1
|
Jaalouk D, Pulumati A, Algarin YA, Humeda J, Goldberg DJ. The impact of energy-based devices on sebum in acne vulgaris: A systematic review. J Cosmet Dermatol 2024; 23:3066-3077. [PMID: 39129257 DOI: 10.1111/jocd.16466] [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: 05/14/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Acne vulgaris (AV) is a widespread inflammatory skin condition associated with increased sebum production, abnormal keratinization, bacterial overgrowth, and inflammation. Overactive sebaceous glands (SGs) produce excess sebum, promote Cutibacterium acnes growth, and affect acne development. Energy-based treatments (EBDs), including light therapy, photodynamic therapy (PDT), lasers, and radiofrequency (RF) devices, have emerged as effective treatment options. As the use of EBDs becomes more widespread, it is imperative to understand their effects on skin parameters, such as sebum, in AV. METHODS Searches were conducted in Embase, PubMed, Web of Science, and the Cochrane Library. The studies included were randomized and nonrandomized trials on facial AV that used EBDs and featured objective casual sebum level (CSL) measurements via Sebumeter. Data synthesis involved percentage reductions in CSL at follow-ups compared to baseline. RESULTS Twenty-three studies were analyzed. PDT and RF consistently reduced CSL by 30%-40% and 30%-35%, respectively. Laser therapy showed lesser reductions, whereas light therapy varied significantly and studies had a high risk of bias. All EBD therapies were more effective than no treatment and PDT was superior to light monotherapy. Laser therapy combined with fractional microneedling radiofrequency (FMR) or as a standalone was more effective than laser alone. CONCLUSION Noninvasive sebum measurement provides valuable insights into AV treatment efficacy. PDT, lasers, especially the 1450-nm diode laser, and FMR are promising for reducing sebum. Standardization of measurement techniques and further research are vital for enhancing treatment personalization, reducing side effects, and improving AV management.
Collapse
Affiliation(s)
- Dana Jaalouk
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
| | - Anika Pulumati
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Yanci A Algarin
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jasmine Humeda
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - David J Goldberg
- Skin Laser & Surgery Specialists, A Division of Schweiger Dermatology Group, New York, New York, USA
- Icahn School of Medicine, Mount Sinai, New York, New York, USA
| |
Collapse
|
2
|
Sahu K, Krishna H, Shrivastava R, Majumdar A, Chowdhury A, Chakraborty S, Majumder SK. Evaluation of the potential of Delta-aminolevulinic acid for simultaneous detection of bioburden and anti-microbial photodynamic therapy of MRSA infected wounds in Swiss albino mice. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 254:112892. [PMID: 38513542 DOI: 10.1016/j.jphotobiol.2024.112892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/13/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND The dramatic increase of drug-resistant bacteria necessitates urgent development of platforms to simultaneously detect and inactivate bacteria causing wound infections, but are confronted with various challenges. Delta amino levulinic acid (ALA) induced protoporphyrin IX (PpIX) can be a promising modality for simultaneous bioburden diagnostics and therapeutics. Herein, we report utility of ALA induced protoporphyrin (PpIX) based simultaneous bioburden detection, photoinactivation and therapeutic outcome assessment in methicillin resistant Staphylococcus aureus (MRSA) infected wounds of mice. METHODS MRSA infected wounds treated with 10% ALA were imaged with help of a blue LED (∼405 nm) based, USB powered, hand held device integrated with a modular graphic user interface (GUI). Effect of ALA application time, bacteria load, post bacteria application time points on wound fluorescence studied. PpIX fluorescence observed after excitation with blue LEDs was used to detect bioburden, start red light mediated antimicrobial photodynamic therapy (aPDT), determine aPDT effectiveness and assess selectivity of the approach. RESULTS ALA-PpIX fluorescence of wound bed discriminates infected from uninfected wounds and detects clinically relevant load. While wound fluorescence pattern changes as a function of ALA incubation and post infection time, intra-wound inhomogeneity in fluorescence correlates with the Gram staining data on presence of biofilms foci. Lack of red fluorescence from wound granulation tissue treated with ALA suggests selectivity of the approach. Further, significant reduction (∼50%) in red fluorescence, quantified using the GUI, relates well with bacteria load reduction observed post topical aPDT. CONCLUSION The potential of ALA induced PpIX for simultaneous detection of bioburden, photodynamic inactivation and "florescence-guided aPDT assessment" is demonstrated in MRSA infected wounds of mice.
