Efficacy of Fire Needling Combined with 420 nm Intense Pulsed Light in the Treatment of Acne Vulgaris

ObjectiveFire needle therapy has shown promise in treating acne vulgaris (AV), improving facial lesions and patient quality of life. This study aims to investigate the effects of combining fire needle therapy with doxycycline hydrochloride tablets (DHT) on the Global Acne Grading System (GAGS), the échelle d’évaluation clinique des cicatrices d’acné (ECCA) grading scale, the Dermatology Life Quality Index (DLQI), and the serum levels of inflammatory factors interleukin-17 (IL-17), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in patients with moderate-to-severe AV.Methods70 patients with moderate-to-severe AV were randomly assigned to the control group (n=35) to receive oral DHT treatment once a day and the intervention group (n=35) to be treated with fire needle therapy on the basis of DHT once a week. The total treatment duration for both groups was 8 weeks. Therapeutic efficacy was evaluated at the 4-week and 8-week marks. The primary outcome measure evaluated was the GAGS score. The secondary outcome measures included the ECCA score, the DLQI score, and the serum levels of the inflammatory factors IL-17, TNF-α, and IL-6.ResultsCompared to baseline data, both groups exhibited marked improvements in skin lesions at both the 4-week and 8-week treatment marks. Significant reductions were observed in the GAGS, ECCA, and DLQI scores, as well as in the serum levels of the inflammatory factors IL-17, TNF-α, and IL-6. Notably, the intervention group demonstrated significantly greater improvements than the control group at both the 4-week and 8-week assessments.ConclusionAn 8-week regimen of fire needle therapy combined with DHT improved lesion severity, scar symptoms, quality of life, and serum inflammatory cytokine levels in patients with moderate-to-severe AV compared to DHT monotherapy.

Objective: To evaluate efficacy and safety of IPL in the treatment of Acne vulgaris. Study Design: Quasi-experimental study. Setting: CMH, Peshawar. Period: 15th January 23 to 15th May 23. Material & Methods: 35 participants having acne vulgaris with age range from 18-35 years were selected. Participants who had used any form of topical, oral, or alternative treatments for acne, including retinoids, within the six months preceding the commencement of the study, history of systemic steroid intake, photosensitivity and herpes simplex, were excluded. Global Acne Grading System (GAGS) score was used to ascertain the severity of acne vulgaris. Four sessions of weekly Intense Pulsed Light (IPL) sessions, utilizing filters of 420nm, 510nm and 560nm for participants having skin type III, IV and V respectively were employed. GAGS score was calculated one week after the last session. Side effects were recorded, degree of improvement and patient reported outcome was noted using a four-point scale limited =<25%, marked =25%-50%, promising 50-75% and profound =>75%. Results: Mean age of participants was 21.63 ± 4.63 years, with a mean duration of acne was 4.26 ± 2.20 years. The mean baseline GAGS score I decreased from 22.00±5.26 to 11.58±4.80, as observed one week following the last IPL session. The calculated p-value was statistically significant (<0.000). 54% of patients encountered no adverse reactions. Conclusion: Intense Pulsed Light (IPL) emerges as a secure and efficacious treatment choice, particularly in the initial stages, to enhance the response to therapy.

