Acne Severity Score Research Articles

ANTIHISTAMINE AS AN ADJUNCTIVE TREATMENT IN ACNE VULGARIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Approximately one-tenth of the global population suffer from acne vulgaris, which is a skin disease with considerable psychological impact. Recently, antihistamines have been used in the treatment of acne. However, their overall treatment effects for this indication remain unclear. This systematic review and meta-analysis aim to evaluate the clinical efficacy and safety of the antihistamines in the treatment of acne vulgaris. The following databases were searched: PubMed, Scopus, Embase, Cochrane Central Register of Controlled Clinical Trials, and Google Scholar. We included the randomized controlled trials on acne vulgaris patients which compared any H1- antihistamine drug in combination with other medications to placebo, no treatment, or other medications, with acne lesion (non-inflammatory and inflammatory) counts, acne severity score, patient satisfaction, acne flare, or adverse events as an outcome of interest. Six studies contributing to 388 patients were included, involving two H1 antihistamines (i.e., levocetrizine and desloratadine), isotretinoin, azithromycin, and topical azelaic acid cream. From the network meta–analysis, levocetirizine+isotretinoin was better than the isotretinoin alone in the inflammatory lesion count, but not in the non-inflammatory lesion count. The desloratadine+isotretinoin retained the best balance in terms of non-inflammatory lesion count, inflammatory lesion count, acne flare, and mucocutaneous adverse events. The desloratadine+isotretinoin and levocetirizine+isotretinoin were considered safe.

Efficacy of Supramolecular Salicylic Acid 30% Combined with Intense Pulsed Light Compare to Monotherapy Supramolecular Salicylic Acid 30% in Acne Vulgaris Patients

Background: Acne is one of the most common inflammatory skin diseases. Treatment of acne has been challenging due to the multiple factors involved in its pathogenesis. To date, there are several treatments available. They are traditional chemical peeling, laser-based therapy, and so on. Therefore, as several studies reached inconsistent conclusions on which treatment was better, this observational study aimed to compare the efficacy of monotherapy supramolecular salicylic acid (SSA) and the combination of SSA with intense pulsed light (IPL) treatment in acne patients. Methods: 43 patients with acne vulgaris were chosen at the outpatient department of dermatology from October 2019 until December 2020. Patients were divided into 2 groups: group 1, with a total of 23 patients who underwent SSA 30% combined with IPL, and group 2, which will do monotherapy with SSA 30%. Chemical peeling with SSA 30% treatment will be done every 2 weeks, while IPL treatment will be performed every 4 weeks for a treatment course of 8 weeks. Each individual had a VISIA skin examination and an investigator global assessment (IGA) of acne severity scores every four weeks to evaluate clinical improvement and treatment efficacy. Results: Patients in the SSA 30% + IPL group were mostly female, with comparable baseline VISIA skin scores. During 8-week intervals, the SSA 30%+IPL group presented with a greater improvement in overall skin condition measured by VISIA compared to the SSA 30% alone. Although both groups have a positive effect on skin condition improvement, when it comes to acne, gradual improvement in porphyrins and red areas was more obvious in the combined SSA 30%+IPL group compared to SSA 30% alone. Conclusion: The combination of SSA 30% with IPL compared to SSA 30% alone not only provides better treatment for acne vulgaris but also improves skin rejuvenation.

Isotretinoin treatment upregulates the expression of p53 in the skin and sebaceous glands of patients with acne vulgaris