Collapse
Affiliation(s)
- Khageswar Sahu
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India; Homi Bhaba National Institute, Training School Complex, Anushakti Nagar, Mumbai 400 094, India.
| | - Hemant Krishna
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Rashmi Shrivastava
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India; Homi Bhaba National Institute, Training School Complex, Anushakti Nagar, Mumbai 400 094, India
| | - Anamitra Majumdar
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Anupam Chowdhury
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Sourabrata Chakraborty
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Shovan Kumar Majumder
- Laser Biomedical Applications Division, Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India; Homi Bhaba National Institute, Training School Complex, Anushakti Nagar, Mumbai 400 094, India
| |
Collapse
|
3
|
Wang D, Yan Y, Wang P, Zhang H, Cao Y, Wang B, Zhang L, Wang X. A prospective, split-face, randomized controlled trial of intense pulsed light-photodynamic therapy for seborrhea. Photodiagnosis Photodyn Ther 2024; 45:103973. [PMID: 38316341 DOI: 10.1016/j.pdpdt.2024.103973] [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: 12/14/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Seborrhea poses a common cosmetic concern in adolescents and young adults, often accompanied by enlarged pores, and contributing to various skin conditions, including acne vulgaris and seborrheic dermatitis. At present, there is a lack of effective treatment for this problem, and the potential of photodynamic therapy (PDT) in reducing sebum remains inconclusive. OBJECTIVE This exploratory, prospective, single-center, double-blinded, randomized split-face controlled trial aimed to compare the efficacy and safety of intense pulsed light-photodynamic therapy (IPL-PDT) versus IPL therapy for seborrhea. METHODS Participants with seborrhea underwent 3 times of IPL treatment (590 nm, 15-17 J/cm2 based on patient's tolerance) for one hemifacial part and IPL-PDT treatment for the other. Follow-up assessment was conducted up to 8 weeks after the final treatment. RESULTS Compared with single IPL treatment, IPL-PDT can significantly inhibit sebum secretion and decrease pore size. PDT group exhibited no additional damage to the skin barrier, with even lower transepidermal water loss (TEWL). Additionally, the PDT group showed superior improvement in scores of porphyrins, red areas, and ultraviolet (UV) spots. Both groups experienced only mild topical adverse effects, well tolerated by the participants. CONCLUSION IPL-PDT is a more effective method than IPL in the treatment of seborrhea, as well as on the improvement of the skin barrier function.
Collapse
Affiliation(s)
- Dixin Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yu Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yajing Cao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan 48109, United States; Avera Medical Group Dermatology Aberdeen, Aberdeen, South Dakota 57401, United States
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|
4
|
Fabi SG, Beleznay K, Berson DS, Cohen JL, Lee S, Dayan SH. Treatment of acne in the aesthetic patient: A round table update. J Cosmet Dermatol 2023; 22:2391-2398. [PMID: 37403516 DOI: 10.1111/jocd.15913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes. AIMS The goal of this work was to deliver a high-quality ethical and evidence-based educational program to physicians and adjunctive health care providers to advance patient care. METHODS This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field. RESULTS A range of topical medications, injectable products, chemical peels, and energy-based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient. CONCLUSION The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care.
Collapse
Affiliation(s)
| | - Katie Beleznay
- Humphrey & Beleznay Cosmetic Dermatology, Vancouver, British Columbia, Canada
| | - Diane S Berson
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, USA
| | - Joel L Cohen
- AboutSkin Dermatology and DermSurgery, PC, Greenwood Village, Colorado, USA
| | - Sandra Lee
- Skin Physicians & Surgeons, Upland, California, USA
| | | |
Collapse
|
5
|
Andreev DA, Zavyalov AA, Ermolaeva TN, Fisun AG, Polyakova KI, Dubovtseva VA, Maksimova TE. Photodynamic therapy as an up-to-date medical technology for the treatment of vulgar acne. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/0042-4609-2019-95-6-44-54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- D. A. Andreev
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| | - A. A. Zavyalov
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| | - T. N. Ermolaeva
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| | - A. G. Fisun
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| | - K. I. Polyakova
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| | - V. A. Dubovtseva
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| | - T. E. Maksimova
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department
| |
Collapse
|
6
|
Requena MB, Vollet Filho JD, Barboza de Nardi A, Escobar A, da Rocha Adams R, Bagnato VS, de Menezes PFC. Topical and intradermal delivery of PpIX precursors for photodynamic therapy with intense pulsed light on porcine skin model. Lasers Med Sci 2019; 34:1781-1790. [PMID: 30903526 DOI: 10.1007/s10103-019-02771-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/06/2019] [Indexed: 11/26/2022]
Abstract
In order to purposely decrease the time of the photodynamic therapy (PDT) sessions, this study evaluated the effects of PDT using topical and intradermal delivery of two protoporphyrin (PpIX) precursors with intense pulsed light (IPL) as irradiation source. This study was performed on porcine skin model, using an IPL commercial device (Intense Pulse Light, HKS801). IPL effect on different administration methods of two PpIX precursors (ALA and MAL) was investigated: a topical cream application and an intradermal application using a needle-free, high-pressure injection system. Fluorescence investigation showed that PpIX distribution by needle-free injection was more homogeneous than that by cream, suggesting that a shorter drug-light interval in PDT protocols is possible. The damage induced by IPL-PDT assessed by histological analysis mostly shows modifications in collagens fibers and inflammation signals, both expected for PDT. This study suggested an alternative protocol for the PDT treatment, possibility half of the incubation time and with just 3 min of irradiation, making the IPL-PDT, even more, promising for the clinical treatment.
