Randomized split-face controlled study to evaluate 1550-nm fractionated erbium glass laser for treatment of acne vulgaris--an image analysis evaluation

BACKGROUND

Novel and promising results in acne treatment with infrared lasers have been reported. The 1,550-nm erbium glass laser is one of the infrared lasers that may be useful in the treatment of acne.

OBJECTIVE

The aim of this study was to evaluate the efficacy of an erbium glass laser in treatment of active acne and to study the effect of this type of laser on sebaceous glands.

PATIENTS AND METHODS

Twenty-four patients with active acne lesions were treated using 1,550-nm (30-40 mJ) fractional erbium glass laser. Every patient received 4 sessions with a 2-week interval. Follow-up was done every 3 months for 1 year. The image analyzer computer system was used to measure the sebaceous gland size.

RESULTS

A significant reduction (p < .0001) in the mean count of lesions was observed after treatment and in the follow-up period. A significant reduction in the size of sebaceous glands was also evident after laser treatment.

CONCLUSION

Treatment of active acne with the 1,550-nm erbium glass laser is effective. Papules, pustules, and nodules all respond well to therapy. The sebaceous gland size decreased significantly, which accounts for the long remission period.

The pulsed-dye laser as an adjuvant treatment modality in acne vulgaris: a randomized controlled single-blinded trial

BACKGROUND

Acne vulgaris is the most common skin disease and can pose a substantial therapeutic challenge. Recently, several phototherapeutic modalities, most notably pulsed-dye laser (PDL) treatment, have been introduced, but the published results - albeit promising - are controversial.

OBJECTIVES

To assess the efficacy of an adjuvant PDL treatment when combined with a proven topical treatment [fixed-combination clindamycin 1%-benzoyl peroxide 5% hydrating gel (C/BPO)].

METHODS

Eighty patients (38 males and 42 females, mean +/- SD age 19.7 +/- 5.9 years) were randomized in a 1 : 2 ratio to receive C/BPO alone or in combination with PDL treatment (wavelength 585 nm, energy fluence 3 J cm(-2), pulse duration 0.35 ms, spot size 7 mm). Patients were evaluated at baseline and at 2 and 4 weeks after initial treatment. The primary end points were the Investigator's Static Global Assessment (ISGA) score and lesion count; the secondary end point was the Dermatology Life Quality Index (DLQI).

RESULTS

Both groups showed a significant improvement during observation [ISGA 27.1% (C/BPO) and 24.6% (C/BPO + laser), total lesion count 9.2% and 9.0%, inflammatory lesion count 36.3% and 36.9%, DLQI 54.5% and 42.5%], but there was no significant or otherwise appreciable difference between treatment modalities as far as the extent of improvement was concerned. Patients with more severe findings at baseline had a greater benefit from either therapy regimen.

CONCLUSIONS

Our findings do not support the concept of a substantial benefit of PDL treatment in acne vulgaris.

Acne vulgaris: lasers, light sources and photodynamic therapy--an update 2007

Inflammatory acne vulgaris remains one of the most common dermatologic disorders seen in clinical practice. Medical therapy remains the gold standard for therapy but recent advances have shown that a variety of lasers and light sources may be useful in the treatment of inflammatory acne vulgaris. In addition, the use of 20% 5-aminolevulinic acid has found a useful niche in the treatment of moderate-to-severe inflammatory acne vulgaris.

Acne and PDT: new techniques with lasers and light sources

Acne vulgaris is one of the most common dermatologic disorders encountered in everyday practice. Treatment options for this often psychologically scarring disease are numerous and, for many individuals, provide relief from the disorder. However, factors such as antibiotic resistance and slow onset of action from many topical therapies have led researchers to seek out alternative therapies, especially for those suffering from moderate to severe inflammatory acne vulgaris. Lasers and light sources are finding increased usage in the treatment of inflammatory acne vulgaris. Light sources including blue lights and intense pulsed lights are becoming regular additions to routine medical management to enhance the therapeutic response. Finally, photodynamic therapy may change many of the acne vulgaris paradigms, as its place is being defined in the treatment of moderate to severe inflammatory acne vulgaris. More and more clinical trials are showing the effectiveness of 5-aminolevulinic acid and photodynamic therapy in the treatment of moderate to severe inflammatory acne vulgaris.