The transcriptomic regulation induced by isotretinoin (13-cis retinoic acid) is still a matter of debate as short-term exposures of immortalized sebocytes with isotretinoin produced conflicting results. Based on translational evidence, it has been hypothesized that oral isotretinoin treatment upregulates the expression of the transcription factor p53. Twenty-five patients suffering from acne vulgaris were treated with isotretinoin (0.6 mg/kg body weight) for 6 weeks. Biopsies from back skin were taken before and after isotretinoin treatment for the determination of p53 expression by immunohistochemical staining, quantification of p53 protein concentration by enzyme-linked immunosorbent assay and TP53 gene expression by quantitative reverse transcription real time PCR. Fifteen socio-demographically cross-matched healthy volunteers served as controls. Isotretinoin treatment significantly increased the nuclear expression of p53 in sebaceous glands of treated patients compared to pre-treatment levels and p53 levels of untreated controls. Furthermore, the p53 protein and gene expression significantly increased in the skin after treatment. The magnitude of p53 expression showed an inverse correlation to acne severity score and body mass index. Under clinical conditions, isotretinoin induced the expression of p53, which controls multiple transcription factors involved in the pathogenesis of acne vulgaris including FoxO1, androgen receptor and critical genes involved in the induction of autophagy and apoptosis. Increased p53-FoxO1 signalling enhanced by systemic isotretinoin treatment explains the underlying transcriptomic changes causing sebum suppression but also the adverse effects associated with systemic isotretinoin therapy.

Lifestyle habits and impact of the Mediterranean diet on facial acne severity in French women: a case-control study.

Acne is a common benign inflammatory disease, but it has a significant psychosocial impact. The role of the diet in the development of acne is controversial. Some daily foods such as milk and fast-release sugars tend to promote acne. The Mediterranean Diet (MD) is based on virgin olive oil and nuts that are rich in polyphenols with anti-inflammatory properties. The aim of this study was to assess an association between the adherence to the MD and the severity of facial acne in French women. A case-control observational study was conducted in Nantes Hospital (France). Based on a validated PREvención con DIeta MEDiterránean questionnaire, the adherence to the MD was assessed. The Global Evaluation Acne severity score was assessed by a trained dermatologist. Forty women with mild-to-severe acne and 40 control subjects were included. A global linear model identified a significant negative correlation between the severity of acne and the adherence to the MD in acne patients (regression coefficient = −0.17; P = 0.017). This was the first study conducted in France to investigate the relationship between the adherence to the MD and the severity of facial acne in women. This study confirmed the importance of using a holistic approach for acne management. Further studies are needed to confirm our findings.

Evaluation of the relationship between insulin resistance and visceral adiposity index in patients with acne vulgaris.

Acne vulgaris (AV) is a chronic inflammatory skin disease that is common among adolescents. Its etiology involves hormones, diet, genetics, and environmental factors. The aim of this study was to investigate the association between acne vulgaris and insulin resistance (IR) and visceral adiposity index (VAI). The study included 184 individuals. Participants' height, weight, waist and hip circumference and blood pressure were measured. Morning fasting blood was obtained from all participants for measuring glucose, insulin, triglyceride (TG), and cholesterol levels. The HOMA index and visceral adiposity index were calculated. The collected data were analyzed using statistical methods. The patient and control groups exhibited similar age, gender, and body mass index (p > 0.05). There was no significant difference between the patient and control groups in HOMA index and VAI (p > 0.05). A positive correlation was observed between VAI and glucose, insulin, HOMA index, TG level, and waist circumference, whereas there was a negative correlation with high-density lipoprotein (HDL). Our study results demonstrated that IR and VAI were similar both in the AV and healthy control groups. There was no correlation between acne severity score and waist circumference, glucose, insulin, TG, HDL, HOMA index, and VAI. These results indicate that IR and visceral adipose tissue dysfunction alone are not effective in the development of acne.

