Acne – Blue Phototherapy

J Cosmet Laser Ther. 2014 Jun;16(3):108-13. doi: 10.3109/14764172.2013.854638. Epub 2013 Nov 18.

Clinical and usability study to determine the safety and efficacy of the Silk'n Blue Device for the treatment of mild to moderate inflammatory acne vulgaris.

Gold MH1, Biron JA, Sensing W.

1Tennessee Clinical Research Center , Nashville, TN , USA.

Abstract

Abstract Introduction: Home devices for acne vulgaris have emerged as a way to utilize our current light based technology for the care of our patients suffering from acne vulgaris.

Materials and methods: Patient received eight treatments with the Silk'n Blue device over a 4-week period. Follow-up visits were at 1 month and 3 months.

Results: Seventeen subjects were entered into this institutional review board (IRB) approved clinical research project. There was a statistically significant decrease in mean acne counts from baseline through the follow-up visits, p = 0.002. Percent reduction was also statistically significant, p = 0.041. The study also showed that 36.4% of the patients had complete clearance with the study device. 100% of the patients showed full comprehension with the label for the device. There were no adverse events. Photos were captured. Discussion: The Silk'n Blue device has an array of 24 LEDs emitting a spectrum of light in the blue-violet range of light (405-460 nm). Subjects enrolled in this clinical trial clearly were able to understand the labeling for the device.

Conclusions: The Silk'n Blue device is a safe efficacious at home device for the treatment of mild to moderate inflammatory acne vulgaris

 
J Cosmet Laser Ther.  2011 Dec;13(6):308-14.

Clinical efficacy of home-use blue-light therapy for mild-to moderate acne.

Gold MH, Sensing W, Biron JA.

Source

Gold Skin Care Center, Department of Dermatology, School of Nursing, Vanderbilt University School of Medicine, Vanderbilt University , Nashville, TN , USA , Fudan University (Shanghai Medical University), Shanghai, China, and China Medical University, Shenyang, China.

 

Abstract

Abstract Introduction: Blue-light light-emitting diode (LED) therapy has become widely used for the treatment of inflammatory acne. In this study we evaluated the efficacy of a home use blue-light LED application in improving lesions and shortening their time to clearance.

Methods: This was an IRB approved randomized self-control study. For each patient (n = 30), 2 similar lesions, one of each side of the face were chosen for treatment with either a blue-light LED hand-held or sham device. Treatments (n = 4) were conducted twice daily in the clinic and lesions were followed-up till resolution. Reduction in blemishes size and erythema and the overall improvement were evaluated by both the physician and the patients. Time to lesion resolution was recorded.

Results: There was a significant difference in the response of lesions to the blue-light LED application as opposed to the placebo in terms of reduction in lesion size and lesion erythema as well as the improvement in the overall skin condition (p < 0.025). Signs of improvement were observed as early as post 2 treatments. Time to resolution was significantly shorter for the blue-light LED therapy.

Conclusion: The results support the effectiveness of using blue-light LED therapy on a daily basis for better improvement and faster resolution of inflammatory acne lesions.

 

J Drugs Dermatol. 2011 Jun;10(6):596-602.

 

Evaluation of self-treatment of mild-to-moderate facial acne with a blue light treatment system.

Wheeland RG, Dhawan S.

Source

Department of Dermatology, University of Missouri Healthcare, 1 Hospital Drive, Columbia, MO 65212, USA. wheelandr@health.missouri.edu

 

Abstract

INTRODUCTION:

This study evaluated the efficacy and tolerability of treating mild-to-moderate facial acne using a new, hand-held, light-emitting diode blue light device in conjunction with a foam cleanser containing 5% glycolic acid and 2% salicylic acid plus a skin rebuilding serum containing 1.25% salicylic acid, 0.5% niacinamide, 0.08% liposomal-based azelaic acid and superoxide dismutase.

METHODS:

Volunteers with mild-to-moderate facial inflammatory acne used the blue light device twice daily for eight weeks, plus the cleanser before treatments and the serum after each evening treatment.

