Light and laser therapy for acne: sham or science? facts and controversies
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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A randomized controlled split face clinical trial of 1320nm Nd:YAG laser therapy in the treatment of acne vulgaris
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Effect of combined topical glucocorticoids and ultraviolet B irradiation on epidermal Langerhans cells
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Pulsed dye laser treatment for inflammatory acne vulgaris: randomized controlled trial
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Long pulsed dye laser versus long pulsed dye laser-assisted photodynamic therapy for acne vulgaris
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Cited by (12)
Do Dermatologic Diagnosis Change in Hot vs. Cold Periods of The Year? A Sub-Analysis of the DIADERM National Sample (Spain 2016)
2019, Actas Dermo-SifiliograficasSeasonal variation of acne and psoriasis: A 3-year study using the Physician Global Assessment severity scale Presented in poster form at the 73rd Annual Meeting of the Academy of Dermatology, San Francisco, CA, March 20-24, 2015.
2015, Journal of the American Academy of DermatologyCitation Excerpt :Its summer improvement may be attributed to the sun's known immunomodulatory and bactericidal effects.2,4 Similarly, acne's summer/fall improvement may be caused by decreased inflammation from ultraviolet light–induced immune suppression1 and/or decreasing Langerhans cell reactivity.5 Although the climate of the northeastern United States may not generalize to regions with less seasonal variation, providers may consider seasonal adjustment of acne plans as they have traditionally done for psoriasis.
Acne treatment based on selective photothermolysis of sebaceous follicles with topically delivered light-absorbing gold microparticles
2015, Journal of Investigative DermatologyCitation Excerpt :However, efficacy is modest; multiple treatments are necessary; and recurrence is common. To date, the use of light-based treatments for acne has been limited (Webster, 2010). Selective photothermolysis (Anderson and Parrish, 1983) of sebaceous glands and sebaceous follicles is a promising paradigm for successful treatment of acne, if it can be localized to the follicles, with a similar mechanism of action as light-based removal of pigmented hair and abnormal blood vessels.
An overview on acne vulgaris
2020, International Journal of Pharmaceutical ResearchSeasonality of acne severity in Korean patients: data from a dermatologic clinic and military hospital
2019, Journal of the European Academy of Dermatology and Venereology