红-蓝光联合治疗寻常痤疮的疗效

目的 探讨红-蓝光联合治疗寻常痤疮临床疗效.方法 对65例痤疮患者采用红-蓝光联合照射治疗,每位患者每次使用蓝光照射20～25 min,然后使用红-蓝光联合照射5～10 min,每周2次,连续照射4周为1个疗程.轻度痤疮患者治疗1个疗程,中、重度痤疮患者连续治疗1～2个疗程.结果 经过系统治疗后,所有患者痤疮皮损均有明显改善且无副作用,轻度痤疮有效率为80%,中度痤疮有效率为89.4%,重度痤疮有效率为88.2%.结论 应用红-蓝光联合治疗寻常痤疮是安全且有效的治疗方法.     

Blue and red light combination LED phototherapy for acne vulgaris in patients with skin phototype IV

BACKGROUND AND OBJECTIVES: Blue light is effective for acne treatment, inducing photodynamic destruction of Propionibacterium acnes (P. acnes). This study was designed to investigate the efficacy of combined blue and red light-emitting diode (LED) phototherapy for acne vulgaris. MATERIALS AND METHODS: Twenty-four patients with mild to moderately severe facial acne were treated with quasimonochromatic LED devices, alternating blue (415 nm) and red (633 nm) light. The treatment was performed twice a week for 4 weeks. Objective assays of the skin condition were carried out before and after treatment at each treatment session. Clinical assessments were conducted before treatment, after the 2nd, 4th, and 6th treatment sessions and at 2, 4, and 8 weeks after the final treatment by grading and lesion counting. RESULTS: The final mean percentage improvements in non-inflammatory and inflammatory lesions were 34.28% and 77.93%, respectively. Instrumental measurements indicated that the melanin levels significantly decreased after treatment. Brightened skin tone and improved skin texture were spontaneously reported by 14 patients. CONCLUSION: Blue and red light combination LED phototherapy is an effective, safe and non-painful treatment for mild to moderately severe acne vulgaris, particularly for papulopustular acne lesions.     

Treatment of Facial Acne Papules and Pustules in Korean Patients Using an Intense Pulsed Light Device Equipped with a 530- to 750-nm Filter

BACKGROUND: A rising number of laser- or light-based therapies are addressing the need for effective acne treatments with minimal downtime. OBJECTIVE: The purpose of this study is to evaluate an intense pulsed light (IPL) equipped with a 530- to 750-nm filter for inflammatory acne treatment. PATIENTS AND METHODS: Thirty female patients (mean age, 25.7 years) with mild-to-moderate acne were enrolled. While using benzoyl peroxide (BP) gel, one side of the face was treated with the PR filter (acne filter) of the IPL. RESULTS: All patients experienced the reduction of inflammatory lesion counts in both sides of face. There was no significant difference between IPL-treated and untreated sides of the face for mean papule plus pustule counts, 3 weeks after three sessions. As to red macules, 63% were good or excellent on the laser-treated side compared to 33% on the untreated side. Improvement of irregular pigmentation and skin tone was detected on the laser-treated side than the untreated side. CONCLUSION: This new wavelength band of IPL system was safe and effective in improving acne red macules, irregular pigmentation, and skin tone but did not affect inflammatory acne lesion counts on the skin of Asian persons.     

红蓝光联合治疗面部寻常性痤疮的临床观察

目的:观察和评价红蓝光联合治疗面部寻常性痤疮的疗效。方法:应用红蓝光联合治疗40例面部寻常性痤疮患者,每周2次,共治疗8次。结果:总有效率为60.00%。非炎性及炎性皮损平均改善率分别为55.57%和70.04%,两者差异具有统计学意义,未见明显不良反应。结论:红蓝光治疗痤疮,对炎症型皮损及非炎症型皮损均有良好的治疗效果,不良反应少,患者依从性良好。     

A pilot investigation comparing low-energy, double pass 1,450 nm laser treatment of acne to conventional single-pass, high-energy treatment