Collapse
Affiliation(s)
| | - José Dirceu Vollet Filho
- São Carlos Institute of Physics, University of São Paulo (USP), São Carlos, São Paulo, Brazil
- Institute of Geosciences and Exact Sciences, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
| | - Andrigo Barboza de Nardi
- College of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Andre Escobar
- College of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Rozana da Rocha Adams
- College of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | | | | |
Collapse
|
7
|
Wang Q, Jiang C, Liu W, Chen J, Lin X, Huang X, Duan X. A new optical intra-tissue fiber irradiation ALA-PDT in the treatment of acne vulgaris in rabbit model: improved safety and tolerability. An Bras Dermatol 2018; 92:350-355. [PMID: 29186247 PMCID: PMC5514575 DOI: 10.1590/abd1806-4841.20175543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 05/03/2016] [Indexed: 11/22/2022] Open
Abstract
Background Photodynamic therapy with topical aminolevulinic acid (ALA-PDT) has been
suggested to be effective in treatment of acne vulgaris. However, adverse
events occur during and after treatment. Objectives To compare the efficacy and tolerability of optical intra-tissue fiber
irradiation (OFI) ALA-PDT versus traditional ALA-PDT in treatment of acne
vulgaris in rabbit models. Methods Twenty-five rabbits of clean grade were used. Twenty rabbits were randomly
selected to establish acne model and the other five were used as control.
Rabbits in model group (40 ears) were further divided into four groups (10
ears/group): I, OFI-ALA-PDT with the head of optical fiber inserted into the
target lesion (intra-tissue); II, traditional ALA-PDT group; III, OFI group;
IV, blank control group without any treatment. Uncomfortable symptoms,
adverse events, and effectiveness rates were recorded on post-treatment day
14, 30, and 45. Results On post-treatment day 14, the effectiveness rate in OFI-ALA-PDT group was
obviously higher than that of the other three groups (P<0.05). However,
no improved effects were observed in OFI-ALA-PDT group on day 30 and 45.
During the period of treatment, the frequencies of uncomfortable symptoms in
ALA-PDT group were obviously higher than those in the other three groups
(P<0.05). The adverse event rate in OFI-ALA-PDT group was obviously lower
than that of the ALA-PDT group (P<0.05). Study limitations The unblindness of the study and temporary animal models of acne induced may
hamper the assessment and monitoring of the results, and future studies are
still needed to clarify it further. Conclusion The OFI-ALA-PDT group (intra-tissue irradiation) showed no improved efficacy
on treating rabbit ear acne but had higher safety and better
tolerability.
Collapse
Affiliation(s)
- Qian Wang
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital - Chengdu, China
| | - Can Jiang
- School of Clinical Medicine, Southwest Medical University - Luzhou, China
| | - Wei Liu
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital - Chengdu, China
| | - Jin Chen
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital - Chengdu, China
| | - Xinyu Lin
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital - Chengdu, China
| | - Xiangning Huang
- Clinical Laboratory Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital - Chengdu, China
| | - Xiling Duan
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital - Chengdu, China
| |
Collapse
|
8
|
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.
Collapse
Affiliation(s)
| | - David J Goldberg
- Skin Laser and Surgery Specialists of NY and NJ, Hackensack, NJ, USA
| | | |
Collapse
|
9
|
Boen M, Brownell J, Patel P, Tsoukas MM. The Role of Photodynamic Therapy in Acne: An Evidence-Based Review. Am J Clin Dermatol 2017; 18:311-321. [PMID: 28276005 DOI: 10.1007/s40257-017-0255-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Acne vulgaris is a highly prevalent skin disorder that affects almost all adolescents and can persist into adulthood. Photodynamic therapy (PDT) is an emerging treatment for acne that involves the use of a photosensitizer in combination with a light source and oxygen. METHODS We performed a systematic review of the literature and critically evaluated the studies. Sixty-nine clinical trials, four case reports, and two retrospective studies met the inclusion criteria, and seven of the studies were high quality. RESULTS The most common photosensitizers used were 5-aminolevulinic acid and methyl aminolevulinate, and both showed similar response. Red light was the most frequently used light source, followed by intense pulsed light, and showed comparable results. Inflammatory and non-inflammatory lesions both responded to treatment, with inflammatory lesions showing greater clearance in most studies. Adverse events associated with PDT for acne were mild and included pain on illumination and post-procedural erythema and edema. PDT has been safely used in higher Fitzpatrick skin types (III-IV), although these patients had a higher risk of transient hyperpigmentation. CONCLUSION This review supports PDT as an efficacious treatment for acne and a good adjunctive treatment for mild to severe acne, especially in patients who have not responded to topical therapy and oral antibacterials, and are not great candidates for isotretinoin. Further studies are warranted to evaluate the optimal photosensitizers, light sources, incubation times, and number of treatments for PDT use in acne.