Akneli Ergenlerin Ebeveynlerinin Yaşam Kalitesi: Kesitsel Bir Çalışma

Objective: Skin diseases affect both a patient's life and the lives of their relatives in a plethora of ways. Although there are several studies on the effects of acne on quality of life (QoL), studies on the QoL of parents with adolescents who have acne are scarce. In this study, we aim to assess the effect of acne vulgaris on parents' QoL and determine how this varies according to acne severity scores of their children. Material and Methods: Our study included 162 patients at 12-18 years of age with acne vulgaris and their parents. The Acne Quality of Life Scale (AQoL) was used to assess the patient's quality of life. The Dermatological Family Impact Scale (DeFIS) was used to evaluate the caregiver's QoL. Besides DeFIS, a semi-structured questionnaire also administered to the caregiver. Results: Of the parents who participated in our study, 62% expressed sorrow and 62% expressed anxiety about their children's acne. The DeFIS scores of the parents were found to be 11.86±8.98 (0-41). There was no correlation between DeFIS scores and acne severity, however a statistically significant correlation was found between AQOL and DeFIS scores. Of the parents, 43% expressed their concern about the side effects of their children's acne treatments and parents' DeFIS scores increased in correlation with their concerns. Conclusions: Our findings show that acne may have an impact on a family's QoL, which is an extension of the QoL of acne patients.

The Efficacy of Pulsed Dye Laser Treatment for Acne Vulgaris: A Systemic Review and Meta-Analysis.

Previous reports have shown that pulsed dye laser (PDL) is promising for the treatment of acne; however, results provide conflicting evidence. To determine the efficacy of PDL in treating acne vulgaris. A systematic review and meta-analysis of studies published before March 31, 2020 was conducted. Randomized controlled trials and case series were analyzed. The meta-analysis estimated the standardized mean difference (SMD) in acne severity score changes in patients treated by PDL versus control and also the SMD of the acne severity scores and comedone counts changes before and after PDL treatment. Eleven studies were included in this systematic review. Six studies were included in the meta-analysis. Pulsed dye laser treatment was not found to be superior to the control group in treating acne vulgaris (SMD: -0.285; 95% confidence interval [CI], -0.886 to 0.317). However, single-arm studies revealed a significantly improved acne severity score after PDL therapy (SMD, -1.321; 95% CI, -2.057 to -0.586), especially when a multiple-session treatment and a longer pulse duration were employed. The comedone counts were significantly decreased after PDL therapy (SMD, -0.596; 95% CI, -1.137 to -0.054). When treatment consisted of 4 or more sessions or longer pulse duration, PDL could significantly decrease the acne severity score.

Efficacy, tolerability, and safety of montelukast versus finasteride for the treatment of moderate acne in women: A prospective, randomized, single-blinded, active-controlled trial.

Acne is a chronic inflammatory skin disease which involves the pilosebaceous unit. Tissue inflammation isone of the crucial mechanisms, amongst others. Of the various cytokines, leukotriene B4 (LT-B4) is the most potentleucocyte chemotactic mediator. Montelukast is an antagonist of the LT-B4 receptor. Finasteride is an antiandrogen whichspecifically inhibits the 5α-reductase enzyme. This study aimed at comparing the efficacy, tolerability and safety of montelukast versus finasteride in the treatmentof moderate acne in women. This randomized, single-blinded, prospective trial over 12weeks recruited 65 female subjects with moderate acne vulgaris (Global Acne Grading System Scale) for evaluation. One group (n=30) received oral montelukast (10mg PO daily), while the second group (n=25) received oral finasteride (2.5mg PO daily) in combination with topical clindamycin 2% solution. Lesion count and acne severity were evaluated at time intervals of 0 (baseline), 4, 8, and 12weeks. Adverse effects of the drugs were noted. Both lesion count and severity of acne decreased significantly after treatment in both the groups as compared to the baseline. The acne severity score reached from 33.93 in time zero to 20.6 in the 12th week and 35.71 at baseline to 16.43 at the end of treatment in the Montelukast and Finasteride groups, respectively. Side effects were noted in 3 patients and 2 patients in the monteleukast and finasteride group, respectively, which were transient and non-serious in nature proving the satisfactory tolerability and safety of these two drugs. The results of this study show that both montelukast and finasteride have good efficacy in the treatment of acne. Finasteride has more efficacy than montelukast for treating moderate acne in normo-androgenic women.

Could acne be a risk factor for developing eating disorders? Acne vulgaris and eating disorders.