BACKGROUND AND OBJECTIVES: Laser treatment using a 1,450 nm diode laser has been shown to improve acne and acne scarring. Its widespread adoption in younger populations has been significantly limited by discomfort. STUDY DESIGN/MATERIALS AND METHODS: Six subjects with active papular acne were treated in a pilot study to determine parameters for a split-face, double-pass, low-energy protocol of 1,450 nm laser treatment. Sides of the face were randomized to receive single-pass, high-energy treatment (13-14 J/cm(2)), or double-pass, low energy treatment (8-11 J/cm(2)), for a total of four treatments delivered at monthly intervals. Acne counts and standardized, digital photograph were performed 2 months following the final treatment, and compared to pre-treatment counts and photographs. RESULTS: Improvement was evaluated comparing pre- and post-treatment photos and averaged 2.5 for the high-energy, single-pass side and 2.3 for the low-energy, double-pass side, using a 0 (worse) to 4 (max improvement) scale. Acne counts were reduced 78% on the high-energy, single-pass side and 67% on the low-energy, double-pass side. Pain ratings on a 1 (min) to 10 (max) scale averaged 5.6 (range 1-9) for the high-energy, single-pass side and 1.3 (range 1-2) for the low-energy, double-pass side. CONCLUSIONS: Low-energy, double-pass 1,450 nm laser treatment effectively reduces acne counts 2 months post-treatment, and dramatically reduces the pain associated with treatment. The treatment parameters used in this study have eliminated the need for anesthetic cream in daily practice.     

Treatment of Inflammatory Facial Acne Vulgaris with Intense Pulsed Light and Short Contact of Topical 5-Aminolevulinic Acid: A Pilot Study

BACKGROUND: Photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) and red light (550-700 nm) has been introduced for effective treatment of facial acne. Untoward side effects are common, however. OBJECTIVE: To evaluate the efficacy and safety of the short contact of topical ALA and intense pulsed light (IPL) in treatment of inflammatory facial acne. METHODS: Fourteen patients with inflammatory facial acne were treated with IPL on the left side and combination of IPL and topical ALA on the right side at 3- to 4-week intervals for three sessions. Clinical photographs and lesion counts were obtained for evaluation. RESULTS: All patients revealed a reduction in number of acne lesions on both sides. On the ALA-pretreated side, lesion counts decreased 87.7% at 12 weeks after the last treatment (p < .01). Meanwhile, lesion counts on the nonpretreated side decreased 66.8% (p < .01). In addition, a number of lesion counts on the ALA-pretreated side decreased. Mild edema and minimal crust developed on the combined-treatment side. CONCLUSION: Short contact of topical ALA and IPL or IPL alone showed some beneficial effect in treatment of inflammatory facial acne; however, degree of improvement was better and remained longer with the combined regimen. Side effects were mild and reversible.     

Comparison of Stacked Pulses versus Double-Pass Treatments of Facial Acne with a 1,450-nm Laser

BACKGROUND: Although effective as a monotherapy for the treatment of inflammatory acne, the 1,450-nm diode laser is associated with considerable pain at higher fluences. MATERIALS AND METHODS: Eleven subjects were treated with a 1,450-nm diode laser in a split-face bilateral paired acne study. One-half of the face received a single-pass consisting of stacked double pulses. The other side received a double-pass treatment of single pulses. Settings were 11 J/cm(2) or lower as tolerated with appropriate dynamic cooling device (range 25-35). RESULTS: The mean pain rating was 5.33 on a 0 to 10 scale on the stacked-pulse treatment side and 5.12 on the double-pass side. Blinded reduction in mean acne lesion counts were 57.6% and 49.8% reduction, respectively. An overall acne scar improvement was seen in 83% of subjects with acne scarring. Transient hyperpigmentation occurred in two patients on the stacked pulse side and completely resolved without sequelae. CONCLUSIONS: The pulsed 1,450-nm diode laser can be used at lower fluences that elicit less discomfort yet effectively improve inflammatory acne. Stacking pulses appears to render a slightly higher efficacy than the multipass technique. Single-pulse, multiple-pass treatments may have a lower risk of cryogen-induced transient hyperpigmentation compared to standard high fluence techniques.     

