Phototherapy in the treatment of acne vulgaris

BACKGROUND: Achieving an effective management of acne vulgaris with minimal complications remains a difficult challenge for physicians. Moreover, the rise in antibiotic-resistant strains reduce the future usefulness of current mainstay therapies, and accordingly, the need for alternative therapies is mandatory. Phototherapy has been shown to be an effective treatment for acne, and there has been a renewed interest in photodynamic therapy as a treatment modality for this condition. OBJECTIVES: To evaluate the effectiveness of pulsed dye laser (PDL), intense pulsed light (IPL) and light-emitting diode (LED) phototherapy for the treatment of moderate to severe acne vulgaris. METHODS: Forty-five patients with moderate to severe acne were randomly divided into 3 equal groups. Group 1 was treated with a PDL, group 2 was treated with IPL, and group 3 was treated with a blue-red combination LED. Treatment was continued until a > or = 90% clearance of patient lesions was achieved. Clinical assessments were conducted before starting treatment, at 1 month as a midpoint evaluation, and after the final treatment session. RESULTS: Patients treated with the PDL reached a > or = 90% clearance of their inflammatory lesions after a mean of 4.1 +/- 1.39 sessions, while patients treated with IPL required a mean of 6 +/- 2.05 sessions. Patients treated with the LED required a mean of 10 +/- 3.34 sessions. At the mid-point evaluation, the percent reduction in acne lesions treated with the PDL was 90% or more, in cases of IPL and the LED, the percent reductions were 41.7% and 35.3%, respectively. Laser and light phototherapy sessions were well tolerated with minimal adverse events experienced as being mild and usually self-limiting. CONCLUSIONS: The encouraging results of the present study contributes evidence of phototherapy as useful therapeutic option for treatment of moderate to severe acne, and validates further studies to evaluate treatments with a larger number of patients and for a longer period of follow-up.