High-Tech Acne Treatments Light the Way for Future Long-Term Solution to Common Skin Condition

Innovative therapies show promise using light, heat to shrink oil glands

WASHINGTON (Feb. 2, 2007) - While a number of long-standing systemic medications have proven beneficial in treating patients with mild, moderate and severe acne, concerns have been raised regarding the potential long-term effects of these types of oral medications. Recently, technological advances in laser, light-based and heat therapies have influenced the way some dermatologists treat acne - shifting from exclusively oral and topical therapies to new procedural treatments that studies suggest may offer a better long-term solution for acne patients.

Speaking today at the 65th Annual Meeting of the American Academy of Dermatology, dermatologist Amy F. Taub, MD, FAAD, clinical instructor of dermatology at Northwestern University Medical School in Chicago, reviewed research demonstrating the safety and efficacy of the leading procedural treatments for acne, as well as their current limitations.

"The introduction of lasers, light sources and heat-based technologies mark the first new therapies to treat acne in more than 20 years," said Dr. Taub. "Unlike their systemic counterparts that offer a short-term solution to treating acne by killing acne-causing bacteria, these devices work differently by altering the structure of the oil glands. Studies show that these newer treatments effectively shrink oil glands and, in some cases, even improve acne scarring and overall skin texture. However, the key to increasing their use among dermatologists is fine tuning the existing treatment protocols to ensure success for the majority of acne patients."

Photodynamic Therapy

Photodynamic therapy, or PDT, is a non-invasive treatment which uses laser or light energy to activate a photosensitizer or photosensitizing agent - applied topically to the skin prior to treatment - known as aminolevulinic acid (ALA). In her study comparing the efficacy of three different light sources - blue light, pulsed light plus radiofrequency, and intense pulsed light - used in PDT to activate the ALA, Dr. Taub reported that the majority of the 19 study patients showed improvement in their acne following three treatments administered two weeks apart with each of the variable light sources. However, the patients randomly selected for treatment with the intense pulsed light laser demonstrated the most improvement - approximately 70 percent of their acne cleared three months following treatment.

"Several studies show dramatic improvement in moderate to severe acne with photodynamic therapy, and dermatologists are continually refining treatments and closing in on best practices that can be applied to all patients," said Dr. Taub. "It´s important to consult a dermatologist for the treatment of acne, as PDT and other procedural treatments do not work for some patients. Since these treatments are considerably more costly than traditional acne medications, we want to ensure that patients have the best chance for success with the fewest number of treatments."

Light Therapy

Light-based therapies work by targeting and destroying the bacteria that cause acne and reducing inflammation. Dr. Taub noted that published reports of randomized controlled trials using light therapies show encouraging results in improving acne, with the greatest improvement observed in patients treated two times per week for four weeks with a combination of blue and red light treatments.

"While some studies show an impressive 60 percent to 80 percent improvement in acne lesions with light therapies, in practical use, I have not seen the results quite measure up to their promise," said Dr. Taub. "I think questions remain concerning the long-term success of these treatments and the cost to the patient for frequent maintenance procedures."
1450 nm Diode Laser

The 1450 nm diode laser targets acne by heating the deep layer of the skin, where the oil glands are located, while a specially equipped cooling device protects the top layer of skin from injury. Dr. Taub explained that studies demonstrate outstanding results with this laser therapy in treating inflammatory acne, with one long-term study reporting a 90 percent improvement at two years post-treatment. One potential drawback is that treatments can be painful, with some researchers cautioning that they may be too painful for teenagers.

"Although my clinical experience with the 1450 nm diode laser is limited in treating patients with acne, I think it holds significant potential as an effective long-term solution for acne patients."
Radiofrequency (RF) Energy

A relative newcomer in the acne playing field, radiofrequency (RF) energy has been gaining attention for its effectiveness in shrinking oil glands and improving acne scarring and overall skin texture. This novel approach works by delivering intense heat deep into the skin to reduce the size of the oil glands associated with acne. A built-in cooling device protects the top layer of the skin during the procedure, keeping it intact.

Two non-ablative (or non-wounding) RF devices are being studied for treating acne - one using monopolar RF energy and the other using bipolar RF energy in addition to blue light. One study using one to three treatments of monopolar RF energy on 22 patients with moderate to severe acne reported a more than 75 percent overall improvement in acne lesions at the end of the study. Another study using a combination device delivering pulsed blue light and RF energies found a 47 percent average reduction in lesions in 32 patients with acne after eight treatments administered twice weekly for four weeks.

"The results of these early studies suggest that radiofrequency energy can significantly alter the oil glands and reduce the number of acne lesions in patients with moderate to severe acne," said Dr. Taub. "But before it can be considered a viable therapy, I think more studies need to be done to confirm these early results."

Dr. Taub expects that ongoing research will improve these procedural acne therapies, which should open the door for more dermatologists to offer these procedures to their patients in the next few years.

"What´s nice about these new treatments is that they are working well for patients of all ages and ethnicities," added Dr. Taub. "For teenagers, compliance is often an issue when prescribing systemic or topical medications - because they have to do something to ensure the success of the treatment. But with procedural therapies, once the treatment is administered in the dermatologist´s office, they don´t have to think about it afterward. It really simplifies the treatment regimen considerably, and that´s something that all patients can appreciate."

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.