Collapse
Affiliation(s)
- Monica Boen
- Department of Dermatology, University of Illinois at Chicago, 808 S. Wood St., Suite 380, Chicago, IL, 60612, USA.
| | - Joshua Brownell
- College of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Room 130, Chicago, IL, 60612, USA
| | - Priyanka Patel
- College of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Room 130, Chicago, IL, 60612, USA
| | - Maria M Tsoukas
- Department of Dermatology, University of Illinois at Chicago, 808 S. Wood St., Suite 380, Chicago, IL, 60612, USA.
| |
Collapse
|
10
|
Koo E, Austin E, Mamalis A, Jagdeo J. Efficacy of ultra short sub-30 minute incubation of 5-aminolevulinic acid photodynamic therapy in vitro. Lasers Surg Med 2017; 49:592-598. [PMID: 28370019 DOI: 10.1002/lsm.22648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE The estimated incidence of cutaneous squamous cell carcinoma (SCC) is 700,000 cases per year. In the US, SCC incidence is highest among fair skinned adults older than 50 years of age. Thus, as the population ages, the reported number of SCCs will likely increase in the future. Photodynamic therapy (PDT) is an FDA approved therapy for treatment of actinic keratoses (AKs), a precursor to cutaneous SCC lesions. The FDA approved incubation time of the photosensitizing agent 5-aminolevulinic acid (ALA) is 14-18 hours. Recent studies have investigated short ALA incubation times of 1-3 hours with ALA and PDT demonstrating treatment success. Therefore, the question exists whether ALA incubation periods of less than 30 minutes are efficacious. Herein, we evaluate the efficacy of short ALA incubation periods by measuring apoptosis after 10, 15, and 20 minutes of ALA incubation. STUDY DESIGN/MATERIALS AND METHODS AG13145 normal human dermal fibroblasts HDFs were incubated with 10, 15, or 20 minute of ALA at various concentrations (0, 0.05, 0.075, 0.1, 0.25, 0.375, 0.5, 1, and 2 mM). After ALA incubation, samples were treated with 1,000 seconds (16 minutes 40 seconds) of Blu-U fluorescent blue light (417 ± 5 nm) for a fluence of 10 J/cm2 . Immediately following treatment with blue light, samples were collected and stained for apoptosis and necrosis with annexin-V and 7-aminoactinomycin D (7-AAD), and then analyzed by flow cytometry. RESULTS HDFs incubated with ALA for 10 minute at 36 °C followed by 10 J/cm2 of blue light had no statistically significant changes in apoptosis. HDFs incubated with ALA for 15 or 20 minutes at 36 °C followed by 10 J/cm2 of blue light had statistically significant increases in the percentages of cells positive for apoptosis in the 0.5, 1.0, and 2.0 mM ALA doses (P < 0.05). CONCLUSIONS We found that incubation of ALA for at least 15 minutes followed by 10 J/cm2 of blue light resulted in a statistically significant increase in apoptosis. Lasers Surg. Med. 49:592-598, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Eugene Koo
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, University of California Davis, Sacramento, California
| | - Evan Austin
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, University of California Davis, Sacramento, California
| | - Andrew Mamalis
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Jared Jagdeo
- Dermatology Service, Sacramento VA Medical Center, Mather, California.,Department of Dermatology, University of California Davis, Sacramento, California.,Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| |
Collapse
|
11
|
Barbaric J, Abbott R, Posadzki P, Car M, Gunn LH, Layton AM, Majeed A, Car J. Light therapies for acne. Cochrane Database Syst Rev 2016; 9:CD007917. [PMID: 27670126 PMCID: PMC6457763 DOI: 10.1002/14651858.cd007917.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Acne vulgaris is a very common skin problem that presents with blackheads, whiteheads, and inflamed spots. It frequently results in physical scarring and may cause psychological distress. The use of oral and topical treatments can be limited in some people due to ineffectiveness, inconvenience, poor tolerability or side-effects. Some studies have suggested promising results for light therapies. OBJECTIVES To explore the effects of light treatment of different wavelengths for acne. SEARCH METHODS We searched the following databases up to September 2015: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and LILACS. We searched ISI Web of Science and Dissertation Abstracts International (from inception). We also searched five trials registers, and grey literature sources. We checked the reference lists of studies and reviews and consulted study authors and other experts in the field to identify further references to relevant randomised controlled trials (RCTs). We updated these searches in July 2016 but these results have not yet been incorporated into the review. SELECTION CRITERIA We included RCTs of light for treatment of acne vulgaris, regardless of language or publication status. