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Pulumati A, Jaalouk D, Algarin YA, Kasheri E, Issa NT, Nouri K. Targeting sebaceous glands: a review of selective photothermolysis for Acne Vulgaris treatment. Arch Dermatol Res 2024; 316:356. [PMID: 38850426 DOI: 10.1007/s00403-024-02979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/19/2024] [Accepted: 04/26/2024] [Indexed: 06/10/2024]
Abstract
Acne vulgaris (AV), characterized by excessive sebum production and Cutibacterium acnes proliferation in the sebaceous glands, significantly impacts physical and psychological health. Recent treatment advancements have focused on selective photothermolysis of sebaceous glands. This review evaluates two innovative therapies: the 1726-nm laser and nanoparticle-assisted laser treatments. We conducted a comprehensive search of PubMed and Embase using the primary terms "acne vulgaris" or "acne" AND "laser," "photothermal therapy," "nanoparticles," "treatment," or "1726 nm laser." Inclusion criteria were articles published in English in peer-reviewed journals that focused on treating AV through targeting the sebaceous glands, yielding 11 studies. Gold nanoparticles, used with 800-nm laser, 1064-nm Nd: YAG laser, or photopneumatic device, and platinum nanoparticles with 1450-nm diode laser, showed notable improvements in severity and number of acne lesions, safety, and patient satisfaction. The 1726-nm laser treatments also showed considerable lesion reduction and tolerability, with minimal side effects such as erythema and edema. Its efficiency is credited to its short, high-power pulses that effectively target sebaceous glands, offering precise treatment with fewer side effects compared to lower-power pulses. Selective photothermolysis using nanoparticle-assisted laser therapy or the 1726-nm laser offers a promising alternative to conventional AV treatments, showcasing efficacy and high patient satisfaction. The 1726-nm laser streamlines treatment but involves new equipment costs, while nanoparticle-assisted therapy integrates well into existing setups but relies on external agents and is unsuitable for certain allergies. Future research should include long-term studies and comparative analyses. The choice of treatment modality should consider patient preferences, cost implications, and availability of specific therapies.
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Affiliation(s)
- Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
| | - Dana Jaalouk
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Yanci A Algarin
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- Eastern Virginia Medical School, Norfolk, VA, USA
| | - Eli Kasheri
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Naiem T Issa
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- Forefront Dermatology, Vienna, VA, USA
- Issa Research and Consulting, LLC, Springfield, VA, USA
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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Scopelliti MG, Hamidi-Sakr A, Möller S, Karavitis M, Kothare A. Selective photothermolysis in acne treatment: The impact of laser power. J Cosmet Dermatol 2024; 23:457-463. [PMID: 37786234 DOI: 10.1111/jocd.16020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/13/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Selective photothermolysis (SPT) using a 1726 nm laser has emerged as a safe and effective treatment option for acne vulgaris by targeting sebaceous glands (SG). Power output plays a crucial role in determining treatment selectivity and efficacy. AIMS This work highlights the advantages of a higher-power laser source and outlines the limitations of lower-power laser sources and the subsequent impact on treatment. METHODS Light transport and bioheat transfer simulations were performed to demonstrate photothermal impact on the SG and the surrounding dermis when irradiated by a high- or lower-power laser source. RESULTS The simulations showed that a single higher-power-shorter-pulse (HPSP) selectively increases SG temperature well beyond bulk temperatures, which is desirable for SPT. Selectivity decreases linearly with power for the single lower-power-longer-pulses (LPLP) exposure. A multiple-LPLP approach elevates bulk temperatures significantly more than a single-pulse strategy, compromising selectivity. CONCLUSION The goal of SPT is to damage SG safely and effectively by creating an intense temperature rise localized to the SG while moderately increasing the dermis temperature. This goal is mostly achieved with higher-power lasers that deliver a single HPSP. Lower-power lasers, longer pulse widths, and multi-pulse strategies result in higher bulk temperatures and lower SG selectivity, making such treatment challenging to execute while adding a higher risk of discomfort and downtime.