RESULTS:

Among 33 subjects aged 25-45 years old, 28 completed. In a 3 cm x 5 cm target area receiving a daily dose of ~29 J/cm2, treatment was associated with significant reductions from baseline in the inflammatory lesion count from week 1 onward (P? .01) and in the non-inflammatory lesion count from week 4 onward (P? .05). The number of flares was significantly reduced from baseline from week 2 onward (P? .05), and flare severity and flare redness were significantly reduced from baseline from week 4 onward (P? .01 and P? .05, respectively). At week 8, more than 90 percent of subjects reported improvements in their skin's overall appearance, clarity, radiance, tone, texture and smoothness. In addition, 82 percent were satisfied, very satisfied, or extremely satisfied with the blue light treatment system and 86 percent agreed the treatment system was much gentler than traditional acne treatments.

CONCLUSION:

The blue light treatment system offers effective, rapid, convenient and well tolerated treatment of inflammatory and non-inflammatory acne lesions. The majority of subjects consider it much gentler than traditional acne treatments and it facilitates effective treatment without the need for antibiotic exposure. The blue light treatment system and blue light therapy alone are attractive treatment options for acne vulgaris, both as alternatives to traditional acne treatments and as adjunctive treatments to complement existing therapies.

 

Hautarzt.  2010 Feb;61(2):132-8.

Physical treatment methods for acne. Light, laser, photodynamic therapy and peeling.

[Article in German]
Borelli C, Korting HC.

Source

Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337 München. claudia.borelli@med.uni-muenchen.de

 

Abstract

The medical treatment of acne is generally sufficient to meet the expectations of acne patients. However, in a number of situations additional therapeutic approaches may be advisable. There are a wide variety of useful physical methods. They range from electromagnetic waves, usually light, to peeling and manual therapy. Phototherapy of acne includes not just visible light but also laser and flash lamp therapy. The present review provides an overview on the evidence. Visible light, in particular blue light, provides an effective option for treatment of inflammatory acne. Photodynamic therapy also is efficacious; however, it should not be used because of an unfavorable risk-benefit ratio. UV treatment of acne is obsolete. Newer studies on the use of a variety of laser systems and flash lamps have demonstrated in part rewarding results.

 

Br J Dermatol. 2009 Jun;160(6):1273-85. Epub 2009 Feb 23.

Laser and other light therapies for the treatment of acne vulgaria: systematic review.

Hamilton FL, Car J, Lyons C, Car M, Layton A, Majeed A.

Department of Primary Care and Social Medicine, Imperial College London, UK. f.hamilton@imperial.ac.uk

BACKGROUND: Acne is common and can lead to scarring of the skin, as well as to psychological distress and reduced self-esteem. Most topical or oral treatments for acne are inconvenient and have side-effects. Laser and other light therapies have been reported to be convenient, safe and effective in treating acne.

OBJECTIVES: To carry out a systematic review of randomized controlled trials of light and laser therapies for acne vulgaris.

METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycInfo, LILACS, ISI Science Citation Index and Dissertation Abstracts International for relevant published trials.

RESULTS: We identified 25 trials (694 patients), 13 of light therapy and 12 of light therapy plus light-activated topical cream (photodynamic therapy, PDT). Overall, the results from trials of light alone were disappointing, but the trials of blue light, blue-red light and infrared radiation were more successful, particularly those using multiple treatments. Red-blue light was more effective than topical 5% benzoyl peroxide cream in the short term. Most trials of PDT showed some benefit, which was greater with multiple treatments, and better for noninflammatory acne lesions. However, the improvements in inflammatory acne lesions were not better than with topical 1% adapalene gel, and the side-effects of therapy were unacceptable to many participants.

CONCLUSIONS: Some forms of light therapy were of short-term benefit. Patients may find it easier to comply with these treatments, despite the initial discomfort, because of their short duration. However, very few trials compared light therapy with conventional acne treatments, were conducted in patients with severe acne or examined long-term benefits of treatment.

An Bras Dermatol.  2009 Oct;84(5):463-8.

A prospective, randomized, open and comparative study to evaluate the safety and efficacy of blue light treatment versus a topical benzoyl peroxide 5% formulation in patients with acne grade II and III.

[Article in Portuguese]
de Arruda LH, Kodani V, Bastos Filho A, Mazzaro CB.