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 71 studies, randomising a total of 4211 participants.Most studies were small (median 31 participants) and included participants with mild to moderate acne of both sexes and with a mean age of 20 to 30 years. Light interventions differed greatly in wavelength, dose, active substances used in photodynamic therapy (PDT), and comparator interventions (most commonly no treatment, placebo, another light intervention, or various topical treatments). Numbers of light sessions varied from one to 112 (most commonly two to four). Frequency of application varied from twice daily to once monthly.Selection and performance bias were unclear in the majority of studies. Detection bias was unclear for participant-assessed outcomes and low for investigator-assessed outcomes in the majority of studies. Attrition and reporting bias were low in over half of the studies and unclear or high in the rest. Two thirds of studies were industry-sponsored; study authors either reported conflict of interest, or such information was not declared, so we judged the risk of bias as unclear.Comparisons of most interventions for our first primary outcome 'Participant's global assessment of improvement' were not possible due to the variation in the interventions and the way the studies' outcomes were measured. We did not combine the effect estimates but rated the quality of the evidence as very low for the comparison of light therapies, including PDT to placebo, no treatment, topical treatment or other comparators for this outcome. One study which included 266 participants with moderate to severe acne showed little or no difference in effectiveness for this outcome between 20% aminolevulinic acid (ALA)-PDT (activated by blue light) versus vehicle plus blue light (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.72 to 1.04, low-quality evidence). A study (n = 180) of a comparison of ALA-PDT (activated by red light) concentrations showed 20% ALA was no more effective than 15% (RR 1.05, 95% CI 0.96 to 1.15) but better than 10% ALA (RR 1.22, 95% CI 1.05 to 1.42) and 5% ALA (RR 1.47, 95% CI 1.19 to 1.81). The number needed to treat for an additional beneficial outcome (NNTB) was 6 (95% CI 3 to 19) and 4 (95% CI 2 to 6) for the comparison of 20% ALA with 10% and 5% ALA, respectively.For our second primary outcome 'Investigator-assessed changes in lesion counts', we combined three RCTs, with 360 participants with moderate to severe acne and found methyl aminolevulinate (MAL) PDT (activated by red light) was no different to placebo cream plus red light with regard to change in inflamed lesions (ILs) (mean difference (MD) -2.85, 95% CI -7.51 to 1.81), percentage change in ILs (MD -10.09, 95% CI -20.25 to 0.06), change in non-inflamed lesions (NILs) (MD -2.01, 95% CI -7.07 to 3.05), or in percentage change in NILs (MD -8.09, 95% CI -21.51 to 5.32). We assessed the evidence as moderate quality for these outcomes meaning that there is little or no clinical difference between these two interventions for lesion counts.Studies comparing the effects of other interventions were inconsistent or had small samples and high risk of bias. We performed only narrative synthesis for the results of the remaining trials, due to great variation in many aspects of the studies, poor reporting, and failure to obtain necessary data. Several studies compared yellow light to placebo or no treatment, infrared light to no treatment, gold microparticle suspension to vehicle, and clindamycin/benzoyl peroxide combined with pulsed dye laser to clindamycin/benzoyl peroxide alone. There were also several other studies comparing MAL-PDT to light-only treatment, to adapalene and in combination with long-pulsed dye laser to long-pulsed dye laser alone. None of these showed any clinically significant effects.Our third primary outcome was 'Investigator-assessed severe adverse effects'. Most studies reported adverse effects, but not adequately with scarring reported as absent, and blistering reported only in studies on intense pulsed light, infrared light and photodynamic therapies. We rated the quality of the evidence as very low, meaning we were uncertain of the adverse effects of the light therapies.Although our primary endpoint was long-term outcomes, less than half of the studies performed assessments later than eight weeks after final treatment. Only a few studies assessed outcomes at more than three months after final treatment, and longer-term assessments are mostly not covered in this review. AUTHORS' CONCLUSIONS High-quality evidence on the use of light therapies for people with acne is lacking. There is low certainty of the usefulness of MAL-PDT (red light) or ALA-PDT (blue light) as standard therapies for people with moderate to severe acne.Carefully planned studies, using standardised outcome measures, comparing the effectiveness of common acne treatments with light therapies would be welcomed, together with adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines.