Aim: Acne vulgaris is one of the most common diseases that affects quality of life. While the Dermatology Life Quality Index (DLQI) is the most frequently used life quality index for dermatologic disorders, the Cardiff Acne Disability Index (CADI) is an acne-spesific quality of life scale. The aim of this study was to determine which scale should be more appropriate and practical to evaluate the quality of life in acne patients and to compare the differences between two scales.Methods: Acne scores of 273 patients who were admitted to the dermatology outpatient clinic between December 2015 and November 2016 were determined by the Global Acne Grading System (GAGS) (range 0 to 44). The DLQI (range 0 to 30) and CADI scores (range 0 to 20) were calculated to evaluate the effect of patients' quality of life.Results: The mean GAGS score of the patients was 20.3, and the mean of CADI score was 6.1, while the mean of DLQI was 6.0. There was a significant positive correlation between total GAGS score and CADI and DLQI (r=0.639, p<0.001). When the relationship between the distribution of acne lesions and quality of life scales was evaluated; CADI score was significantly higher in the forehead localization group than in the non-forehead localization group (p=0.012), and the CADI and DLQI scores were higher in the upper back group than the group without back localization (p=0.001and p= 0.017 respectively). Conclusion: In our study, it was observed that the DLQI and CADI scales were not superior to each other in evaluating the quality of life in patients with acne. Besides, we think that the effect of quality of life on facial acne cases can be determined more clearly with CADI scale.

To sum up clinical researches and the rule of acupoint selection on the treatment of psoriasis by acupuncture and moxibustion in the past 20 years, so as to provide new ideas and reference for improving the clinical effect of acupuncture for psoriasis. Research papers, published from January 1, 2002 to December 31, 2022 in both Chinese and English, were searched from databases of China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WanFang), and Chinese Science and Technology Journal (CSTJ), PubMed, Embase and Web of Science by using key words of psoriasis, psoriases, psoriasis vulgaris, acupuncture, needle, acupoint and moxibustion. Then, Microsoft Excel 2021 was used for data entry, extraction and sorting of the included literature, data extraction mainly includes diagnostic criteria, treatment methods, treatment frequency, total course of treatment, selection of acupoints, efficacy evaluation and outcomes. SPSS Modeler 18.1 software was used to make analysis on the association rules of acupoints. A total of 26 papers were included, and the diagnostic criteria of clinical studies on acupuncture treatment of psoriasis are constantly updated. Of the 26 clinical studies, 23 had both treatment group and control group, 21 were randomized controlled trials. The main methods for treatment of psoriasis included fire needle, acupuncture, electroacupuncture, acupuncture combined with moxibustion or fire needle, fire needle plus western medicines, etc. with the acupuncture combined with moxibustion, and fire needle combined with western medicines being most frequently used. The observation index and clinical efficacy evaluation were effective rate, psoriasis area and severity index, dermatology life quality index, Traditional Chinese Medicine syndrome score, etc., with the effective rate being about 40% to 100%. Comparison of clinical efficacy of acupuncture in treating psoriasis showed that the simple fire needle, simple acupuncture, acupuncture combined with moxibustion, fire needle or acupuncture combined with western medicines were superior to simple western medicines, etc. In regard to acupoint selection, a total of 35 acupoints were found in the 26 studies included, among which the top 5 frequently used were Ashi points (skin lesion region), Geshu (BL17), Feishu (BL13), Ganshu (BL18) and Quchi (LI11), and there were strong association rules among BL17, BL13, BL18 and Shenshu (BL23). Acupuncture is safe and effective in the treatment of psoriasis, and acupuncture combined with moxibustion and fire acupuncture needle combined with western medicines are recommended as the main intervention method, with Ashi-point, BL13, BL17, BL18 and BL23 as the main acupoints.