Skin findings such as acne, hypertrichosis, and hyperpigmentation may be a clue for the diagnosis of eating disorders. There are studies on skin findings in eating disorders, but there is no study evaluating eating disorders in acne patients. We aimed to investigate eating disorders in acne patients and evaluate the effect of acne severity, quality of life, and body mass index (BMI) on eating disorders. Two hundred thirty-two acne patients and 314healthy controls were enrolled. Acne severity was detected according to Grading Acne Severity Scale (GAGS) by the dermatologists. Eating Attitude Test-40 (EAT) and Acne Quality of Life Scale (AQLS) were filled out by patients. The controls filled out EAT. Individuals scoring EAT≥30 points were considered at risk for eating disorders. The median EAT score (15 vs. 13) and the number of patients scoring EAT ≥30 (14.2% vs. 2.2%) were found to be significantly higher in the patients' group compared with control group (p: 0.005, p<0.001). There was a significant positive correlation between EAT score and AQLS score but no significant relationship between acne severity and EAT score. A significant positive correlation was found between EAT scores and BMI. Eating disorders and acne are mostly seen in adolescence, and both have high biopsychosocial morbidity. Also eating disorders can even be mortal sometimes. There are common psychopathological mechanisms in eating disorders and acne.

Efficacy of a combined chemical peel and topical salicylic acid-based gel combination in the treatment of active acne.

Acne vulgaris is a common skin condition affecting the pilosebaceous unit of the skin characterized by the presence of comedones, papules, pustules, nodules, and cysts, which might result in permanent scars. It commonly affects adolescents, but it can occur in any age-group with the second group of incidence in young women in their 30s. Acne vulgaris can highly affect a person's quality of life. Therefore, it is necessary to act against it to prevent emotional impact and long-term complications. This study aimed to demonstrate the efficacy of a chemical peel in combination with a home care-exfoliating and purifying product in improving mild and moderate acne. The study included 45 patients with mild-to-moderate acne. Patients were treated with a chemical peel containing a mix of salicylic acid, pyruvic acid, and retinoic acid once every 3weeks for 4 times, plus a home care treatment after the healing process. Michaelson's acne severity score, Subject Global Aesthetic Improvement Scale, and Face Skin Q questionnaire were used to evaluate patients' skin improvement and patients' satisfaction. All patients have shown improvement in skin lesions after 4sessions of chemical peel according to Michaelson's acne severity score and Subject Global Aesthetic Improvement Score. Face Skin Q questionnaire demonstrated an improved quality of life in all treated patients. The combination of salicylic acid-based chemical peel plus exfoliating home care treatment appears to be a very good strategy against acne. Therefore, the physician may use this combination as an effective treatment for patients dealing with acne vulgaris.

Parametric Acne Severity (PAS) Score and Lesion Counts From Multi-Modality Facial Image Analysis Correlates Strongly with Investigator Assessment.

Variability in acne lesion counting and assessing global severity necessitates large sample sizes that increase trial costs. Lack of standardized measures for these outcomes precludes the conduct of meta-analyses needed to compare efficacy of acne treatments. The goal of this study was to evaluate objective measures of lesion counts and global severity using analysis of multimodal photography. An algorithm for counting lesions was trained and validated in 30 acne subjects and compared to parallel assessments by 2 expert raters. A composite of photographic data representative of acne lesion topography, erythema, and C Acnes fluorescence was used to generate a Parametric Acne Severity (PAS) score. No relationship was identified between lesion counts and IGA. The correlation coefficients between raters and the algorithm when compared per view for the inflammatory and non-inflammatory lesion counts were 0.77 (P=0.001) and 0.85 (P=0.001), respectively. The correlation coefficient between the raters&rsquo; IGA grades and the PAS score was 0.82 (P&lt;0.05). These data demonstrate that the lesion counting, and PAS are objective measures that strongly correlate with investigator assessments. Inclusion of these measure in clinical trials may reduce variability, standardize outcomes, and provide insights into treatment effects on photographic parameters associated with acne. J Drugs Dermatol. 2021;20(6):642-647. doi:10.36849/JDD.6165.