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Bakus AD, Yaghmai D, Massa MC, Garden BC, Garden JM. Sustained Benefit After Treatment of Acne Vulgaris Using Only a Novel Combination of Long-Pulsed and Q-Switched 1064-nm Nd: YAG Lasers. Dermatol Surg 2018; 44:1402-1410. [PMID: 29877931 DOI: 10.1097/dss.0000000000001565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Acne vulgaris remains a challenging disease to treat in many patients. Traditional therapies may have limited successes with potential side effects. Laser and light energy devices may offer a desirable alternative. OBJECTIVE To evaluate the effectiveness and safety in using a combination laser approach with both long-pulsed (LP) and Q-switched (QS) Nd:YAG lasers in the treatment of active acne. METHODS Twenty patients with moderate to severe inflammatory acne were treated with LP YAG laser followed immediately with QS YAG laser. Patients received at least 8 treatments. Follow-up evaluation occurred at a minimum of 12 months. Pre- and post-treatment photographs were graded by blinded physicians. All topical acne medications and oral antibiotics were discontinued throughout the therapy and follow-up period. RESULTS There was a 81% reduction in acne lesions, with 60% of patients having 90% or greater reduction. Overall appearance was graded at 84% improvement at follow-up. Follow-up occurred at a mean of 22.7 months after completion of therapy. Aside from transient erythema, there were no other adverse effects. CONCLUSION Active acne can be treated successfully with a combination of LP and QS YAG lasers with patients remaining off acne medications throughout laser therapy and the follow-up period.
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Affiliation(s)
- Abnoeal D Bakus
- Physicians Laser and Dermatology Institute, Chicago, Illinois
| | - Dina Yaghmai
- Physicians Laser and Dermatology Institute, Chicago, Illinois
| | - Mary C Massa
- Physicians Laser and Dermatology Institute, Chicago, Illinois.,Department of Dermatology, Rush University Medical School, Chicago, Illinois
| | - Benjamin C Garden
- Physicians Laser and Dermatology Institute, Chicago, Illinois.,Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
| | - Jerome M Garden
- Physicians Laser and Dermatology Institute, Chicago, Illinois.,Department of Dermatology and Biomedical Engineering, Northwestern University, Chicago, Illinois
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Gold MH, Goldberg DJ, Nestor MS. Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser. J Cosmet Dermatol 2017; 16:303-318. [PMID: 28703382 DOI: 10.1111/jocd.12367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.
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Affiliation(s)
| | - David J Goldberg
- Skin Laser and Surgery Specialists of NY and NJ, Hackensack, NJ, USA
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Wanner M, Sakamoto FH, Avram MM, Anderson RR. Immediate skin responses to laser and light treatments. J Am Acad Dermatol 2016; 74:807-19; quiz 819-20. [DOI: 10.1016/j.jaad.2015.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 12/23/2022]
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Immediate skin responses to laser and light treatments. J Am Acad Dermatol 2016; 74:821-33; quiz 834, 833. [DOI: 10.1016/j.jaad.2015.06.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 12/17/2022]
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Han HH, Lee JY, Rhie JW. Successful treatment of areolar Fox-Fordyce disease with surgical excision and 1550-nm fractionated erbium glass laser. Int Wound J 2016; 13:1016-9. [PMID: 27072751 DOI: 10.1111/iwj.12586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 02/11/2016] [Indexed: 11/29/2022] Open
Abstract
Fox-Fordyce disease (FFD) is a rare chronic disorder characterised by persistent inflammation because of the obstruction of apocrine sweat glands, which is a key factor of pathogenesis. The treatment of FFD is known to be difficult, and the modalities of treatment have not yet been widely studied. We report the successful treatment of a case of bilateral areolar FFD by a combination of surgical excision and 1550-nm fractionated erbium glass laser in an 18-year-old woman. The patient presented with a bilateral areolar eruption of multiple, severely pruritic, 3-4 mm skin- to grey-coloured folliculocentric dome-shaped papules. The initial treatment plan was for bilateral surgical excision of the larger and more highly elevated papules via circumferential dermal excision, which was intended to maintain the areolar contour and minimise distortion. A 1550-nm fractional erbium glass laser was then used to control the remnant lesions. The patient was recurrence-free at 14 months after the final laser treatment, and she was fully satisfied with the treatment results.
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Affiliation(s)
- Hyun H Han
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jun Y Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong W Rhie
- Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, Republic of Korea.