窄谱红/蓝光与单纯蓝光治疗寻常性痤疮的对比观察

目的：探讨红/蓝光照射治疗寻常性痤疮的临床疗效和安全性。方法：将982例轻、中度寻常性痤疮患者分为两组,试验组窄谱红/蓝光局部照射,对照组单纯照射窄谱蓝光,每周治疗2次,共治疗8周。治疗前及治疗4、8周后评价疗效及不良反应。结果：治疗4周后试验组痊愈率为8.0%,有效率为62.4%;对照组痊愈率（4.6%）及有效率（45.3%）均低于试验组,两组比较有显著性差异（P〈0.05）。治疗8周后试验组痊愈率为23.6%,有效率为86.8%;对照组痊愈率（13.9%）及有效率（70.8%）均低于试验组,有显著性差异（P〈0.05）。结论：联合应用红/蓝光照射治疗轻、中度寻常性痤疮安全有效,疗效优于单纯照射窄谱蓝光。     

The long-term effect of 1550 nm erbium:glass fractional laser in acne vulgaris

We evaluated the short-term and long-term effects of the 1550 nm erbium:glass (Er:glass) fractional laser in the treatment of facial acne vulgaris. Forty-five (9 male and 36 female) acne patients were treated 4 times at 4-week intervals with the following parameters: 169 spot density and 15–30 mJ/cm² fluence. There was no control group. The laser spots were adjustable (maximum overlap: 20 %) according to the treatment area, and delivered in rows in order to cover all the face. Clinical photographs were taken. The IGA scores and lesion counts were performed for each treatment. Their current state was obtained by phone call follow-up to determine the long-term effect and photographs were offered by themselves or taken in hospital. After four treatments, all patients had an obvious reduction of lesion counts and IGA score and the peak lesion counts decreased to 67.7 % after the initial four treatment sessions. For long-term effect, 8 patients lost follow-up, hence 37 patients were followed-up. 8 patients were 2-year follow up, 27 at the 1-year follow-up, and all patients at the half-year follow-up. The mean percent reduction was 72 % at the half-year follow-up, 79 % at the 1-year follow-up and 75 % at the 2-year follow-up. Side effects and complications were limited to transient erythema and edema, and few patients suffered from transient acne flare-ups and sensitivity. All patients responded that their skin was less prone to oiliness. In conclusion, acne can be successfully treated by 1550 nm Er:glass fractional laser, with few side effects and prolonged acne clearing.     

Comparison of α- and β-Hydroxy Acid Chemical Peels in the Treatment of Mild to Moderately Severe Facial Acne Vulgaris

BACKGROUND Chemical peels are used as adjuvants for treatment of facial acne. No well-controlled studies have compared α- and β-hydroxy acid peels in the treatment of mild to moderately severe facial acne.
OBJECTIVE To compare the efficacy of α- and β-hydroxy acid chemical peels in the treatment of mild to moderately severe facial acne vulgaris.
MATERIALS AND METHODS Twenty patients were recruited in this split-face, double-blind, randomized, controlled study. An α-hydroxy acid (30% glycolic acid) was applied to one-half of the face and a β-hydroxy acid peel (30% salicylic acid) was applied contralaterally every 2 weeks for a total of six treatments. A blinded evaluator performed quantitative assessment of papules and pustules.
RESULTS Both chemical peels were significantly effective by the second treatment ( p <.05) and there were no significant differences in effectiveness between the two peels. At 2 months posttreatment, the salicylic acid peel had sustained effectiveness. More adverse events were reported with the glycolic acid peel after the initial treatment.
CONCLUSION The glycolic acid and salicylic acid peels were similarly effective. The salicylic acid peel had sustained effectiveness and fewer side effects. α- and β-Hydroxy acid peels both offer successful adjunctive treatment of facial acne vulgaris.     

