PEER-REVIEW | ACNE TREATMENT |
Coproporphyrin III, which have been shown to have
absorption spectra in the near UV range of light. This absorption spectrum is in the blue light range, with peak absorption seen at 415 nm, as shown in Figure 1. The PDT reaction that occurs works through the photoactivation of the P. acnes porphyrins with exposure to the appropriate light source. This causes the formation of singlet oxygen within the bacteria and selective destruction of the P. acnes bacteria, with destruction of the acne lesion itself, leaving the surrounding tissues and associated structures alone. A variety of laser and light sources have been used to
treat acne vulgaris via P. acnes destruction. In the past these have included halogen, xenon, and tungsten light sources. More recent investigations have predominantly focused on blue and red light. With the addition of a topical photosensitiser applied to the skin prior to light therapy, blue and red light, vascular lasers, and the intense pulsed light (IPL) sources all seem to work even better than the laser or light source alone. Once again, the reader should review the medical literature as to how PDT with photosensitisers can be used to treat acne vulgaris.
Treatment of acne vulgaris with blue light In-office blue light sources Blue light therapy for the treatment of inflammatory acne vulgaris has been reviewed extensively in the medical literature 2,7
. There have been three major blue light systems available for the treatment of inflammatory 22 ❚ May/June 2013 |
prime-journal.com
The first
FDA-approved blue light was a high-intensity, narrow-band
source with an absorption peak at 417 nm.
acne and these systems, along with the literature supporting them, will be reviewed. The reader should be aware that other blue light systems have since come and gone, and although they may be comparable to what is described below, each system is unique and should be studied on its own merits for the treatment of inflammatory acne vulgaris. The first FDA-approved blue light was a high-intensity,
narrow-band source with an absorption peak at 417 nm. Commercially, this machine was known as the ClearLight™ Acne PhotoClearing System (CureLight, Yokneam, Israel). Its FDA clearance was for the treatment of mild-to-moderate inflammatory acne vulgaris and its use in the medical field, as well as its safety and efficacy, is well documented in the medical literature. The recommended use for this device was to treat patients twice per week for up to 4 weeks for appropriate inflammatory acne vulgaris lesion control. Kawada et al 8
reported that by using a blue light source
for inflammatory acne vulgaris twice weekly for 5 weeks, inflammatory acne lesions were reduced, on average, by 64% in the 30 patients they treated. Shalita et al 9
, in a
multicentre clinical trial for the ClearLight system, reported an 80% significant improvement in treating 35 individuals with mild-to-moderate inflammatory acne vulgaris twice weekly for 4 weeks. Of note in this clinical trial was, following therapy, further acne vulgaris improvement in many of the patients entered into the study. Adverse events were not seen and all skin types were successfully treated in the trial. Gold et al then reported on 40 individuals treated
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