Source

Serviço de Dermatologia, Hospital Escola Celso Pierro, Faculdade de Medicina, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brasil. dermato@hmcp.puc-campinas.edu.br

Abstract

BACKGROUND:

Many acne patients improve after exposure to sunlight and there are many reports about the efficacy of blue light phototherapy on acne lesions.

OBJECTIVES:

The purpose of this study was to evaluate efficacy and safety of blue light treatment versus topical benzoyl peroxide 5% formulation in patients with acne grades II and III.

METHODS:

Sixty volunteers with facial acne were included and evaluated in 5 visits: the first one for screening, another 3 held on days 7, 14 and 28 of treatment, and the last one after 14 days of the end of treatment. Thirty of them were irradiated with Blue Light (8 times, twice a week) and the other thirty were treated with topical Benzoyl Peroxide 5% formulation, auto-applied twice a day, every day. We assessed the severity of acne by counting the lesions and analyzing the photographs.

RESULTS:

The improvement achieved by the blue light was the same as the one with benzoyl peroxide, regardless of the type of lesion (p 0.05). Otherwise, the side effects were less frequent in the group treated with blue light.

CONCLUSIONS:

Blue light irradiation was as effective as benzoyl peroxide in acne treatment grades II and III but there were fewer side effects.

J Cosmet Laser Ther. 2009 Jun;11(2):125-8.

A study to determine the effect of combination blue (415 nm) and near-infrared (830 nm) light-emitting diode (LED)therapy for moderate acne vulgaris.

Sadick N.

Weill Cornell Medical College, New York, NY, USA. nssderm@sadickdermatology.com

BACKGROUND AND OBJECTIVE: Acne vulgaris remains a major problem in dermatological practice. Phototherapy for acne with blue (415 nm) and red (633 nm) light-emitting diode (LED) arrays has recently attracted attention. This pilot study assessed the efficacy of the combination of 415 nm and near-infrared (IR) LED therapy for moderate acne.

METHODS: Seventeen individuals were recruited: 13 females and four males. Skin types ranged from type II to type VI, and the acne grades at baseline ranged from Burton grade 1 to 5. Patients underwent twice-weekly 20-minute sessions of LED therapy for 4 weeks, alternating between the blue (415 nm) and near-IR (830 nm) heads. No other treatment was allowed. Results were assessed and compared with the baseline values at 1, 4 and 8 weeks post-treatment.

RESULTS: Six individuals failed to complete the study. Eleven individuals showed improvement ranging from 0% to 83.3%. A downward shift in the Burton grade was seen overall. Non-inflammatory lesion counts increased in four patients, but improved in the other seven by an average of 48.8%. No adverse effects were reported.

CONCLUSIONS: The combination therapy for acne produced results which were less effective in the reduction of inflammatory lesions than those achieved with the previously reported blue/red combination. Further study with a much larger patient population is warranted.

Semin Cutan Med Surg. 2008 Sep;27(3):207-11.

Evidence for laser- and light-based treatment of acne vulgaris.

Munavalli GS, Weiss RA.

Dermatology, Laser, and Vein Specialists of the Carolinas, Charlotte, NC 28207, USA. gmunava@yahoo.com

Acne is a very prevalent skin disorder, affecting more than 85% of adolescents and often continuing into adulthood. Active acne and its sequelae, especially permanent scarring, may cause longstanding psychological or emotional harm in patients. Novel and promising treatments with laser/light devices (such as blue light, red light, pulsed dye laser, infrared lasers, light-emitting diodes, and pulsed light) have been reported to have varying degrees of efficacy for treatment. The authors compiled a summary of evidence-based literature on laser/light treatment for acne to assist clinicians to more appropriately identify treatment options, should they choose to supplement current medical antiacne therapies.

J Cosmet Dermatol. 2008 Sep;7(3):180-8.

An assessment of the efficacy of blue light phototherapy in the treatment of acne vulgaris.

Ammad S, Gonzales M, Edwards C, Finlay AY, Mills C.

Cardiff University, Cardiff, UK. s_ammad@yahoo.com

BACKGROUND: Acne vulgaris is a common skin condition that affects 8 out of 10 people. It varies from mild to severe, and different treatments target various aspects of the disease. Propionibacterium acnes, one of the culprits involved in the pathogenesis of acne vulgaris, is the main target of all major medical treatments used. Studies conducted in recent years have shown favorable effects within the visible light spectrum for the treatment of acne vulgaris.