窄谱红蓝光治疗仪联合中药面膜治疗寻常性痤疮疗效观察

目的:探讨蓝光(417nm)和红光(630nm)交替照射治疗轻中度痤疮的疗效。方法:将94例轻中度痤疮患者随机分为治疗组、对照1组和对照2组,共三组。治疗组采用红蓝光照射联合中药面膜;对照1组单用红蓝光照射;对照2组单用自制中药面膜敷脸,均2次/周,三组均外用痤疮洗剂,口服复方珍珠暗疮片,共4周。结果:治疗组总有效率为80.00%,对照1组、对照2组总有效率分别为66.66%、64.51%,治疗组总有效率与对照组比较差异有统计学意义(χ21=4.23,χ22=4.85,P<0.01),对照1组和对照2组比较差异无统计学意义(χ2=12.34,P>0.05)。结论:417nm蓝光和633nm红光联合中药面膜对轻中度痤疮的治疗安全、有效,可以缩短疗程,提高治愈率。     

Salicylic Acid Peels for the Treatment of Acne Vulgaris in Asian Patients

BACKGROUND: Salicylic acid peels have been introduced as a useful modality in acne treatment. Few studies have examined its efficacy and safety, especially in darker skin. OBJECTIVE: To assess the efficacy and safety of salicylic acid peels as a treatment for acne vulgaris in Asian patients. METHODS: Thirty-five Korean patients with facial acne were treated with 30% salicylic acid peels biweekly for 12 weeks. Lesion counts and Dr. Cunliffe's score were assessed by a blinded evaluator. Safety assessments and patient's evaluations were also recorded. RESULTS: Both inflammatory and noninflammatory acne lesion counts were decreased in proportion to the duration of treatment. Dr. Cunliffe's acne grade was statistically significantly decreased after treatment. The side effects were tolerable in most cases, and all patients were pleased with their peel results. Stratum corneum hydration, skin surface lipid, skin pH, and transepidermal water loss were unchanged from baseline levels. CONCLUSION: Salicylic acid peels are an effective and safe therapy for acne vulgaris in Asian patients.     

红蓝光联合治疗中、重度痤疮疗效对比观察

目的：评价红蓝光联合治疗中、重度痤疮的疗效。方法：采用红蓝光联合照射加药物治疗中度和重度痤疮,分别与单纯药物治疗的对照组比较,并观察疗效。结果：红蓝光联合照射治疗中度痤疮疗效佳,优于对照组（P〈0.05）;治疗重度痤疮无显著疗效（P〉0.05）。结论：红蓝光联合照射治疗对重度痤疮疗效一般,而对中度痤疮效果佳,不良反应少,可推广应用。     

红蓝光联合自制中药面膜治疗寻常性痤疮疗效观察

目的:观察红蓝光联合自制中药面膜治疗寻常性痤疮的疗效。方法:将180例寻常性痤疮患者随机分为对照组60例,治疗组120例。两组均先使用氦氖激光复合LED治疗仪治疗,治疗结束后对照组予普通市售倒模粉外敷20min,治疗组予自制中药面膜外敷30min,两组均每周治疗1次,一般需治疗3~4次。结果:治疗组有效率明显优于对照组(χ2=8.99,P0.05),且无明显不良反应。结论:红蓝光联合自制中药面膜治疗寻常性痤疮疗效好,安全性高,值得临床推广。     

Subcision and 1320-nm Nd:YAG Nonablative Laser Resurfacing for the Treatment of Acne Scars: A Simultaneous Split-Face Single Patient Trial

BACKGROUND: Many methods have been proposed for the treatment of acne scars with variable cosmetic results. Subcision has been successfully used, although complications often include a hyperpigmented and hypertrophic wound healing response. Nonablative skin resurfacing with a 1320-nm Nd:YAG laser has also been proposed; however, the results are generally inferior to those of more invasive modalities. OBJECTIVE: The objective was to improve on the results of 1320-nm Nd:YAG nonablative laser resurfacing by combining this treatment of acne scars with needle subcision. METHODS: A split-face trial was conducted in a patient with severe rolling and boxcar acne scars. One side of the face was treated with two sessions of subcision alone, spaced 6 weeks apart, whereas the other side was treated with two sessions of subcision spaced 6 weeks apart and 1320-nm Nd:YAG laser sessions every 2 weeks starting after the first subcision. At the conclusion of the split-face trial, the unlasered side was then treated with six biweekly sessions of 1320-nm Nd:YAG. RESULTS: Although the use of subcision resulted in an improvement of the patient's acne scars, the combination of subcision and nonablative laser resurfacing was superior in topography, pigmentation, and overall appearance of the acne scars. CONCLUSION: This case illustrates that dual treatment with subcision and 1320-nm Nd:YAG nonablative laser resurfacing is a well-tolerated and highly effective regimen for the improvement of facial acne scars, compared to subcision alone.     

