Ultrastructural evidence for thermal injury to pilosebaceous units during the treatment of acne using photopneumatic (PPX) therapy

Advancing precision acne therapy using a novel photopneumatic device

Photopneumatic therapy (PPT) combines vacuum and pulsed, broadband light to extract debris and bacteria from the pilosebaceous units; monotherapy is unexplored. Facial acne lesions and skin texture were evaluated after up to six PPT treatments, 1-2 weeks apart for 15-20 minutes per treatment using customized energy settings, in seven female patients with inflammatory, comedonal and pustular lesions. Lesion and redness reduction with improvement in skin texture and pore size were observed after 1-3 treatments; adverse effects were infrequent. PPT may optimize lesion clearance as monotherapy and/or as an adjuvant. The ability to change pulse structure, pulse duration, vacuum pressure and fluence allow for treatment that best matches skin type and acne severity.

A split-face comparative trial of photopneumatic therapy versus intense pulsed light for the treatment of acne vulgaris

A novel photopneumatic (PPX) technology, combining blue light-emitting diode (LED) and broadband intense pulsed light (IPL) with vacuum pressure, was developed for the treatment of acne vulgaris (AV). In this study, we enrolled 50 patients with mild to moderate AV. Five successive treatments were performed on one side of the face with a combined PPX device, and the opposite side was treated with only IPL with the same fluences at 2-week intervals. Clinical improvement was evaluated by inflammatory and non-inflammatory acne lesion counts. Additionally, patient self-assessment scores were assessed. The results showed that inflammatory and non-inflammatory acne lesion counts were significantly improved on both sides of the face after treatment (p < .001, p = .001, respectively). Both inflammatory and non-inflammatory lesion counts were significantly reduced on the side treated with PPX when compared to the side treated with IPL alone (p = .008, p = .045, respectively). Thirty-eight of 44 patients reported slight to moderate improvement on the patient self-assessment score. No significant side effect was observed during the study periods.In conclusion, PPX therapy is an effective and safe modality to treat mild to moderate AV. This study shows that PPX therapy has superior efficacy for the treatment of AV compared to IPL monotherapy.

Effectiveness of photopneumatic technology: a descriptive review of the literature

Usage of photopneumatic technology has recently increased for treatment of different skin conditions such as acne, keratosis pilaris (KP), and rosacea. Photopneumatic devices combine gentle negative pressure with broad band pulsed light simultaneously to attack multiple targets in the skin for better treatment outcomes. In this literature review, we evaluate the efficacy of photopneumatic therapy on treatment of acne, keratosis pilaris (KP), and rosacea.

Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser

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.

Light-based therapies in acne treatment

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.

Photopneumatic technology in acne treatment and skin rejuvenation: histological assessment

BACKGROUND AND AIMS

Recent reports indicate that a variety of light-based devices have been used for acne treatment and skin rejuvenation. A new technology combining intense pulsed light with negative pressure, photopneumatic technology, has recently attracted interest. The present study assessed acne treatment and skin rejuvenation with this novel approach Subjects and Methods: Acne, 450 nm tip. Five Japanese volunteers (1 male, 4 female; mean age 28.6 yr; skin type III) with mild to moderate/moderate active acne participated. The face was treated with 2 sessions, 2 weeks apart. Biopsies were obtained immediately after the first session and 1 week after the second session, and routinely processed for transmission electron microscopy (TEM). Rejuvenation, profusion tip with topical preparation . In 5 Japanese volunteers (3 male, 2 female; mean age 37.6 yr, skin type III), the volar aspect of both forearms was treated with the 530 nm head at P6 (around 12 J/cm(2)). The left arm was then treated with a pre-infused profusion tip and vacuum only. Four sessions were given, 14-day intervals. Biopsies were taken from both arms 2 weeks after the 2nd session and 3 weeks after the 4th session. One-half of each biopsy was assessed with histo-and immunohistochemistry, and the other with TEM.

RESULTS

Acne trial: A combination of physical extraction of comedones, mild photothermal damage of the follicle and damage to identified bacilli was noted post-treatment, with macroscopic improvement of the skin. Rejuvenation with profusion: Significant morphological and immunohistochemical differences were seen between the control and profusion-treated arms at the first assessment. These differences became less significant at the 2nd assessment.

CONCLUSIONS

Macroscopically and histologically, photopneumatic technology improved acne lesions, suggesting a synergistic effect between the components of the technology. In skin rejuvenation, the profusion therapy accelerated the regenerative process, and could have excellent additional potential as a noninvasive transepidermal drug delivery system.

An open-label, split-face trial evaluating efficacy and safty of photopneumatic therapy for the treatment of acne

Background

Acne vulgaris is the most common skin disease worldwide, with many available treatment modalities, including oral and topical medications and laser therapy. Recently, a novel device (Isolaz, Pleasanton, CA, USA) that combines vacuum pressure and a broadband light source (400 nm to 1,200 nm) was developed for the treatment of acne.

Objective

To determine the clinical efficacy and safety of photopneumatic therapy for the treatment of acne vulgaris of the face.

Methods

Twenty adults with mild to moderate facial acne vulgaris received 4 successive treatments on one side of the face with a combined photopneumatic device (intense pulsed light: fluence=5.8 J/cm²; negative pressure=iMP mode) at 2 week intervals. Acne lesions on the opposite side of the face were not treated. Lesion counts were performed at baseline, prior to each treatment session, and at 3 months after the final treatment session.

Results

Significant lesion improvements and reduced numbers of acne lesions were observed on the treated side of the faces. Most patients experienced global clinical improvement. No severe side effects occurred during the study, with only a few patients experiencing transient erythema, purpura and/or exacerbation of pre-existing acne.

Conclusion

Photopneumatic therapy is a safe and effective treatment for mild to moderate acne vulgaris.

Novel photopneumatic therapy for the treatment of rosacea

BACKGROUND

Rosacea is a common skin condition, but the currently available treatments are not satisfactory.

OBJECTIVE

We wanted to assess the efficacy and safety of photopneumatic therapy (PPx), which delivers pneumatic energy and broadband light (400~1,200 nm), for the treatment of erythematotelangiectatic rosacea.

METHODS

Twenty two patients with erythematotelangiectatic rosacea were treated 3~5 times with PPx. Three independent dermatologists evaluated the efficacy of PPx by comparing the photographs taken before and after treatment. Patient self-assessment was also done by interviews.

RESULTS

The photographic assessment by the dermatologists of the improvement showed that >50% improvement occurred in 64% (14/22) of the patients. The specific categories of improvement were as follows: poor (<25% improvement), 1 patient; fair (25~50% improvement), 7 patients; good (50~75% improvement), 11 patients; and excellent (>75% improvement), 3 patients. Based on the patients' self-assessment, 20 patients (91%) acknowledged an improvement.

CONCLUSION

PPx is an effective and safe treatment option for erythematotelangiectatic rosacea.

Laser treatment of acne, psoriasis, leukoderma, and scars

Lasers frequently are used by dermatologists for their multiple aesthetic applications, but they also can be used to treat a variety of medical dermatology conditions. Conditions such as acne vulgaris, psoriasis, and vitiligo can all be successfully treated with laser, thereby providing the patient with additional therapeutic options. Lasers have also been used for years to improve the appearance of scars. The newer fractionated lasers have been especially effective in enhancing the clinical outcomes of scar revision.