Feature: Newer Treatments Offer Advantages

ermatologists are finding that lasers, light-based devices, radiofrequency and some of the other newer technological devices can be quite effective in treating acne.

Treating acne with one of these devices ? sometimes in combination with a topical medication ? has the potential to have a sea change effect in the way patients are now treated for this condition, some dermatologists believe.
The downside, however, is that many of these devices are still experimental when it comes to treating acne and no one is sure how many treatments patients will need and how often re-treatment will be necessary.
However, devices and treatment techniques are rapidly changing and improving, so many promising therapies continue to emerge.

What the FDA has Cleared or Approved for Treating Acne
In August 2002, the ClearLight (Lumenis) was the first device cleared to treat acne. The FDA cleared this device, which uses high-intensity, narrow-band light, for treatment of moderate inflammatory acne vulgaris.

Next came approval for the Smoothbeam laser (Candela) in October of last year. The Smoothbeam was the first laser to receive 510K clearance to treat acne. This 1450 nm diode laser is indicated for treating acne lesions on the back. In addition, Smoothbeam also received FDA clearance this past January to use the laser for treating atrophic acne scars.

Then, this past May, the CoolTouch 1320 nm laser system (New Star Lasers) received clearance from the FDA for treating back acne and acne scars.
The latest laser to receive clearance from the FDA is the NLite-V laser system (Photonics). Cleared in late June, this 585 nm pulsed dye laser is the first laser to be cleared by the FDA for treatment of inflammatory acne vulgaris on the face.

Lastly, in June a new type of treatment utilizing light emitting diodes received marketing clearance from the FDA. The OmniLux Blue (Alderm LLC) is specifically indicated to treat moderate inflammatory acne vulgaris.

This article will further discuss and highlight cases from each of these approved therapies as well as some others that are seeking FDA approval or are still experimental but hold promise.

ClearLight
As mentioned above, the ClearLight (Lumenis) was the first device cleared to treat acne. The FDA cleared this device, which uses high-intensity, narrow-band light, for treatment of moderate inflammatory acne vulgaris. The device works by targeting the bacterium Propionibacterium acnes by using high-intensity light to excite P. acnes porphyrins and in turn destroy them without damaging surrounding tissue.

According to Lumenis, a multi-center clinical study of 120 patients at six centers was conducted using a 400-watt 407 nm to 420 nm halide lamp to deliver high-intensity light to areas of acne-affected areas of the skin.

Patients underwent eight bi-weekly treatments and 80% of patients who had mild-to-moderate papulo-pustular acne experienced significant improvement in both inflammatory and non-inflammatory lesions. Inflammatory lesion counts decreased by a mean of more than 60% after treatment ended and by nearly 70% 2 weeks following the last treatment.

Smoothbeam
The first laser to receive 510K clearance to treat acne, the Smoothbeam (Candela) is a 1450 nm diode laser indicated for treating acne lesions on the back. The laser also received FDA clearance for treating atrophic acne scars.
A multi-year study, which researched the Smoothbeam?s affect on back acne, was conducted at the Naval Medical center in San Diego.

This study found that lesion counts were significantly reduced after one treatment and that patients had a reduction in lesions of more than 98% after four, 20-minute laser sessions.

In addition, patients experienced a 6-month remission of acne lesions following treatment.

CoolTouch
The CoolTouch 1320 nm laser system (New Star Lasers) is indicated for treatment of back acne and acne scars.

The laser targets the sebaceous glands without damaging the skin?s surface. According to New Star Lasers, the CoolTouch is also experimentally being used to treat acne scarring.

A recent study by Jeffrey Dover, M.D., associate clinical professor of dermatology at Yale University School of Medicine, found positive results with the CoolTouch for treating acne scars.

In his study, 60 patients with acne scarring underwent a series of six treatments at monthly intervals.

Patients reported that the treatment was nearly pain-free, and all but two patients said they were highly satisfied with their outcomes. None of the patients in the study reported any adverse effects.

NLite-V
This 585 nm pulsed dye laser is the first laser to be cleared by the FDA for treatment of inflammatory acne vulgaris on the face.

The NLite-V (Photonics) laser emits a wavelength of yellow light that heats small blood vessels, encouraging healing and stimulating collagen production.

In clinical trials conducted at Hammersmith Hospital in London, 41 patients underwent treatment with the NLite-V for their acne.

According to Photonics, patients experienced a 50% improvement in acne lesion counts after one 5-minute treatment session.

Results typically lasted for up to 3 months.

5-amino levulinic acid (Levulan) and photodynamic therapy
An experimental treatment, ALA/PDT is successfully being tapped as a treatment for moderate to severe acne.

Physicians are applying ALA for as little as 15 minutes and then using either an intense pulsed light device or pulsed dye laser to activate the areas where ALA was applied. The results have significant promise for treating severe cystic acne, as well as a whole host of other conditions, including actinic damage, rosacea (see photos above) and for certain types of skin cancers.

In the two photos at the top of the page, a patient with severe acne benefited from this combination treatment.

The patient case depicted in the patient case in the bottom two photos underwent treatment for rosacea.

Date: 2016-06-13; view: 399