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Nestor MS, Swenson N, Macri A. Physical Modalities (Devices) in the Management of Acne. Dermatol Clin 2016; 34:215-23. [DOI: 10.1016/j.det.2015.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Liu Y, Zeng W, Hu D, Jha S, Ge Q, Geng S, Xiao S, Hu G, Wang X. The long-term effect of 1550 nm erbium:glass fractional laser in acne vulgaris. Lasers Med Sci 2016; 31:453-7. [PMID: 26796708 DOI: 10.1007/s10103-016-1871-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 01/11/2016] [Indexed: 11/30/2022]
Abstract
We evaluated the short-term and long-term effects of the 1550 nm erbium:glass (Er:glass) fractional laser in the treatment of facial acne vulgaris. Forty-five (9 male and 36 female) acne patients were treated 4 times at 4-week intervals with the following parameters: 169 spot density and 15-30 mJ/cm(2) fluence. There was no control group. The laser spots were adjustable (maximum overlap: 20%) according to the treatment area, and delivered in rows in order to cover all the face. Clinical photographs were taken. The IGA scores and lesion counts were performed for each treatment. Their current state was obtained by phone call follow-up to determine the long-term effect and photographs were offered by themselves or taken in hospital. After four treatments, all patients had an obvious reduction of lesion counts and IGA score and the peak lesion counts decreased to 67.7% after the initial four treatment sessions. For long-term effect, 8 patients lost follow-up, hence 37 patients were followed-up. 8 patients were 2-year follow up, 27 at the 1-year follow-up, and all patients at the half-year follow-up. The mean percent reduction was 72% at the half-year follow-up, 79 at the 1-year follow-up and 75% at the 2-year follow-up. Side effects and complications were limited to transient erythema and edema, and few patients suffered from transient acne flare-ups and sensitivity. All patients responded that their skin was less prone to oiliness. In conclusion, acne can be successfully treated by 1550 nm Er:glass fractional laser, with few side effects and prolonged acne clearing.
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Affiliation(s)
- Yale Liu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Weihui Zeng
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China.
| | - Die Hu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Smita Jha
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Qin Ge
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Songmei Geng
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Shengxiang Xiao
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Guanglei Hu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
| | - Xiaoxiao Wang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi Province, 710004, China
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Abstract
The use of light and laser in the treatment of acne is increasing as these modalities are safe, effective, and associated with no or minimal complications when used appropriately. These light and laser sources are also being used in combination with pharmacological and/or physical measures to synergize their effects and optimize the therapeutic outcome. This review focuses on optical devices used in treating acne and serves to delineate the current application of various methods, including their utility and efficacy.
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Affiliation(s)
- Susan Pei
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Arun C Inamadar
- Department of Dermatology, SBMP Medical College, BLDE University, Bijapur, Karnataka, India
| | - Keshavmurthy A Adya
- Department of Dermatology, SBMP Medical College, BLDE University, Bijapur, Karnataka, India
| | - Maria M Tsoukas
- Department of Dermatology, College of Medicine, University of Illinois, Chicago, Illinois, USA
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Randomized split-face controlled study to evaluate 1550-nm fractionated erbium glass laser for treatment of acne vulgaris--an image analysis evaluation. Dermatol Surg 2014; 40:1191-200. [PMID: 25310750 DOI: 10.1097/dss.0000000000000167] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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McLeod MP, França K, Nouri K, Elsaie ML. Laser Treatment for Acne. Dermatol Surg 2012. [DOI: 10.1002/9781118412633.ch45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Helbig D, Bodendorf MO, Grunewald S, Kendler M, Albert M, Simon JC, Paasch U. Comparative treatment of multiple vellus hair cysts with the 2940 nm Er:YAG and 1540 nm Er:Glass laser. J COSMET LASER THER 2011; 13:223-6. [DOI: 10.3109/14764172.2011.606464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Affiliation(s)
- Klaus Degitz
- Department of Dermatology, Ludwig-Maximilian University, Pasinger Bahnhofsplatz 1, Munich, Germany.
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Gold MH. Acne vulgaris: lasers, light sources and photodynamic therapy--an update 2007. Expert Rev Anti Infect Ther 2008; 5:1059-69. [PMID: 18039088 DOI: 10.1586/14787210.5.6.1059] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
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.
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Affiliation(s)
- Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, 2000 Richard Jones Road, Suite 220, Nashville, TN 37215, USA.
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