developed facial KCs compared with 54.2% of matched control individuals (P = .0047). Confounding based on differences in sunscreen use between patients and control individuals was unlikely, Hu said, because “our patient population at the cosmetic center is very on top of their sunscreen use.” 

The findings added to a growing body of evidence, dating back more than a decade, that laser treatments have a prophylactic effect with regards to KCs. In 2023, the same Harvard University–based research group, led by Mathew Avram, MD, director of the MGH Dermatology Laser and Cosmetic Center, found that facial NAFL treatment was associated with a decreased risk for subsequent facial KC development.

In a joint interview at the meeting, Avram and Hu commented that while the effect seen previously for fractional laser treatment has been linked to skin changes that boost DNA repair, the mechanism with PDL may be different. “There are a few other theories,” Avram said. One is that PDL reduces the proinflammatory cytokine milieu associated with increased basal cell development, as seen in a recent study of patients with granulomatous rosacea. Another relates to enhanced immune surveillance stimulated by PDL. And finally, “we actually treat basal cell carcinomas with the pulsed laser. So it may be that we are treating incipient ones unknowingly,” Avram said.

In a separate interview at the conference, R. Rox Anderson, MD, director of the Wellman Center for Photomedicine at MGH, who was not involved with this study, said it was a “real surprise” to him that both the fractional laser and the pulsed laser, which work differently and target different dermal structures, would both be associated with a decreased risk of developing KCs.

Anderson, who invented PDL technology, said he nonetheless suspected that the same mechanisms thought to underlie the prophylactic activity of other laser treatments were also at play here.

He said that the findings of protective effects from skin lasers, when first reported, had struck him as counterintuitive: Early on, he had feared that the treatments might increase cancer risk.

“I come in with a laser and I randomly kill 20% of your epidermis. Those cells have to be replaced. You would think that the cells that had accumulated mutations that allow them to replicate really well would be the ones that would win,” Anderson said. “Instead, those micro-injuries stimulate the [DNA] repair process. It’s not an anticancer treatment but is an interesting mechanism that may well be applicable beyond the skin.”

This study was funded by Hu and Avram’s institutions. Avram is a consultant for Solta, Sofwave, Cytrellis, Pelage, and B.A.I. Biosciences and holds intellectual property with Cytrellis. Anderson disclosed having financial relationships with Blossom Innovations, AVAVA, R2 Dermatology, Cytrellis, and Brixton Biosciences. Hu reported no financial conflicts of interest.