Elsevier

Clinics in Dermatology

Volume 28, Issue 1, January–February 2010, Pages 31-33
Clinics in Dermatology

Light and laser therapy for acne: sham or science? facts and controversies

https://doi.org/10.1016/j.clindermatol.2009.04.002Get rights and content

Abstract

It has long been known that light is helpful in acne. Teens recognize that summer sun diminishes pimples, and wise pharmaceutical companies (which is limiting) know that a drug trial ending in sunny months will have an elevated placebo response.

Section snippets

Propionibacterium acnes

Propionibacterium acnes is an obvious target for acne phototherapy because it is central to the inflammatory process. The organism makes porphyrins that are present in the follicle in proportion to its population.2 These photoactive compounds can be excited by light to generate reactive oxygen, which is toxic to P acnes.3 An inherent limitation of this approach is that to reduce P acnes effectively, the therapy would have to be given very frequently, because the organism proliferates rapidly

Notable observations and studies

In contrast to a loosely controlled study showing that one low-dose nonpurpuric treatment with the pulsed dye laser resulted in acne improvement up to 12 weeks after therapy,13 another blinded, split-face study was performed of similar low-dose pulsed dye laser therapy for acne.14 The treatment had no effect on the number of lesions or on the clinical grade of the acne.

A series of 13 patients with severe or cystic acne were treated with long-pulsed 585-nm pulsed dye laser and ALA. All patients

Future directions for investigation

Clinical trials where phototherapy is the only agent used. Even though most acne treatments are not used as a monotherapy in the clinic, in the development phase it is important to test laser or photodynamic therapy as monotherapy to ascertain whether it actually has any effect in acne and to be able to define the best regimen.

Investigation of the ability of phototherapy to modulate inflammatory systems. Selective modulation of Toll-like receptors in the skin, for example, Ttoll-like receptor 2

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