OBJECTIVE: In this study, we have evaluated the use of intense blue light within the spectral range of 415-425 nm (peak 420 nm) in the treatment of acne vulgaris.

METHODS: Twenty-one patients with mild to moderate facial acne were treated with blue light phototherapy. All patients were given 14-min treatment sessions twice a week for 4 weeks. Acne severity was assessed using the Leeds Technique for grading and lesion counts. Disability was assessed using the Dermatology Life Quality Index (DLQI). In addition, standard digital and cross-polarized light photographs were taken and graded by a blinded evaluator. Visual analog scale (VAS) scores and cultures for P. acnes were carried out before starting the treatment and upon completion of the treatment.

RESULTS: Significant improvement was achieved in the Leeds Acne Grade (P = 0.001). The inflammatory (P = 0.001) and noninflammatory (P = 0.06) lesion counts also improved significantly. A similar change was noted in the DLQI (P = 0.001); a degree of significance was also achieved in the patients' and the investigators' VAS scores (P = 0.01 and P = 0.001, respectively). P. acnes colony counts failed to show a significant decrease at the end of the treatment and remained almost constant (P = 0.660).

CONCLUSIONS: We believe that blue light does appear to have some role in the management of acne and may be beneficial for the treatment of a select group of mild to moderate acne patients.

J Drugs Dermatol. 2008 Apr;7(4):347-50.

Handheld LED array device in the treatment of acne vulgaris.

Sadick NS.

Weill Medical College of Cornell University, Department of Dermatology, New York, NY, USA. nssderm@sadickdermatology.com

The successful treatment of acne still remains problematic. Conventional therapies often prove inconsistent with unacceptable side effects and recurrence rates, leading to patient noncompliance. A thermal phototherapy treatment using a combination of blue light and red light has recently attracted much attention and seems to offer an effective alternative. The objective of this study was to evaluate the efficacy of blue light (415 nm) in combination with red light (633 nm) in the reduction of inflammatory lesions on the face of subjects (n=21) with mild to moderate acne vulgaris after a course of 8 20-minute (blue) or 30-minute (red) alternated light treatments, self-administered by a handheld unit over a period of 4 weeks. Lesion counts progressively reduced throughout the 4-week light therapy period and continued to reduce up to 8 weeks posttherapy, with a final average reduction of 69% seen 8 weeks after the treatment course (P>.001). This pattern is similar to previously reported studies.

J Drugs Dermatol. 2007 Aug;6(8):838-40.

Combination of a new radiofrequency device and blue light for the treatment of acne vulgaris.

Braun M.

Vancouver Laser and Skin Care Centre Inc, Vancouver, BC, Canada. info@vancouverlaser.com

Acne vulgaris is the most common skin disease treated by physicians. Current topical and oral treatments may have short- and long-term negative consequences. Since radiofrequency (RF) energy has been shown to reduce sebum production and 410-nm blue light has been shown to kill Propionibacterium acnes (P. acnes) cells, these modalities in combination should be a highly effective treatment of acne vulgaris with little or no downtime or risk. This case report describes the efficacy and safety of RF energy (Accent, Alma Lasers Inc, Buffalo Grove, IL) and blue light (BLU-U, Dusa Pharmaceuticals, Inc, Wilmington, MA) used in combination to treat grade 4 cystic acne and acne scars in an Asian woman of skin type IV. The results were considered excellent by both investigators and the patient, with improvement in the skin tone as an added cosmetic benefit.

Photodermatol Photoimmunol Photomed.  2007 Feb;23(1):32-4.

A new targeted blue light phototherapy for the treatment of acne.

Noborio R, Nishida E, Kurokawa M, Morita A.

Source

Department of Geriatric and Environmental Dermatology, Nagoya City University of Medical Sciences, Mizuho-cho, Nagoya, Japan.

Abstract

BACKGROUND:

The effects of blue light phototherapy on inflammatory acne lesions were recently investigated. Many reports have used high-intensity, narrow-band 420 nm UV-free blue light delivery systems. The aim of this study was to evaluate a new blue light system (MultiClear) for targeted blue light phototherapy.