Collapse
Affiliation(s)
- Jelena Barbaric
- School of Medicine, University of ZagrebAndrija Stampar School of Public HealthRockefellerova 4ZagrebCroatia10000
| | - Rachel Abbott
- University Hospital of WalesWelsh Institute of DermatologyHeath ParkCardiffUKCF14 4XW
| | - Pawel Posadzki
- Lee Kong Chian School of Medicine, Nanyang Technological UniversityCentre for Population Health Sciences3 Fusionopolis Link, #06‐13Nexus@one‐northSingaporeSingapore138543
| | - Mate Car
- Imperial College LondonDepartment of Primary Care and Public HealthSt Dunstan's RoadLondonUKW6 8RP
| | - Laura H Gunn
- Stetson UniversityPublic Health Program421 N Woodland BlvdDeLandFloridaUSA32723
| | - Alison M Layton
- Harrogate and District NHS Foundation TrustDepartment of DermatologyHarrogateUK
| | - Azeem Majeed
- Imperial College LondonDepartment of Primary Care and Public HealthSt Dunstan's RoadLondonUKW6 8RP
| | - Josip Car
- Lee Kong Chian School of Medicine, Nanyang Technological UniversityCentre for Population Health Sciences3 Fusionopolis Link, #06‐13Nexus@one‐northSingaporeSingapore138543
- University of LjubljanaDepartment of Family Medicine, Faculty of MedicineLjubljanaSlovenia
- Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public Health, School of Public HealthReynolds BuildingSt Dunstans RoadLondonUKW6 8RP
| | | |
Collapse
|
12
|
Canavan TN, Chen E, Elewski BE. Optimizing Non-Antibiotic Treatments for Patients with Acne: A Review. Dermatol Ther (Heidelb) 2016; 6:555-578. [PMID: 27541148 PMCID: PMC5120627 DOI: 10.1007/s13555-016-0138-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Indexed: 12/22/2022] Open
Abstract
Acne is a very common non-infectious skin condition that is frequently treated in dermatological practices. Because acne is often chronic and may persist for years, safe and effective long-term maintenance therapy is often required. Given the increasing frequency of antibiotic-resistant bacteria and the gravity of the consequences of this trend, it behooves dermatologists to maximize use of non-antimicrobial therapy when treating acne. In this review of the literature we present data regarding the efficacy and appropriate use of non-antimicrobial treatments for acne. A variety of topical and oral treatment options exist that can be used in a step-wise manner according to the patients’ severity and therapeutic response. Non-antimicrobial treatments can be highly efficacious at controlling acne, especially when used as maintenance therapy. While antibiotics have a role in acne treatment, they should not be used as monotherapy, and lengthy courses of antibiotic use are discouraged.
Collapse
Affiliation(s)
- Theresa N Canavan
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA
| | - Edward Chen
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA
| | - Boni E Elewski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA.
| |
Collapse
|
13
|
Wang Q, Yuan D, Liu W, Chen J, Lin X, Cheng S, Li F, Duan X. Use of Optical Fiber Imported Intra-Tissue Photodynamic Therapy for Treatment of Moderate to Severe Acne Vulgaris. Med Sci Monit 2016; 22:362-6. [PMID: 26839152 PMCID: PMC4745657 DOI: 10.12659/msm.896586] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background To treat moderate to severe acne vulgaris, we developed an optical fiber imported intra-tissue photodynamic therapy: the optical fiber irradiation 5-aminolevulinic acid photodynamic therapy (OFI-ALA-PDT). The aim of this study was to compare the treatment effect and tolerability of OFI-ALA-PDT versus traditional ALA-PDT in the treatment of moderate to severe acne vulgaris. Material/Methods 60 patients with facial acne enrolled into this study were randomly divided into an OFI-ALA-PDT group and a traditional ALA-PDT group, with 30 patients in each group. The difference between these 2 groups was the red light irradiation methods used. In the OFI-ALA-PDT group we used intra-tissue irradiation (import the red light directly into the target lesion with optical fiber) for 5 min, while the traditional ALA-PDT group received whole-face irradiation for 20 min. All patients received 1 irradiation every 7 to 10 days for a total of 6 irradiations. Treatment effects and adverse reactions were recorded after the 4th and 6th irradiation, and at 4, 8, 16 weeks after the entire treatment. Results After the 4th irradiation, significantly different effective rates were observed in these groups (90.0% for the OFI-ALA-PDT group and 66.7% for the control group). However, no significant difference in effective rate was recorded in the later observations. There were 182 adverse reactions in the OFI-ALA-PDT group and 497 in the control group, which showed a significant difference (P<0.05). Conclusions OFI-ALA-PDT showed improved treatment effective rate in the early stage of irradiation, and it had fewer adverse reactions.
