At the 65th Annual Meeting of the American Academy of Dermatology, in Washington, DC, Amy F. Taub, MD, FAAD, clinical instructor of dermatology at Northwestern University Medical School in Chicago, reviewed research that demonstrated the safety, efficacy, and current limitations of the leading treatments for acne.

“The introduction of lasers, other light sources, and heat-based technologies mark the first new therapies to treat acne in more than 20 years,” Taub reported. “Unlike their systemic counterparts that offer a short-term solution to treating acne by killing acne-causing bacteria, these devices work differently by altering the structure of the oil glands.

Studies show that the newer treatments effectively shrink oil glands and, in some cases, even improve acne scarring and overall skin texture. However, the key to increasing their use among practitioners is fine-tuning the existing treatment protocols to ensure success for the majority of acne patients.”

According to Taub, photodynamic therapy is a noninvasive treatment that uses laser or light energy to activate a photosensitizer called aminolevulinic acid that is applied topically to the skin prior to treatment.

In her study that compared the efficacy of three different light sources, including blue light, pulsed light plus radiofrequency (RF), and intense pulsed light, Taub reported that most of the 19 study patients showed improvement in their acne following three treatments administered 2 weeks apart with each of the variable light sources. However, the patients randomly selected for treatment with the intense pulsed-light laser demonstrated the most improvement— approximately 70% of their acne had cleared 3 months following treatment.

Light-based therapies work by targeting and destroying the bacteria that cause acne and reducing inflammation. Taub noted that published reports of randomized controlled trials using light therapies show encouraging results in improving acne, with the greatest improvement observed in patients treated two times per week for 4 weeks with a combination of blue and red light treatments.

The 1450-nm diode laser targets acne by heating deep into the skin where the oil glands are located, while a specially equipped cooling device protects the top layer of skin from injury. Taub said that studies demonstrate outstanding results from laser therapy in treating inflammatory acne; one long-term study reported a 90% improvement at 2 years post-treatment. One potential drawback is that treatments can be painful; some researchers caution that they may be too painful for teenagers.

RF energy has been gaining attention for its effectiveness in shrinking oil glands and improving acne scarring and overall skin texture, Taub added. This approach works by delivering intense heat deep into the skin to reduce the size of the oil glands associated with acne. A built-in cooling device protects the top layer of the skin during the procedure, keeping it intact.

“The results of these early studies suggest that RF energy can significantly alter the oil glands and reduce the number of acne lesions in patients with moderate to severe acne,”  Taub said. “But before it can be considered a viable therapy, I think more studies need to be done to confirm these early results.”

[www.newswise.com, January 31, 2007]