Biofeedback therapy (BFT) is the first-line treatment for anismus, a constipation-type defecation disorder characterized by pelvic floor muscle dyscoordination during defecation; however, BFT has limited efficacy and is associated with high recurrence. Acupoint thread embedding (ATE) is a traditional Chinese medicine therapy offering sustained stimulation. We aimed to evaluate the short-term efficacy of ATE, BFT, and their combination in treating anismus, and explore the prognostic value of the traditional Chinese medicine syndrome (TCMS) score. This retrospective cohort study included 150 patients with anismus treated at Guilin Hospital of Integrated Traditional Chinese and Western Medicine between January 2019 and December 2024. Patients were divided into ATE (n = 45), BFT (n = 45), and ATE + BFT (n = 60) groups. The primary outcomes were the Cleveland Clinic constipation (CCC) and TCMS scores at 3-month posttreatment. Secondary outcomes included the patient assessment of constipation quality of life (PAC-QOL) score, total effectiveness rate, and safety, evaluated 3-month posttreatment and at the 3- and 6-month follow-ups. Multivariable linear regression was used to identify prognostic factors. Three-month posttreatment, the ATE + BFT group reported significantly lower CCC, TCMS, and PAC-QOL scores compared with the BFT group and significantly lower PAC-QOL scores compared with the ATE group (P < .01). At the 3-month follow-up, the CCC, TCMS, and PAC-QOL scores in the ATE + BFT group were significantly lower than those in the BFT group (P < .05); the TCMS and PAC-QOL scores were significantly lower than those in the ATE group (P < .01). At the 6-month follow-up, all scores had returned to the baseline levels. The total effectiveness rate was the highest in the ATE + BFT group (85.00%), significantly surpassing that in the BFT group (68.89%, P = .03). A ≥5-point reduction in the TCMS score at 3-month posttreatment independently predicted a favorable outcome (P < .01). This study demonstrated that the combination of ATE and BFT is significantly superior to either monotherapy alone in the short-term management of anismus, evidenced by greater reductions in CCC, TCMS, and PAC-QOL scores posttreatment. Furthermore, a ≥5-point reduction in the TCMS score was identified as an independent predictor of a favorable prognosis.

Acne vulgaris is highly prevalent among young adults and is associated with psychosocial distress, yet the relationship between clinical severity and quality of life (QoL) in this population remains incompletely understood. To evaluate changes in acne severity and dermatology-related QoL among young adults aged 18 to 22 years and to explore whether improvement in clinical grading corresponds with changes in patient-reported outcomes. A pre-post observational study was conducted with 16 participants. At baseline (Week 0) and after 8 weeks of treatment, acne severity was assessed using the Global Acne Grading System (GAGS), and QoL was measured with the Dermatology Life Quality Index (DLQI). Descriptive statistics summarized demographic characteristics. Paired t-tests compared pre- and post-treatment scores, and correlation analysis examined the relationship between changes in GAGS and DLQI. Both acne severity and dermatology-related QoL significantly improved over the 8-week treatment period; however, changes in GAGS scores were not significantly correlated with changes in DLQI scores, indicating that perceived QoL improvement did not directly mirror clinical acne improvement. Among young adults with acne, meaningful improvements in both clinical severity and QoL were observed following routine treatment. The lack of correlation between these changes suggests that QoL might be influenced by factors beyond visible lesion reduction, underscoring the importance of incorporating patient-reported outcomes into acne management.

This meta-analysis investigates the efficacy of oral traditional Chinese medicine (TCM) combined with fire needling in the treatment of psoriasis vulgaris. Fifteen randomized controlled trials (RCTs) were included, evaluating key outcomes such as overall response rate (ORR), Psoriasis Area and Severity Index (PASI) scores, TCM syndrome scores, and pruritus severity scores. The results indicated that the combination of oral TCM and fire needling significantly improved the ORR (odds ratio (OR) 3.49, 95% confidence interval (CI) [2.48, 4.93], p < 0.0001) and significantly reduced PASI scores (mean difference (MD) -5.31, 95% CI [-7.37, -3.25], p < 0.0001). In addition, it improved TCM syndrome scores (MD -3.43, 95% CI [-5.41, -1.46], p < 0.0001) and reduced pruritus severity scores (MD -0.77, 95% CI [-0.90, -0.65], p < 0.0001). Sensitivity analysis confirmed the robustness of the findings, and no significant publication bias was detected. The GRADE assessment indicated that evidence quality for ORR and PASI scores was moderate, while the quality for TCM syndrome and pruritus severity scores was low. Overall, this meta-analysis demonstrates that combining oral TCM with fire needling is an effective and reliable treatment for psoriasis vulgaris, with potential for broader clinical application. Future studies should focus on enhancing the rigor of RCTs and standardizing treatment protocols to further validate these findings.

