March 18, 2006
Health Sciences Center (Sunnybrook site) and the University of Toronto, Toronto, ON, Canada; Mediprobe Research Inc, London, ON, Canada
Acne vulgaris results from accumulation of sebum and Propionibacterium acnes bacteria in the pilosebaceous unit, producing pustules, papules and cysts. Current acne therapies may require ongoing applications or be associated with the potential for severe side effects. Intense pulsed light (IPL) therapy may provide a faster, easier method of treating inflammatory acne, with a low risk of side effects.
The Palomar LuxV handpiece provided IPL wavelengths of 400 to 700 nm and 870 to 1200 nm in the treatment of 15 patients with Fitzpatrick skin phototypes I to V. Each treatment used a fluence of 11 J/cm2 with either 60- or 100-msec pulse width and 3 to 4 passes over the entire treatment area. Each patient received 3 to 5 treatment sessions at intervals of 1 to 2 weeks. A final follow-up took place 3 months after completion of the last treatment.
Global severity grading, comedone counts and papule/pustule counts were performed prior to each treatment. The mean global severity grade of acne at baseline was 3.1 (mild to moderate acne: >20 noninflammatory comedones; 10-15 inflammatory papules/pustules; may or may not be one small nodulocystic lesion). At baseline, the mean comedone, papule, and pustule counts were 33.4, 19.3, and 4.4, respectively. At final follow-up, the mean global severity score was 2.3 (minimal to moderate: 10-20 noninflammatory comedones; <10 inflammatory papules/pustules; no nodulocystic lesions). Mean comedone, papule and pustule counts were 17.4, 8.1 and 2.1, respectively. The reduction from baseline in inflammatory lesions (sum of papules and pustules) was significant (P = .0026), as was the reduction in global severity score (P = .019). No significant difference in noninflammatory lesion (comedone) counts was found. No significant adverse effects were noted. Occasional flare-ups of inflammatory acne immediately after treatment were reported, but resolved in 3 to 5 days without medical intervention. There were reports in the skin type V group of mild crusting associated with postinflammatory hyperpigmentation that resolved without complications or medical intervention. Based on these preliminary results, IPL is effective and safe in the treatment of the inflammatory lesions of acne vulgaris in a variety of skin types. Larger scale trials to confirmthe efficacy need to be performed, with higher numbers of patients in each skin type, and longer follow-up to determine how long benefits are maintained. Author disclosure: Dr Gupta has been a clinical investigator for and has received honoraria and research grants from Palomar Medical Technologies. Supported in part by Palomar Medical Technologies.