The advancement in science brings with it new modalities of treatment for medicine. One of it is laser technology. It has found application in various fields of medicine, such as surgery and dermatology. Laser is being used extensively in various surgical operations, liposuction, varicose veins ablation and aesthetic treatments.
Light therapy is the latest addition in the arsenal of treatment for acne. Laser, which produces a high-energy beam of light of precise wavelength, is the most common light source in acne therapy. It selectively damages Propionibacterium acnes, the bacteria responsible in the formation of acne. It acts on the porphyrins, the pigment being produced by the said bacteria, which in turn causes sensitization and its subsequent destruction.
The popularity of laser and other light-sources is prompting several studies regarding its application in acne treatment. Under investigation are broad-spectrum continuous wave visible-light sources (blue light and blue-red light), specific narrow-band light, intense pulsed light (IPL), pulsed dye lasers (PDL), potassium titanyl phosphate lasers, infrared diode lasers and photodynamic therapy (PDT) with or without photosensitizing agents (aminolevulinic acid or methyl-aminolevullinic acid).
To date substantial evidence in support of light therapy as mode of treatment in acne is lacking. Outcomes of some trials are contradictory. In a study by Haedersdal , red-light-activated methyl-aminolevulinic acid-PDT and aminolevulinic acid-PDT were efficacious in 50-60% of patients up to 20 weeks after one to three weeks of treatment. In another study by Wiegell et al, effect lasted up to 1 year after treatment. Moreover, IPL-assisted PDT seems to be more effective than IPL alone.
Some studies compared the efficacy of broad-spectrum light sources versus existing topical treatments. Blue light twice-weekly for 4 weeks was reported to be superior to topical clindamycin. Mixed blue-red light daily for 12 weeks reduced more acne lesions than BPO.
Kumaresan and Snirivas evaluated the efficacy of single against burst-pulse mode in IPL therapy. They have concluded that IPL as single therapy was beneficial in the treatment of acne. Results also showed that burst-pulse mode was better than the single pulse mode in clearing acne.
Despite the studies, laser treatment is not considered the first choice in the treatment of acne today. It only serves as an adjunct to medical therapy. Significant improvement is observed when laser is utilized in combination with topical and systemic medications.
References:
- Treating acne vulgaris: systemic, local and combination therapy: Adjunctive therapies. Medscape
- Kumaresan M, Srinivas CR. Efficacy of IPL in treatment of acne vulgaris : Comparison of single- and burst-pulse mode in IPL. Indian J Dermatol [serial online] 2010 [cited 2011 Feb 27];55:370-2.
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