Pulse dye laser efficacy in acne erythema therapy inconclusive
The use of pulsed dye laser (PDL) in the treatment of acne vulgaris and acne erythema in young adults yields no significant improvement, but leads to high satisfaction among patients, according to a study.
A total of 30 patients with mild to moderate acne (mean age 18 years; 56.7 percent male) were blocked-randomized to receive treatment on one side of the face, with the untreated side serving as a control. The treated side of the face underwent two PDL treatment sessions (595 nm; fluence, 8 J/cm3; pulse duration, 10 ms; spot size, 7 mm), performed at baseline and at 2 weeks thereafter.
Acne lesion counts, acne erythema grading and acne severity grading were evaluated at baseline and at 2, 4 and 8 weeks.
There were no statistically significant differences observed in the outcomes evaluated, with the exception of the papule count at week 4 (−1.828 on the treated side vs 0.103 on the nontreated side of the face; p=0.0018). Acne severity grading and acne erythema grading did not significantly differ between the two sides of the face.
The mean scores of patients’ satisfaction on the laser-treated side were 75 percent at week 2, 81 percent at week 4 and 81 percent at week 8.
Researchers noted that a statistically significant improvement only in papule lesion count on the PDL-treated side of the face from baseline at week 4 and might not be clinically significant in real dermatologic practice due to the high cost of PDL treatment when compared with conventional therapy.
The lack of significant results was attributed to the following factors: (1) the patients had more prominent comedonal lesions than inflammatory papules and nodules; (2) the number of treatment sessions were too few; and (3) the duration of follow-up may not have been long enough to see a positive clinically significant result.
Acne vulgaris is one of the most common adolescent problems, with a prevalence ranging from 70 to 87 percent. The condition is traditionally managed using topical and systemic medications, which have various adverse effects such as skin irritation, bacterial resistance and potentially serious teratogenic effects. [Pediatrics 2013;131:S163–S186; BMJ 2013;346:f2634; Clin Dermatol 2006;24:26–32]
PDL, on the other hand, is specifically used for the treatment of vascular lesions, with haemoglobin as the targeted chromophore. PDL has been shown to be effective in other inflammatory diseases such as psoriasis, rosacea and lupus erythematosus. [J Am Acad Dermatol 2013;69:609–615]