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Single Pulsed-Dyed Laser Treatment Improved Inflammatory Acne

Pulsed-dye laser therapy resulted in substantial improvement in acne severity in a small group of patients with inflammatory acne vulgaris, researchers report.

Between November 2001 and April 2001, E. D. Seaton, MRCP, Imperial College, London, United Kingdom, and colleagues randomised 41 patients, (aged from 20 to 36 years, acne duration 5 to 26 years), to either a single pulsed-dye laser (PDL) treatment (n=31) or a sham treatment (n=10). Laser treatments were delivered at 2 fluences, 1.5 J/cm squared and 3.0 J/cm squared, on opposite sides of the midline to allow subgroup analysis of the effect of dosage.

The investigators assessed acne severity at baseline and 12 weeks after treatment using the Leeds revised grading system. They also assessed adverse events and any changes in lesion counts in the study group. Patients did not use acne treatments during the study period and were free of oral antibiotics for 4 weeks, cyproterone acetate-containing contraceptives for 12 weeks, oral isotretinoin for 52 weeks, and topical treatment for 2 weeks prior to study entry.

Acne severity reduced from 3.8 at baseline to 1.9 after 12 weeks in the PDL group compared with 3.6 to 3.5 in the control group. Total lesion counts fell by 53% compared with 9% in the PDL and control groups, respectively while inflammatory lesion counts fell by 49% in the PDL group compared with 10% in controls. The investigators found no significant differences in the change in lesion counts at different fluences in the laser group.

Four patients in the PDL group withdrew (3 patients moved, 1 required systemic antibiotic treatment for worsening truncal acne) while 1 control patient withdrew due to dissatisfaction with clinical response. Adverse events included pain, transient purpura, pruritus, dry skin or lips, and watery eye in 6 of the PDL treated patients compared with 2 control patients who reported pruritus and dry skin. The 2 laser patients who reported moderate transient discomfort during irradiation at a high fluence both had deeply pigmented Afro-Caribbean skin.

"Our results suggest that this laser treatment could be developed as a new therapeutic approach that would allow simultaneous treatment of both active acne and associated scarring," the authors conclude, adding that "laser treatment should be further explored as an adjuvant or alternative to daily conventional pharmacological treatments."

Lancet 2003;362:1347-52.

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