A combination of standard biomedical treatment and traditional Chinese medicine (TCM) has been suggested as a therapeutic approach for rosacea that may significantly lower the recurrence rate and clinical symptom scores. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of this combination treatment on clinical symptom and TCM syndrome scores, as well as on the scores of the Dermatology Life Quality Index (DLQI), erythema index (EI), and interleukin 37 (IL-37) levels in patients with rosacea. The PROSPERO registration number for the study is CRD42023472737. We systematically searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure Wanfang Database, China Biomedical Medicine database (CBM), and the VIP information resource integration service platform (cqvip) databases for RCTs (published from the beginning to September 2023, regardless of the language used) that compared the traditional Chinese medicine and standard biomedical treatment combination treatment to conventional anti-rosacea treatments. Our primary outcomes comprised the clinical symptom and TCM syndrome scores, and the scores of Dermatology Life Quality Index, erythema index, and IL-37 levels. We used a random-effects model to evaluate the pooled data. We identified 260 studies. Of these, 13 eligible studies were employed for analysis (N = 1,348 participants). Compared with other anti-rosacea treatments, the TCM and standard biomedical treatment combination treatment yielded an improved mean reduction in the clinical symptom score -2.24% [95% CI (-3.02 to -1.46), p < 0.00001], TCM syndrome score -4.42 [95% CI (-5.33 to -3.50), p < 0.00001], and the score of DLQI of -2.55 [95% CI (-3.73 to -1.36), p < 0.00001], EI of -151.97 [95% CI (-276.59 to -27.36), p < 0.00001], and IL-37 level -4.23 [95% CI (-4.95 to -3.51), p = 0.854], as well as in the overall effective rate risk ratio (RR) = 1.25 [95%CI (1.18, 1.32), p = 0.994] and the recurrence rate = 0.27 [95%CI (0.15, 0.46), p = 0.297]. The TCM and standard biomedical treatment combination treatment can provide a better outcome, including a reduction in the TCM syndrome and clinical symptom scores, and in the scores of DLQI, EI, and IL-37. Hence, this combination is a viable and more effective therapeutic approach for rosacea. However, these results should be considered cautiously because of uncertain evidence and the low quality of the study reports considered in this meta-analysis. website, identifier CRD42023472737.

Background and Aim: Adults with acne have been found to have a higher incidence of anxiety, depression, and suicidal ideation as compared to the general population. To the best of our knowledge, there is a dearth of studies assessing the quality of life among males with acne. This study explores the clinical patterns of acne with special emphasis on quality of life among adult males with acne vulgaris. Materials and Methods: All male patients visiting the dermatology outpatient department with acne were included after obtaining informed consent. Demographic data were recorded. Clinical assessment was done based on Global Acne Grading System (GAGS) and qualitative global acne scar grading. Assessment of quality of life was done using Dermatological Life Quality Index (DLQI) and Cardiff Acne Disability Index (CADI) in each patient. Results: Among 322 patients recruited in this study, 293 patients (91.3%) had mild acne, followed by 29 patients (8.7%) who had moderate acne as per GAGS score. The mean DLQI and CADI scores were 5.07 ± 5.0 and 4.0 ± 2.8, respectively. GAGS was found to have a significant correlation with CADI but not with DLQI. Conclusion: CADI score is an important tool which can enable dermatologists to assess the psychosocial burden of the disease in men with acne. This can enable the development of a comprehensive management plan which will enable better treatment and better quality of life in men with acne.

