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    From scars to active acne: Technological treatment for hard-to-treat cases



    Lasers and photodynamic therapy are practical treatment options for acne patients who fail or aren’t compliant with traditional first-line therapies. Today’s energy devices might also enhance acne treatment as adjuvant therapy, according to a review of newer studies looking at acne vulgaris and laser or photodynamic therapy.

    Researchers included studies on the topic from January 2015 to March 2016, excluding papers on acne scarring.

    Keeping up with what’s going on in acne treatments is important for practicing dermatologists, according to the review’s lead author Marjon Vatanchi, M.D., senior dermatology resident, SUNY Downstate Medical Center, New Dr. VatanchiYork City.

    “I can’t imagine a skin condition more relevant than acne, about 90 percent of the population has had acne at one point or another in their lives. For the past 40 years, the mainstay of treatment has primarily included retinoid or antibiotic medications. Acne is a multifactorial process, so, in the past decade, we’ve seen acne research that has begun to look at new technologies,” Dr. Vatanchi says.


    Energy device progress has been made on two fronts:  In the advancement or creation of new energy devices or laser devices, and the discovery of new uses for existing technology. An example of the second, according to Dr. Vatanchi, is using photodynamic therapy, which is traditionally used in a practice for sun damage and actinic keratosis in an older population, to treat younger acne patients.

    Initially, laser treatments for acne concentrated on treating acne scars — not so much treatment of active, inflammatory acne. Acne scar treatments included CO2 laser therapy, to improve scarring, or pulsed dye lasers, to treat redness or any vascular component that remains, she says.

    In general, Dr. Vatanchi and colleagues note a transition from treating acne scars to treating active inflammatory acne lesions.

    “Today we’re seeing a surge in clinical trials using energy devices to target the sebaceous glands or the inflammatory mediators,” Dr. Vatanchi says. “[Studies suggest that] with adequate treatment, red light can produce a brisk effect. The downsides are discomfort and downtime to heal. Blue light, which is more prevalent in the U.S., can also be used. While this is more tolerable or even painless, it does yield a more judicious result.”

    Researchers also are looking at new laser options for acne.

    “We’re seeing studies with animal and human models, such as evaluating the use of gold or silver microparticles. They’re used in conjunction with laser therapy,” she says. “Microparticles are light-absorbing. Through selective photothermolysis, [they] injure and denature sebaceous glands, thereby, hindering one of the key components of acne vulgaris. These trials have shown significant improvement. Patients in a lot of these studies were followed up to three to four months, with sustained results. As more research becomes available, it will be exciting to see what the long-term results show.”

    NEXT:  An emphasis on scar prevention

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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