PEER-REVIEW | DERMATOLOGY |
Ghada Farouk Abd El-Kaream Mohammed discusses the energy based treatment options available for acne and acne scars, including ultraviolet, intense pulse light, and photodynamic therapy
AACNE ANDCNE SCARS TREATMENT OPTIONS FOR ENERGY-BASED
ABSTRACT Background: Over the years, there has been no 100% effective treatment for acne vulgaris (AV) and post acne scars. However, recently, new modalities for non- compliant, non-responder patients and those suffering from acne scarring have been developed. These include energy based treatments, such as the 585 and 595 nm pulsed dye lasers, the 1450 nm diode laser, the potassium
mechanisms (Figure 1)1-2
in which the collagen in the skin is damaged from inflammation; resulting in permanent texture changes and topographic depressions (Figure 2)3
A . 24 . Though acne scarring is permanent, it can be treated.
No treatment has been 100% effective, but the best result is improvement. Treatment of scarring may require many different modalities of treatments, depending on the kind of scarring present. It is important that all the acne is inactive before treating the scarring4
Laser and light-based therapies for acne vulgaris Lasers/light-based devices may offer an alternative and adjuvant to conventional acne treatments in non-compliant, non-responder patients or in antibiotic resistance patients. Over the past decades, many types of light devices were introduced to treat and improve acne symptoms5
. July/August 2014 |
prime-journal.com
GHADA FAROUK ABD EL-KAREAM MOHAMMED, MD, Faculty of Medicine, Suez Canal University, Department of Dermatology and Venereology, Ismailia 41511, Egypt. Tel:+01112518631; Fax:+20643208543;
email: Dr_Ghada77@hotmail. com
titanyl phosphate laser, intense pulsed light sources, radiofrequency devices, and photodynamic therapy using 5-aminolevulinic acid and indocyanine green for AV or ablative and non ablative laser skin resurfacing for post acne scars. Methods: The aim of writing this article is to review information about pathogenesis of acne and acne scarring, as well as energy based potential modalities.
CNE VULGARIS (AV) IS A SKIN DISORDER of the pilosebaceous apparatus, which refers to hair follicles and their attached glands. Pathogenesis of AV is multifactorial, including
hormonal,
microbiological, and immunological . Post-acne scarring is a process
Conclusion: Energy-based treatment options for acne and acne scars can be an alternative to medical modalities for non responders; those who have severe acne and are concerned about oral medications owing to potential adverse effects, or be used in combination with a topical medication. The goal of any modality in acne scars is not perfection; rather it is making scars less visible.
Ultraviolet A/B Improvement of acne was reported in 70% of patients after sunlight exposure6
. Ultraviolet-A (UVA) and UVB
therapy was found to have some beneficial effect, but it is potentially carcinogenic.7
Blue light and red light Porphyrins are involved in processes of prokaryotic and eukaryotic cells, such as photosynthesis, biological oxidation, respiration, rearrangement of the carbon backbone, and sulphate reduction. P. acnes produce porphyrins, most notably on the nose and the forehead. The 407 to 420 nm band has the strongest porphyrin photo-excitation coefficient and blue light is the highest photo-activator of endogenous porphyrin component of P. acnes. However, blue light has poor skin penetration8
.
Red light, in contrast, has deeper penetration, up to the sebaceous glands, and also has anti-inflammatory properties9
. Seventeen
patients received eight sessions with the Silk’n Blue
(Home
KEYWORDS Acne vulgaris; acne scars; energy- based treatment; Laser modalities
Skinovations Inc., Richmond Hill, ON) device over a
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