Acne scars are common in patients with moderate to severe acne. Isotretinoin is the first-line treatment for those patients, but whether oral isotretinoin can improve acne scar is not clear. Picosecond lasers (FxPico) has been reported to improve acne scars. In the present study, we evaluated the clinical efficacy of low-dose isotretinoin with or without FxPico treatment for acne scars. A total of 48 patients with acne scars were enrolled and were randomly assigned to receive low dose oral isotretinoin or not. For all the patients in both treatment groups, one side of face were randomly assigned to be treated with picosecond laser. Assessments, including photos, échelle d'évaluation clinique des cicatrices d'acné(ECCA) and Global Acne Grading System(GAGS) score, the number of lesions, melanin and erythema indexes, transepidermal water loss were assessed at 0, 1, 2, and 3 month. Side effects, Dermatology Life Quality Index (DLQI) and satisfaction were recorded before and after the study. A total of 44 patients completed the study (24 received oral low dose isotretinoin and 20 did not). Low dose oral isotretinoin treated group showed significant improvement on ECCA (from 112.5 [50-180] to 105 [50-160]), GAGS score (from 12.6 ± 3.3 to 10.1 ± 3.0), the count of papules (from 4.3 ± 3.7 to 1.0 ± 1.5) than the blank group, and higher improvement were noticed after isotretinoin combined with FxPico. All the side effects were temporary and tolerable, no adverse effects were observed. Higher DLQI and patients' satisfaction were achieved by oral isotretinoin alone and isotretinoin combined with FxPico. This is the first paper showing the improvement of scars by early low dose-isotretinoin intervention with or without the combination of picosecond laser. Early intervention with oral low-dose isotretinoin is effective for the treatment and prevention of acne scars, the combined therapy with FxPico can achieve better outcome.

The skin microbiota partly determined by epidermal barrier plays an important role in acne vulgaris and intense pulsed light (IPL) has been verified as a safe and effective therapeutic option for this disease. Nevertheless, the exact role of the IPL treatment on the skin microbiota and epidermal barrier for patients with acne vulgaris remains unclear. This article was designed to solve this problem. Nineteen healthy controls and 20 patients with mild to moderate acne were enrolled in this study, who received IPL treatment for 12 weeks. The epidermal barrier and skin samples were collected at baseline and after treatment. The microbial diversity was analyzed based on a high-throughput sequencing approach, which targets the V3-V4 region of the bacteria 16S ribosomal RNA genes. After treatment of IPL, the Global Acne Grading System (GAGS) scores, sebum, sclererythrin, and red area of patients were significantly improved by IPL treatment (P < 0.05). Although there was no difference in microbiota diversity before and after IPL treatment, the Nonmetric Multidimension Scaling (NMDS) analysis showed that the samples of the acne patients before and after treatment could be divided into two different sets by skin microbiota (P = 0.011), which could be verified by heatmap analysis. Moreover, we found that the relative abundance of Staphylococcus epidermidis (S. epidermidis) significantly increased, but Cutibacterium acnes (C. acnes) decreased after IPL treatment. The sebum concentration was positively correlated with PH value (R = 0.525, P = 0.017), and the GAGS was positively associated with both sclererythrin (R = 0.477, P = 0.002) and red area (R = -0.503, P = 0.001). IPL could successfully improve the GAGS scores of acne vulgaris, as well as regulate the equilibrium between C. acnes and S. epidermidis, and inhibitthe sebum secretion. Lasers Surg. Med. © 2021 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.