METHOD:

Ten Japanese patients with acne on the face or back were treated with targeted blue light once or twice a week. Acne severity was graded according to the acne severity score suggested by Allen and Smith (1982). If the acne was prevalent on the back or chest, the acne severity score of Burton et al. (1971) was adopted. The new targeting blue light system is equipped with a flexible optical light guide as a delivery system and the treatment device is placed directly only on the affected area.

RESULT:

Of the 10 patients, eight had a significantly reduced acne severity score without any side effects. Although two patients discontinued the study because of unsatisfactory results, none of the patients showed any harmful side effects from the targeted blue light phototherapy.

CONCLUSION:

Targeted blue light phototherapy with MultiClear is effective for the treatment of inflammatory acne lesions. This new irradiation device offers some advantages over previous blue light systems.

J Drugs Dermatol.  2006 Jul-Aug;5(7):605-10.

Anti-inflammatory properties of narrow-band blue light.

Shnitkind E, Yaping E, Geen S, Shalita AR, Lee WL.

Source

Department of Dermatology at SUNY Downstate Medical Center, Brooklyn, NY 11203, USA. shnitkind@yahoo.com

 

Abstract

BACKGROUND:

Narrow-band blue light (420 nm) has demonstrated safety and efficacy in the treatment of acne vulgaris. It works by exhibiting a phototoxic effect on the heme metabolism of Propionibacterium acnes. Previous studies using blue light showed more improvement in inflammatory lesions than in comedones, as well as some improvement on the untreated side. Cytokines have demonstrated a critical role in the development of inflammation. The expression of pro-inflammatory cytokines such as IL-1alpha have been shown to result in the expression of vascular and dermal adhesion molecules, the chemoattraction of inflammatory cells, and the stimulation of other inflammatory mediators. In addition, UVB radiation serves as a potent modulator of cell-mediated immune responses.

PURPOSE:

This study investigated the effect of narrow-band blue light on the inflammatory process in the presence and absence of cytokines and UVB using IL-1alpha and ICAM-1 as markers for inflammation.

METHODS:

Two immortalized keratinocyte cell lines were compared: HaCaT, produced by spontaneous immortalization of a genetically altered cell line, and hTERT, obtained by stable transfection of primary cell culture with human telomerase reverse transcriptase. Cells were treated with INF-y and TNF-alpha and exposed to UVB (312 nm at 50 mJ/cm2) and/or blue light (420 nm at 54 mJ/cm2 and 134 mJ/cm2). The expression of IL-1alpha and ICAM-1 was measured by quantitative ELISA.

RESULTS:

The results showed that blue light and low-dose UVB treatment of HaCaT and hTERT cells resulted in inhibition of cytokine-induced production of IL-1alpha. The level of IL-1alpha decreased by 82% in HaCaT and by 75% in hTERT cells when exposed to blue light. It decreased by 95% in HaCaT and by 91% in hTERT cells when blue light was used in combination with UVB. ICAM-1 expression was similarly reduced in HaCaT, but not in hTERT cells.

CONCLUSIONS:

This study showed that narrow-band blue light has anti-inflammatory effects on keratinocytes by decreasing the cytokine-induced production of IL-1alpha and ICAM-1. In addition, blue light demonstrated synergistic effects with low-dose UVB light. These results expand the properties of narrow-band blue light in modulating the inflammatory process and will facilitate testing of its phototherapeutic applications in different inflammatory skin conditions.

 

 

J Cosmet Laser Ther. 2006 Jun;8(2):71-5.

Combination blue (415 mm) and red (633 nm) LED phototherapy in the treatment of mild to severe acne vulgaris.

Goldberg DJ, Russell BA.

Skin Laser & Surgery Specialists of New York/New Jersey, and Department of Dermatology, Mount Sinai School of Medicine, New York, NY 10022, USA. drdavidgoldberg@skinandlasers.com

BACKGROUND AND OBJECTIVE: Acne vulgaris represents both a challenge to the treating dermatologist and a major concern for the patient. Conventional treatments have proved inconsistent with often unacceptable side effects and high rates of recurrence. Non-thermal, non-laser, phototherapy for acne with a combination of blue and red light has recently attracted attention. The present study was designed to assess the efficacy of this combination phototherapy.