Collapse
Affiliation(s)
- Qian Wang
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| | - Dan Yuan
- , Sichuan Medical University, Luzhou, Sichuan, China (mainland)
| | - Wei Liu
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| | - Jin Chen
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| | - Xinyu Lin
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| | - Shi Cheng
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| | - Fumin Li
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| | - Xiling Duan
- Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China (mainland)
| |
Collapse
|
14
|
Chen X, Song H, Chen S, Zhang J, Niu G, Liu X. Clinical efficacy of 5-aminolevulinic acid photodynamic therapy in the treatment of moderate to severe facial acne vulgaris. Exp Ther Med 2015; 10:1194-1198. [PMID: 26622463 DOI: 10.3892/etm.2015.2638] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 04/22/2015] [Indexed: 11/06/2022] Open
Abstract
Acne vulgaris is considered as a therapeutic challenge in terms of managing ongoing symptoms and preventing scar formation. Although there are many available treatments for alleviating acne, therapies for resistant or moderate-to-severe forms have been limited to systemic agents that are accompanied by potentially severe side-effects. While, aminolevulinic acid (ALA) photodynamic therapy (PDT) has increasingly been used as a simple and safe therapeutic option of acne vulgaris, the clinical efficacy requires confirmation in further studies. The aim of this study was to investigate the efficacy and safety of 5-ALA-PDT in the treatment of moderate-to-severe facial acne vulgaris. A total of 50 patients with moderate-to-severe facial acne were enrolled in the study and randomly divided equally into a therapy group and a control group. In the therapy group, the patients were treated with 5% 5-ALA for 1.5 h, followed by three 20-min doses of infrared radiation once a week; in the control group, the patients were treated with three 20 min doses of infrared radiation without 5-ALA once a week. Both treatments lasted for 3 weeks. The clinical efficacy was determined by evaluating acne lesion counts at weeks 0, 2, 4 and 6. Total efficacy rate (TER) was the primary endpoint of the study, and was defined as the proportion of the patients whose treatment effectiveness evaluation was cured (≥90% of skin lesions improved) and excellent (60-89% improvement). Adverse effects were recorded throughout the study. The study was completed by 24 patients in the therapy group and 23 patients in the control group. The numbers of acne lesions significantly decreased. The TER of the therapy group was significantly higher than that of the control group at weeks 4 and 6. Adverse effects were observed in 12 patients of the therapy group and 2 patients of the control group. In the therapy group the most common adverse effect was a burning sensation (n=7), followed by transient hyperpigmentation (n=3) and acute acneform lesions (n=2), while in control group, the 2 patients experienced flushing and dryness. The adverse effects were all cured by a symptomatic approach prior to the end of the study. 5-ALA-PDT combined with infrared radiation is an effective and safe therapy for moderate-to-severe facial acne.
Collapse
Affiliation(s)
- Xiangqi Chen
- Department of Dermatology, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China ; Department of Pharmacy, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Hongtao Song
- Department of Pharmacy, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Shengping Chen
- Department of Dermatology, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Jing Zhang
- Department of Pharmacy, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Gaoxiang Niu
- Department of Dermatology, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Xiangnong Liu
- Department of Dermatology, Fuzhou General Hospital, Fuzhou Medical College, Second Military Medical University, Fuzhou, Fujian 350025, P.R. China
| |
Collapse
|
15
|
González-Rodríguez A, Lorente-Gual R. Current Indications and New Applications of Intense Pulsed Light. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
16
|
González-Rodríguez A, Lorente-Gual R. Indicaciones actuales y nuevas aplicaciones de los sistemas de luz pulsada intensa. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:350-64. [DOI: 10.1016/j.ad.2014.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/26/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022] Open
|
17
|
Biel MA. Antimicrobial photodynamic therapy for treatment of biofilm-based infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 831:119-36. [PMID: 25384666 DOI: 10.1007/978-3-319-09782-4_8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Merrill A Biel
- Ear, Nose and Throat Specialty Care of MN, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA,
| |
Collapse
|
18
|
Photodynamic therapy using 5-aminolevulinic acid and intense pulsed light against intense pulsed light alone in the treatment of acne vulgaris. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2014. [DOI: 10.1097/01.ewx.0000452298.99232.bf] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Wan MT, Lin JY. Current evidence and applications of photodynamic therapy in dermatology. Clin Cosmet Investig Dermatol 2014; 7:145-63. [PMID: 24899818 PMCID: PMC4038525 DOI: 10.2147/ccid.s35334] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In photodynamic therapy (PDT) a photosensitizer – a molecule that is activated by light – is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT.
