Abstract
BACKGROUND: Intense pulsed light (IPL) therapy is widely used for facial rejuvenation, targeting vascular, pigmentary, and textural changes. However, comprehensive, real-world evidence evaluating long-term, regular IPL treatment across multiple dimensions of skin improvement remains limited. OBJECTIVES: This study aimed to assess the efficacy and safety of long-term, regular IPL therapy in improving facial erythema, pigmentation, and wrinkles, and to identify predictors of favorable response. METHODS: This retrospective real-world study included 236 patients who underwent six or more IPL sessions between 2020 and 2025. Patients were categorized as acne, rosacea, or cosmetic subjects. VISIA imaging quantified erythema, pigmentation, and wrinkle indices, while the Global Aesthetic Improvement Scale (GAIS) was used to assess aesthetic outcomes. Logistic regression identified predictors of good response. RESULTS: Significant improvements were observed in erythema, pigmentation, and wrinkle indices after treatment (all p < 0.05). Regular treatment intervals and total number of sessions were independently associated with better outcomes (OR = 13.62 and 3.80, respectively, both p < 0.05). Patients with Fitzpatrick Type IV skin showed lower response rates (OR = 0.12, p = 0.001). VISIA analyses demonstrated quantifiable reductions in erythema and pigmentation areas, while wrinkles showed notable textural improvement. No severe adverse events occurred. CONCLUSIONS: Long-term, regular IPL therapy effectively improves facial erythema, pigmentation, and wrinkles, confirming its value as a comprehensive rejuvenation strategy. Regular treatment intervals optimize cumulative effects, while objective imaging enhances precision in outcome evaluation. These findings support IPL as a safe, evidence-based, and multidimensional approach to long-term facial rejuvenation.