METHODS: Twenty-four subjects, Fitzpatrick skin types II-V, with mild to severe symmetric facial acne vulgaris were recruited for the study. Subjects were well matched at baseline in terms of both age and duration of acne. Subjects were treated over eight sessions, two per week 3 days apart, alternating between 415 nm blue light (20 minutes/session, 48 J/cm2) and 633 nm red light (20 minutes/session, 96 J/cm2) from a light-emitting diode (LED)-based therapy system. Patients received a mild microdermabrasion before each session. Acne was assessed at baseline and at weeks 2, 4, 8 and 12.

RESULTS: Twenty-two patients completed the trial. A mean reduction in lesion count was observed at all follow-up points. At the 4-week follow-up, the mean lesion count reduction was significant at 46% (p=0.001). At the 12-week follow-up, the mean lesion count reduction was also significant at 81% (p=0.001). Patient and dermatologist assessments were similar. Severe acne showed a marginally better response than mild acne. Side effects were minimal and transitory. Comedones did not respond as well as inflammatory lesions.

CONCLUSIONS: Combination blue and red LED therapy appears to have excellent potential in the treatment of mild to severe acne. Treatment appears to be both pain- and side effect-free.

J Cosmet Laser Ther. 2006 Apr;8(1):31-3.

Light-emitting diode 415 nm in the treatment of inflammatory acne: an open-label, multicentric, pilot investigation.

Tremblay JF, Sire DJ, Lowe NJ, Moy RL.

Source

UCLA School of Medicine, Los Angeles, CA, USA.

Abstract

BACKGROUND:

The management of acne remains a challenge, with current therapies linked to significant side effects and patient non-compliance. Phototherapy using blue light has been proven in the treatment of acne vulgaris and offers the clinician an effective alternative.

OBJECTIVE:

To determine the effect of narrowband light-emitting diode (LED) blue light in the reduction of inflammatory and non-inflammatory lesions in patients with mild to moderate acne and to evaluate patient tolerance of the therapy.

METHODS:

Forty-five patients were treated with high-intensity pure blue light, 415 nm and 48 J/cm2, receiving two treatments of 20 minutes per week for a period of 4-8 weeks. Clinical assessment was performed at baseline, and 2, 4 and 8 weeks after treatment. A patient's therapeutic response was measured using a global improvement scoring system.

RESULTS:

The mean improvement score was 3.14 at 4 weeks and 2.90 at 8 weeks. Nine patients experienced complete clearing at 8 weeks. The treatment was well tolerated, with 50% of patients highly satisfied with the treatment.

CONCLUSION:

This open-label study suggests the therapeutic efficacy of high-intensity LED pure blue light in the treatment of acne vulgaris with no reported side effects.

1: Hautarzt. 2005 Nov;56(11):1027-32.

Light, laser and PDT therapy for acne

[Article in German]

Borelli C, Merk K, Plewig G, Degitz K.

Klinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München. c.borelli@med.uni-muenchen.de

In recent years, a number of studies have evaluated the treatment of acne using electromagnetic waves, such as lasers, photodynamic therapy, visible light or radio waves. While the efficacy of laser treatment is still uncertain, photodynamic therapy shows promising results, but with marked side-effects, as destruction of sebaceous glands. Treatment with blue light (405-420 nm wavelength) also appears effective and can be regarded as an treatment option for inflammatory acne.

Semin Cutan Med Surg. 2005 Jun;24(2):107-12.

Lasers and light therapy for acne vulgaris.

Bhardwaj SS, Rohrer TE, Arndt K.

Department of Dermatology, University of Minnesota, USA.

Acne vulgaris remains an emotionally and debilitating dermatologic disease, and is conventionally treated with a variety of oral and topical therapies with a number of significant side effects. An evolving understanding of laser-tissue interactions involving Propionibacterium acnes-produced porphyrins, and the development of infrared nonablative lasers to target sebaceous glands, has lead to the development of an escalating number of laser, light and radiofrequency devices for acne. Used as monotherapy or in combination, these devices are showing promise as a method to clear acne in a convenient, non-invasive manner, though there remains a clear need for long-term data and randomized, blinded studies.

