Efficacy of Lasers and Light Sources for Telangiectasias in the Setting of Systemic Sclerosis and Systemic Lupus Erythematosus: A Review

OBJECTIVES: Lasers and light sources are effective treatment modalities for numerous vascular conditions of the skin, including rosacea and port-wine capillary malformations. While they are widely accepted as effective therapies for sporadic idiopathic telangiectasias, there is limited data regarding their efficacy in treating telangiectasias that occur due to connective tissue diseases (CTD) of systemic sclerosis (SSc) and lupus erythematosus (LE). The primary objective of this review is to analyse data on the effectiveness of lasers and light sources in treating SSc and LE associated telangiectasias. Ultimately, we hope that this will help guide physicians in managing these telangiectasias. METHODS: A PubMed search was conducted March 2025 on the efficacy of lasers and light based devices known to help with vascular lesions in treating telangiectasias associated with a variety of connective tissue diseases including SSc, LE, dermatomyositis, mixed CTD, and morphea. Ultimately, 10 full-text articles met inclusion criteria. Available studies only investigated the use of either pulsed dye laser (PDL) or intense pulsed light (IPL) for telangiectasias within the context of SSc and LE, and thus these conditions became the focus of our review. RESULTS: All 10 articles demonstrated that PDL or IPL resulted in an improvement in telangiectasias associated with SSc and LE. In seven of the studies, there was both a reduction in the number of telangiectasias and overall visual improvement after PDL treatment. In all 4 studies that accounted for patient perspective, all subjects reported satisfaction with treatment and endorsed a better quality of life after PDL. Two studies suggested that telangiectasias secondary to SSc or LE may be more recalcitrant than sporadic telangiectasias, necessitating a greater number of treatments. One study found that PDL may be more effective than IPL when comparing clinical photographs and dermoscopic findings. All adverse events were transient and have also been seen in treatment of sporadic telangiectasias. No studies reported exacerbation of the underlying SSc or LE. CONCLUSION: Overall, PDL and IPL appear to be relatively safe and effective treatments for managing SSc and SLE-associated telangiectasias. More treatment sessions may be required compared to sporadic idiopathic telangiectasias. Future randomized controlled studies with more objective outcomes would help better characterize the effect of light-based devices in this unique patient population.