The Tolerability Profile of Clindamycin 1%/Benzoyl Peroxide 5% Gel vs. Adapalene 0.1%/Benzoyl Peroxide 2.5% Gel for Facial Acne: Results of Two Randomized, Single-Blind, Split-Face Studies

Objective: To compare the first two weeks of tolerability of clindamycin/benzoyl peroxide gel versus adapalene/benzoyl peroxide gel followed by six weeks of open-label clindamycin/benzoyl peroxide gel therapy in subjects with mild-to-moderate acne who participated in two eight-week, identically designed, clinical studies. Methods: Using a split-face method, patients received both clindamycin/benzoyl peroxide gel and adapalene/benzoyl peroxide gel once daily for two weeks (allocation to the right or left side of the face was randomized) in an investigator-blinded fashion. Patients then went on to receive a further six weeks of open-label, full-face clindamycin/benzoyl peroxide gel. The primary outcome was to compare signs and symptoms of tolerability during the first two weeks of treatment using an investigator-assessed 4-point rating scale. Secondary endpoints included assessment of acne severity (Investigator Static Global Assessment and lesion counts), quality of life, product acceptability/preference, and patient assessments of tolerability and safety. Results: Of the 76 subjects enrolled in the two studies, 72 completed them. Overall both products were well tolerated, but mean scores for erythema, dryness, and peeling were significantly higher with adapalene/benzoyl peroxide gel than with clindamycin/benzoyl peroxide gel at both Weeks 1 and 2 (p<0.03). Patients also rated clindamycin/benzoyl peroxide gel significantly more tolerable than adapalene/benzoyl peroxide gel for redness, dryness, burning, itching, and scaling at Weeks 1 and 2 (p 0.0073). Mean Investigator Static Global Assessment score improved with both products during the first two weeks of treatment and continued to show significant improvement versus baseline when treatment with clindamycin/benzoyl peroxide gel was continued for a further six weeks (p<0.001 at Week 8). Lesion counts improved throughout the study with significant reductions from baseline occurring at Weeks 5 and 8 (p<0.0001 for both time points for total lesion counts). Clindamycin/benzoyl peroxide gel and adapalene/benzoyl peroxide gel were well tolerated, with most adverse events of mild-to-moderate severity. Conclusion: Clindamycin/benzoyl peroxide gel had better tolerability with regard to erythema, dryness, and peeling than adapalene/benzoyl peroxide gel during the first two weeks of treatment.     

红蓝光联合治疗面部中重度痤疮的临床疗效观察

目的:评价红蓝光联合治疗中、重度痤疮的临床疗效。方法:治疗组50例,采用红蓝光联合照射治疗,每位患者每次使用蓝光照射20mi n,然后使用红光照射5～10mi n,每周2次;对照组40例,口服丹参酮胶囊联合外用克林霉素磷酸酯凝胶,两组均治疗4周后判定疗效。结果:红蓝光联合照射治疗中重度痤疮疗效佳,优于对照组(P<0.05)。结论:红蓝光联合照射治疗中、重度痤疮安全有效。     

Nonablative Radiofrequency for Active Acne Vulgaris: The use of Deep Dermal Heat in the Treatment of Moderate to Severe Active Acne Vulgaris (Thermotherapy): A Report of 22 Patients