J Cosmet Dermatol. 2005 Dec;4(4):318-20

Light/laser therapy in the treatment of acne vulgaris.

Nouri K, Villafradez-Diaz LM.

Department of Dermatology, University of Miami School of Medicine, Miami, FL.

Acne vulgaris is one of the most prevalent skin diseases known. As common as this condition is, the social and psychological consequences are limitless. Although current treatments are available and include topical or oral antibiotics, it is crucial to develop a less risky and more effective therapy such as light/laser therapy. This article focuses specifically on the benefits of the light/laser treatment on acne vulgaris. Porphyrins accumulated in the bacteria, Propionibacterium acnes, one of the etiologic factors involved in the pathogenesis, allows phototherapy to be a successful modality. They have specific absorption peaks at which lasers have optimal effects. The longer the wavelength of the light is, the deeper its penetration and thus the greater its damage to the sebaceous glands. Although blue light is best for the activation of porphyrins, red light is best for deeper penetration and an anti-inflammatory effect. Ultraviolet (UV) light, although it may have initial an anti-inflammatory effects, has been proven to be potentially carcinogenic and have adverse effects such as aging (by UV-A) and burning (by UV-B). Previous studies indicate successful long-term intervention and selective damage of the sebaceous glands by using a diode laser with indocyanine green (ICG) dye. Mid-infrared lasers have been found to decrease lesion counts while also reducing the oiliness of skin and the scarring process. Nonablative laser treatment of acne scars using the Er:YAG laser with a short-pulsed mode has been successful in reducing the appearance of scars by stimulating neocollagenesis. The light/laser therapy has started to be explored with promising results in highly selected patients that require further investigation in greater populations and well-designed protocols.

J Dermatolog Treat. 2005;16(4):219-23.

An open study to determine the efficacy of blue light in the treatment of mild to moderate acne.

Morton CA, Scholefield RD, Whitehurst C, Birch J.

Source

Department of Dermatology, Falkirk Royal Infirmary, Falkirk, UK. colin.morton@fvah.scot.nhs.uk

Abstract

BACKGROUND:

The effective management of acne remains a challenge; achieving an optimal response whilst minimizing adverse events is often difficult. The rise in antibiotic resistance threatens to reduce the future usefulness of the current mainstay of therapy. The need for alternative therapies remains important. Phototherapy has previously been shown to be effective in acne, with renewed interest as both endogenous and exogenous photodynamic therapies are demonstrated for this condition.

OBJECTIVES:

To determine the effect of narrowband blue light in the reduction of inflammatory and non-inflammatory lesions in patients with mild to moderate acne and to evaluate patient tolerance of the therapy.

METHODS:

We performed an open study utilizing a blue LED light source in 30 subjects with mild to moderate facial acne. Two weeks after screening, lesions were counted and recorded by lesion type. Over 4 weeks, patients received eight 10- or 20-minute light treatments, peak wavelength 409-419 nm at 40 mW/cm2. Assessments were taken at weeks 5, 8 and 12 and lesion counts were recorded. Repeated measures-ANOVA and Dunnett's tests, respectively, allowed assessment of the different scores over time and permitted comparison of mean counts.

RESULTS:

An overall effect on inflammatory counts was observed at week 5, and a statistically significant decrease in inflamed counts was detected at the week 8 assessments, which continued to week 12. There was little effect on non-inflamed lesions. The treatment was well tolerated with adverse events experienced generally rated as being mild and usually self-limiting.

CONCLUSIONS:

Eight 10- or 20-minute treatments over 4 weeks with a narrowband blue light was found to be effective in reducing the number of inflamed lesions in subjects with mild to moderate acne. The treatment had little effect on the number of comedones. The onset of the effect was observable at the first assessment, at week 5, and maximal between weeks 8 and 12. Blue light phototherapy using a narrowband LED light source appears to be a safe and effective additional therapy for mild to moderate acne.

Photodermatol Photoimmunol Photomed.  2004 Oct;20(5):266-9.

Blue light phototherapy in the treatment of acne.

Tzung TY, Wu KH, Huang ML.