BackgroundAcne vulgaris imposes a significant psychosocial burden, which may be intensified when patients’ perceived severity diverges from objective clinical grading. Such discordance may be amplified in high-stress populations like military personnel, yet evidence in this cohort remains limited. This study quantified this discordance in male military personnel and evaluated whether subjective or objective severity better predicts quality of life (QoL) impairment and treatment adherence.MethodsWe conducted a cross-sectional, questionnaire-based study at a major military medical center in China from March to July 2025. A total of 300 active-duty male military personnel with acne vulgaris were enrolled. Acne severity was objectively assessed by dermatologists using the Global Acne Grading System (GAGS) and subjectively by patients using a 10-cm visual analog scale (VAS). QoL was measured using the Dermatology Life Quality Index (DLQI). Associations between severity scores, DLQI, sociodemographics, and treatment patterns were analyzed using Spearman’s rank correlation, Mann–Whitney U-test, Kruskal–Wallis H-test, and Chi-square test as appropriate.ResultsSignificant discordance existed between clinician and patient severity assessments (P<0.001). Clinicians classified severity as mild (39.0%), moderate (52.7%), and severe (8.3%), whereas self-ratings were 12.7% mild, 53.0% moderate, and 34.3% severe; 52.3% of patients overestimated their severity. Self-rated severity correlated more strongly with DLQI impairment than GAGS scores (r=0.314 vs. 0.206, both P<0.001). GAGS scores were primarily associated with impairments in physical symptoms, clothing, and social activities, while self-rated severity correlated significantly with all 10 DLQI domains. Higher DLQI scores were associated with marriage, acne scars, military service of 2–5 years, and persistent symptoms (all P<0.05). A treatment paradox emerged: patients with objectively severe acne sought more interventions but had shorter treatment duration (64% discontinued within ≤1 month, P=0.040), whereas those with subjectively severe acne maintained longer courses (69.9% continued >3 months, P=0.011).ConclusionIn military populations, self-perceived acne severity more strongly predicts QoL impairment than objective grading and drives differential treatment engagement. Integrating dual-dimensional assessments and psychological support into military dermatology protocols is essential to optimize acne management.

PurposeNumerous tools are available to assess acne severity. It is important to have an acceptable and easy to use tool for acne assessment for many reasons, such as initial assessment and follow-ups, clinical trials, and comparisons of clinical studies. The aim was to investigate the agreement between different observers (inter-observer variation) in the evaluation using the Global Acne Grading System (GAGS) and Investigator Global Assessment of Acne (IGA). Besides, to investigate the correlation between the assessment scores and its relation to the quality of life scales Dermatology Life Quality Index (DLQI) and the Cardiff Acne Disability Index (CADI).Patients and MethodsThis was a prospective study. Four investigators involved to evaluate the study subject surveyed 54 patients complaining of acne using IGA and GAGS scores (DLQI and CADI).ResultsA significant relation was seen between GAGS and IGA (Pearson chi-square test p= 0.001), and they demonstrated excellent inter-rater reliability. There was no correlation between IGA and quality of life measures (CADI nor DLQI). However, there was a significant weak correlation between GAGS and CADI.ConclusionThe two methods for acne severity assessment are reliable, and they are correlated. Quality of life concerning acne is not correlated with the severity of the disease.

Disease-specific quality of life is associated with anxiety and depression in patients with acne.

Background Hidradenitis suppurativa is a chronic inflammatory disease with high burden. Treatment options are often unsatisfactory. We assessed the effect of a combination therapy of intense pulsed light (IPL) and radiofrequency (RF). Methods The explorative study included 47 patients and was performed as a prospective, monocentric, randomized, three-arm parallel-group design trial with a prior 12 weeks observation period. Treatment arms were IPL and RF monotherapies or IPL + RF combination therapy. After 12 weeks, all patients received IPL + RF for additional 12 weeks (cross-over). Primary endpoint was the change in active lesion numbers, secondary endpoint the change in Dermatology Quality of Life Index (DLQI). Results After 12 weeks, active lesion counts of the IPL + RF group decreased more than in the IPL group (p = .044); the decrease in DLQI was significantly higher in the IPL + RF and RF groups compared to IPL. Prolonged 24-week treatment with IPL + RF obtained better results as 12 weeks. Overall, disease burden after 24 weeks of treatment compared to disease fluctuation during the observation period was significantly lower (change in active lesions −3.6, p = .001; in DLQI −5.2, p = .003). Conclusions IPL + RF treatment appears to represent a promising therapeutic option that leads to reduction of disease activity without severe side effects.