Resolution of Treatment-Refractory Papulopustular Rosacea With Combined Light Source Photodynamic Therapy Using Pre-incubation Nonablative Fractionated Laser Resurfacing

Papulopustular rosacea is an inflammatory subtype of rosacea that can significantly impair patients' quality of life. Available treatment options range from anti-inflammatory topical and oral medications to laser and light therapies. Photodynamic therapy with aminolevulinic acid (ALA-PDT) has emerged as a more recent treatment option for papulopustular rosacea. ALA-PDT can significantly reduce the inflammatory component of rosacea, and pre-incubation nonablative fractionated laser resurfacing (NAFR) may enhance transcutaneous delivery of topical ALA. We present a case in which treatment-refractory papulopustular rosacea of 10-year duration was resolved with ALA-PDT using pre-incubation NAFR. This case highlights a novel, alternative approach to rosacea treatment that may be useful for patients recalcitrant to more conventional therapies.