Source

Department of Dermatology, Veterans General Hospital Kaohsiung, 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan. tytzung@isca.vghks.gov.tw

Abstract

BACKGROUND:

Blue light irradiation is known to be effective against acne. However, the profile of a good candidate is still unclear.

METHODS:

Thirty-one Taiwanese with symmetrical facial acne were irradiated with blue light on one side of the face selected randomly twice weekly for 4 consecutive weeks. The other half of the face was left untreated as control. Parameters, including scar type, pore size, and facial follicular porphyrin fluorescence intensity, were documented. The severity of acne was assessed before the treatment, after two, four, and eight sessions of treatment, and 1 month after the treatment was completed.

RESULTS:

Compared with the non-irradiation side, eight sessions of blue light irradiation were effective in acne treatment (P<0.001). Gender (P=0.471), scar type (P-values of pitted, atrophic, and hypertrophic type were 0.688, 0.572, and 0.802, respectively), pore size (P=0.755), and pretreatment fluorescence intensity (P=0.656) could not be used as predictive factors of therapeutic effectiveness. Compared with pretreatment, nodulocystic lesions tended to worsen despite treatment. In addition, the therapeutic effectiveness was not related to the fluorescence intensity change (P=0.812).

CONCLUSIONS:

Blue light irradiation is effective in acne treatment. Patients without nodulocystic lesions are better candidates for blue light irradiation.

Am J Clin Dermatol. 2004;5(4):211-6.

Phototherapy in the treatment of acne vulgaris: what is its role?

Charakida A, Seaton ED, Charakida M, Mouser P, Avgerinos A, Chu AC.

Department of Dermatology, Faculty of Medicine, Hammersmith Campus, Imperial College, London, UK. e.charakida@imperial.ac.uk

Acne vulgaris is a common dermatosis affecting 80% of the population. To date, different treatments have been used to manage this condition. Antibacterials and retinoids are currently the mainstay of treatment for acne, but their success rate varies. Phototherapy is emerging as an alternative option to treat acne vulgaris. Studies examining the role of different wavelengths and methods of light treatment have shown that phototherapy with visible light, specifically blue light, has a marked effect on inflammatory acne lesions and seems sufficient for the treatment of acne. In addition, the combination of blue-red light radiation seems to be superior to blue light alone, with minimal adverse effects. Photodynamic therapy has also been used, even in nodular and cystic acne, and had excellent therapeutic outcomes, although with significant adverse effects. Recently, low energy pulsed dye laser therapy has been used, and seems to be a promising alternative that would allow the simultaneous treatment of active acne and acne scarring. Further studies are needed to clarify the role of phototherapy as a monotherapy or an adjuvant treatment in the current management of acne vulgaris.

Br J Dermatol.  2000 May;142(5):973-8.

Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris.

Papageorgiou P, Katsambas A, Chu A.

Source

Unit of Dermatology, Imperial College of Science, Technology and Medicine, Hammersmith Hospital, DuCane Road, London W12 0NN, U.K.

Abstract

In this study we have evaluated the use of blue light (peak at 415 nm) and a mixed blue and red light (peaks at 415 and 660 nm) in the treatment of acne vulgaris. One hundred and seven patients with mild to moderate acne vulgaris were randomized into four treatment groups: blue light, mixed blue and red light, cool white light and 5% benzoyl peroxide cream. Subjects in the phototherapy groups used portable light sources and irradiation was carried out daily for 15 min. Comparative assessment between the three light sources was made in an observer-blinded fashion, but this could not be achieved for the use of benzoyl peroxide. Assessments were performed every 4 weeks. After 12 weeks of active treatment a mean improvement of 76% (95% confidence interval 66-87) in inflammatory lesions was achieved by the combined blue-red light phototherapy; this was significantly superior to that achieved by blue light (at weeks 4 and 8 but not week 12), benzoyl peroxide (at weeks 8 and 12) or white light (at each assessment). The final mean improvement in comedones by using blue-red light was 58% (95% confidence interval 45-71), again better than that achieved by the other active treatments used, although the differences did not reach significant levels. We have found that phototherapy with mixed blue-red light, probably by combining antibacterial and anti-inflammatory action, is an effective means of treating acne vulgaris of mild to moderate severity, with no significant short-term adverse effects.