BACKGROUND: Acne vulgaris is an exceedingly common condition in adolescence and may extend into adult life in some individuals. Even though this condition is at times minimized, it has been found to have a profound impact in the quality of life of many affected individuals. Acne scarring can be even more of a source of psychological and social problems than active acne is, and when inadequately treated, the latter can lead to the former. Moderate and severe acne vulgaris usually require a regimen of systemic and/or topical medications, which are given for several months or even years and frequently require multiple visits to the physician office, the laboratory, etc. This results in loss of time at school and considerable expense. Side effects from medications and the frequent need to use alternative drugs when there is no response to medical treatment are possible. OBJECTIVE: To evaluate the role of a novel medical device that uses radiofrequency as a source of energy to produce volumetric tissue heating, while sparing the epidermis, allowing for a procedure with no down time and no postoperative care required. METHODS: Twenty-two patients, 10 women and 12 men, ranging in age from 16 to 28, with moderate to severe, scarring, cystic, active, acne vulgaris participated. Only nine of these patients were on concomitant medical treatment such as oral antibiotics or topical agents. All 22 patients were treated with a new nonablative radiofrequency unit, which delivers a concomitant spray of cryogen for epidermal sparing. One session was done in 20 patients and two sessions in 2 patients. The average fluence per energy delivery was 72 J/cm2. Follow-up ranged from 1 to 8 months. Patient questionnaires and active acne lesion counts were used to evaluate the response to treatment. RESULTS: Excellent response was seen in 82% (n=18). Modest response was seen in 9% (n=2), and no response was seen in 9% (n=2); t-test on active lesion counts before treatment and after treatment was less than 0.009004. No side effects were identified on any of these patients. No down time from the procedure was seen. Only topical anesthesia, ELA-Max 5% (Ferndale Labs, Ferndale, MI) was used; 59% of patients were on no acne medication before, during, or after the procedure. CONCLUSIONS: Nonablative radiofrequency appears to be a new safe and effective treatment alternative for moderate to severe acne vulgaris. Further research is in progress to evaluate this treatment modality in a larger number of patients.     

中药联合红蓝光照射治疗中重度痤疮的疗效观察

目的：观察中药联合红蓝光照射治疗中重度成年女性痤疮的临床疗效。方法：选择中重度成年女性痤疮患者（Pi11sbury分级为II～IV度）87例,分为治疗组（45例）和对照组（42例）,治疗组采用中药联合红蓝光治疗,对照组采用中药联合阿达帕林治疗。结果：治疗组总有效率为93．33％,对照组总有效率为61．90％,两组比较有显著性差异（P〈0．01）。结论：采用中药联合红蓝光治疗中重度成年女性痤疮具有较好的疗效,无明显的副作用,疗效方面明显优于中药联合阿达帕林治疗。     

Acne Lesion Extraction versus Oral Doxycycline for Moderate Acne Vulgaris: A Randomized Clinical Trial

Clinical trial ID{"type":"clinical-trial","attrs":{"text":"NCT04206631","term_id":"NCT04206631"}}NCT04206631BackgroundAcne vulgaris is a polymorphic skin condition comprising inflamed and noninflamed lesions. In addition to topical retinoids, systemic antibiotics play a role as a main therapy for acne with inflamed papules and cysts. However, due to the increasing tendency for bacterial resistance, alternatives to antibiotics are needed.ObjectiveThe aim of this study was to evaluate the effectiveness of acne lesion extraction compared to oral doxycycline for moderate acne vulgaris and to explore the impact of both treatments on Hypoxia-inducible factor (HIF)-1 alpha.MethodsThis randomized clinical trial was conducted in two teaching hospitals in 2016. Subjects with moderate acne vulgaris (N=140) were divided into two groups. Each subject in both groups received 0.05% tretinoin cream, applied to the entire face each night, and 2.5% benzoyl peroxide gel, applied to the acne lesions in the morning and afternoon. One group was also treated with oral doxycycline 100mg once daily and the other was treated with acne lesion extraction performed on all facial lesions every two weeks; the patients were evaluated via patient-reported self-assessment and lesion counts every two weeks for six weeks. HIF-1 alpha expression of the biopsied lessions was examined via immunohistochemistry.Results128 subjects completed the study. Among these 128 subjects there was a prominent decrease in inflamed lesions at Week 6 in the lesion extraction group compared to the oral doxycycline group (p<0.05). HIF-1 alpha expression of the biopsied lesions was found in 7 of 9 samples taken from the oral doxycycline group, while 3 of 4 samples in the lesion extraction group were found negative.ConclusionAccording to our results, acne lesion extraction appeared to be more effective than oral doxycycline in treating this sample of patients with moderate acne vulgaris. Additionally, HIF-1 alpha expression appeared to be decreased after acne lesion extraction.