PEER-REVIEW | ACNE TREATMENT |
with the ClearLight system for mild-to-moderate inflammatory acne vulgaris 10
. The patients in this clinical
trial also received twice weekly blue light therapy for 4 weeks and were then followed 1 and 3 months following their final ClearLight treatment. A 43% reduction in inflammatory acne vulgaris lesions was noted. Adverse events, similar to the previous work, were not observed in this study and results were noted to further improve in many during the follow-up period. When comparing the Gold and Shalita clinical trials, Gold’s data included both ‘responders’ and ‘non-responders’, something that was not done in the Shalita clinical trial. It has been noted that, upwards of 20% of individuals treated with the blue light system are non-responders. Adding them into the total percentage of clearance would certainly have brought the two clinical trials closer together in numbers and percentage clearance. The ClearLight high-intensity blue light system is not
currently commercially available, and its replacement device, known as the iClear, is also no longer available. Many still use these light sources in their everyday clinical practice and have made significant differences for many suffering from inflammatory acne vulgaris, which has either not been adequately controlled with medical therapy or the patient is looking for a faster path to acne lesion clearance.
Clinical trials A number of other clinical trials are worth reviewing for completeness in the blue light field, and other blue light sources are also worthy of mention. Papageorgiou et al 11
used a
light system that was mixed blue and red light (415 nm and 660 nm) in one patient group, a blue light treatment group, and a group who received white light therapy. They were able to demonstrate that the combination of blue and red light decreased inflammatory acne lesions by 76% compared with 58% clearance in the blue light treatment group, and both were more effective than
Blue light therapy for
inflammatory acne vulgaris is a true and tried method for improving the outcomes of those suffering from acne vulgaris.
24 ❚ May/June 2013 |
prime-journal.com Key points
■ Acne is a very common skin concern seen by dermatologist
■ Blue light for acne vulgaris works well and has been demonstrated to be safe and effective in clinical trials
■ Blue light works in the office setting
■ Home blue light sources also seem to have a prominent role
treatment with white light alone, which showed only a 25% clearance. Meffert et al used a high-energy broad- spectrum blue light source that combined both blue light and UVA light, and noted a marked improvement in patients with pustular inflammatory acne vulgaris after a total of 10 treatments 12
. The second blue light source available in the US for
the treatment of inflammatory acne vulgaris, and still currently available today, is known commercially as the BLU-U (Dusa Pharmaceuticals, MA, USA). This is a low-intensity blue light source that has also shown its safety and efficacy in treating individuals with inflammatory acne vulgaris. Goldman et al 13
first
reported on its effectiveness in acne vulgaris in a series of 12 patients. In their study, they were able to document a 40% reduction in papular acne lesions, a 65% reduction in pustular acne lesions, and a 62% reduction in comedonal acne lesions. This was one of the first significant publications that noted not only an improvement in the inflammatory component of acne vulgaris with blue light, but also an improvement in the non-inflammatory acne lesions. These improvements were seen from as early as 2 weeks of therapy, similar to that reported with the high-intensity blue light systems. Gold et al 14
followed-up on the previous report and
looked at a comparison clinical trial of topical 1% clindamycin solution versus the blue light therapy in patients with mild-to-moderate inflammatory acne vulgaris. They demonstrated that blue light therapy was more effective than topical clindamycin in
reducing
inflammatory acne lesions. A recent clinical evaluation
looking at blue light therapy with the BLU-U and its effect on acne — with or without a topical p h o t o sensi tiser — demonstrated that blue light
alone was
statistically significant in improving
inflammatory
severe acne
vulgaris, leading to a
supplemental FDA filing that was granted for this claim 15
. A clinical example for using the BLU-U is shown
in Figure 2. A third blue light source developed for the treatment of inflammatory acne vulgaris is called the OmniLux Blue™ PhotoTherapeutics System (OmniLux, Manchester, UK). Clinical studies have also shown its effectiveness in treating inflammatory acne
vulgaris. It uses LED blue light arrays with a peak irradiance of 410–420 nm and has shown acne lesion reductions of up to 74% in reported clinical trials 16
.
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