Collapse
Affiliation(s)
- Marilyn T Wan
- Melanoma Program, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jennifer Y Lin
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Wat H, Wu DC, Rao J, Goldman MP. Application of Intense Pulsed Light in the Treatment of Dermatologic Disease: A Systematic Review. Dermatol Surg 2014; 40:359-77. [DOI: 10.1111/dsu.12424] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
21
|
Ma L, Xiang LH, Yu B, Yin R, Chen L, Wu Y, Tan ZJ, Liu YB, Tian HQ, Li HZ, Lin T, Wang XL, Li YH, Wang WZ, Yang HL, Lai W. Low-dose topical 5-aminolevulinic acid photodynamic therapy in the treatment of different severity of acne vulgaris. Photodiagnosis Photodyn Ther 2013; 10:583-90. [DOI: 10.1016/j.pdpdt.2013.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 06/15/2013] [Accepted: 06/20/2013] [Indexed: 01/22/2023]
|
22
|
Mei X, Shi W, Piao Y. Effectiveness of photodynamic therapy with topical 5-aminolevulinic acid and intense pulsed light in Chinese acne vulgaris patients. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2013; 29:90-6. [PMID: 23458393 DOI: 10.1111/phpp.12031] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/26/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Xingyu Mei
- Dermatology Department; Shanghai First People's Hospital; Shanghai; China
| | - Weimin Shi
- Dermatology Department; Shanghai First People's Hospital; Shanghai; China
| | - Yinglan Piao
- Dermatology Department; Tongji Hospital; Shanghai; China
| |
Collapse
|
23
|
Wang HW, Lv T, Zhang LL, Guo MX, Stepp H, Yang K, Huang Z, Wang XL. Prospective study of topical 5-aminolevulinic acid photodynamic therapy for the treatment of moderate to severe acne vulgaris in Chinese patients. J Cutan Med Surg 2012; 16:324-33. [PMID: 22971307 DOI: 10.1177/120347541201600509] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Topical photodynamic therapy (PDT) mediated with 5-aminolevulinic acid (ALA) offers an alternative option for the treatment of acne vulgaris. OBJECTIVE To study the effects of ALA dose, incubation time, and lesion type on protoporphyrin IX (PpIX) production and treatment outcomes. METHODS To examine the time course of PpIX production, 10% ALA was applied to inflammatory papules for 1 to 5 hours and followed by in situ fluorescence examination. To determine the effects of ALA dose and lesion type, 3, 5, and 10% ALA was applied to acne lesions in split-face fashion for 3 hours followed by whole-face light irradiation at 633 nm and 30 to 70 J/cm2. Treatment was repeated twice at 2-week intervals. RESULTS PpIX reached a stable level after 3 hours of incubation. Similar PpIX levels were seen in areas receiving 3, 5, and 10% ALA. Poisson regression analyses indicated that lesion counts decreased by 0.791 times for a one-unit increase in treatment times (95% CI 0.782-0.799 < .0001) but only by 0.999 times for a one-unit increase in ALA dose (95% CI 0.998-1.000 = .22). CONCLUSION The combination of low-dose ALA and a red light is a safe and effective option for the treatment of moderate to severe acne.
Collapse
Affiliation(s)
- Hong-Wei Wang
- Shanghai Skin Diseases Hospital, Shanghai, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Nast A, Dréno B, Bettoli V, Degitz K, Erdmann R, Finlay AY, Ganceviciene R, Haedersdal M, Layton A, López-Estebaranz JL, Ochsendorf F, Oprica C, Rosumeck S, Rzany B, Sammain A, Simonart T, Veien NK, Zivković MV, Zouboulis CC, Gollnick H. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol 2012; 26 Suppl 1:1-29. [PMID: 22356611 DOI: 10.1111/j.1468-3083.2011.04374.x] [Citation(s) in RCA: 224] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- A Nast
- Division of Evidence-Based Medicine, Klinik für Dermatologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
What is the role of photodynamic therapy in the treatment of acne vulgaris? Photodiagnosis Photodyn Ther 2012; 9:2-4. [DOI: 10.1016/j.pdpdt.2011.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 12/27/2011] [Indexed: 11/21/2022]
|
26
|
Lee JW, Kim BJ, Kim MN, Ahn GY, Aso H. Selective sebaceous gland electrothermolysis as a treatment for acne: a prospective pilot study. Int J Dermatol 2012; 51:339-44. [DOI: 10.1111/j.1365-4632.2011.05255.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
27
|
Piérard-Franchimont C, Paquet P, Piérard GE. New approaches in light/laser therapies and photodynamic treatment of acne. Expert Opin Pharmacother 2011; 12:493-501. [PMID: 21269242 DOI: 10.1517/14656566.2011.547476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acne is a domain in which the technology and understanding of light/laser therapeutic procedures have advanced considerably. The aim of the paper was to revisit adjunctive physical treatments of acne, including light/laser treatments and photodynamic therapy. This review summarizes findings about such treatment modalities with particular emphasis on efficacy and safety. A number of laser/light-based modalities have been developed to meet the increasing demand for new acne treatments. The current devices correspond, on the one hand, to light-emitting diode therapy and, on the other hand, to the 532-nm potassium titanyl phosphate laser, the 585- and 595-nm pulsed dye laser, the 1450-nm diode laser, the 1320-nm Nd:YAG laser and intense pulsed light. Photodynamic therapy is also available. It is claimed that light/laser treatments might induce a faster response compared with the 1-3 months needed for response to traditional oral and topical treatments. In conclusion, pulsed dye laser shows efficacy in some patients with mild to moderate acne. The relative effectiveness compared with other treatments is unconfirmed; from the published information, evidence-based efficacy assessment of light/laser therapies in acne remains almost impossible.
Collapse
|
28
|
García-Morales I, Harto A, Fernández-Guarino M, Jaén P. Estudio del empleo de láser de colorante pulsado y metilaminolevulinato en la terapia fotodinámica del acné. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/j.ad.2010.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
29
|
Photodynamic Therapy for Acne: Use of the Pulsed Dye Laser and Methylaminolevulinate. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/s1578-2190(10)70714-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|