Comparing clinical acne vulgaris severity to adolescent and parent perceptions of acne severity and impact on quality of life.

Little research has compared clinician acne severity assessment with either adolescent- or parent-rated scales of acne severity or impact on quality of life (QOL). We sought to assess how adolescents and their parents perceive the severity and impact of acne on the adolescent's QOL and correlate this with clinical severity. Each adolescent and a parent completed a validated QOL survey regarding the adolescent's acne and rated the adolescent's acne severity and QOL impact using a Likert scale. Clinicians assessed the adolescent's acne using a standardized acne severity scale. Statistical analysis compared adolescent scores with respective parent scores or with clinician assessment using a paired t test or Spearman rank-order correlation test. The Likert impact score more accurately reflected acne impact on QOL for adolescents than for parents when considering the validated QOL survey as the gold standard (r2 =.56 vs r2 =.36). Likert scores for adolescents and parents were weakly correlated for acne severity but not for acne QOL impact (r2 =.36 vs r2 =.18). Correlations of acne severity scores between clinician and either adolescent or parent were weak. Parents and adolescents are in relative agreement regarding acne severity and QOL impact. However, parent and adolescent perceptions are disparate from clinician acne assessment. It is important that physicians identify and consider adolescent and parent perceptions in addition to clinical assessment to better inform the approach to acne management.

Efficacy of Modified Qufeng Runmian Powder () on Acne Vulgaris with Syndromes of Dampness and Blood Stasis: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

To evaluate the efficacy and safety of a Chinese medicine (CM) Modified Qufeng Runmian Powder (, MQFRMP) for the treatment of acne vulgaris with CM syndromes of dampness and blood stasis. In this multicenter, randomized, double-blind, placebo-controlled clinical trial, 220 acne vulgaris patients with CM syndrome of dampness and blood stasis were included and randomly assigned using a central area group random design to receive either MQFRMP or the placebo, with 110 cases in each group. MQFRMP or a placebo at 145 g/bag were administered once daily for 4 weeks, respectively. The primary index of efficacy was the effective rate according to the acne severity score (ASS). The secondary indices of efficacy included the changes in the dermatology life quality index (DLQI) score, VISIA scores (spots, pores, brown spots, porphyrins and red areas) and skin assessment (skin pH, sebum amount and hydration) according to a SOFT skin multianalyzer. (1) Follow-up: a total of 204 patients completed the follow-up, with 103 in the treatment group and 101 in the control group. (2) Effective rate: the total effective rate of the treatment group was significantly higher than the control group [83.5% (86/103) vs. 31.7% (32/101), P<0.01)] with 95% confidence interval of 39.3%-66.4%. (3) DLQI: DLQI scores were significantly decreased the treatment and control groups (both P<0.01), but the treatment group was more obvious than the placebo group (P<0.01). (4) VISIA scores: the scores of spots, brown spots and red areas in the treatment group decreased compared with baseline (P<0.05). In the control group, the scores of brown spots and pores decreased compared with baseline (P<0.05). The improvement was more obvious in the treatment group than in the control group for all items (P<0.05). (5) Skin assessment: the pH and sebum score in the both groups decreased drastically compared with the baseline (all P<0.01), however, the improvement was more obvious in the treatment group than in the control group (P<0.01). The hydration amount in the two groups showed no statistically significant difference compared with the baseline (both P>0.05). (6) Safety: two cases of mild drug allergy were observed in the treatment group. MQFRMP was effective and safe for the treatment of acne vulgaris with syndromes of dampness and blood stasis. (No. ChiCTR1900020479).

Comparison between the therapeutic effect of microneedling versus tretinoin in patients with comedonal acne: a randomized clinical trial

Background: Microneedling has been shown to be a clinically effective and safe treatment for comedonal acne vulgaris. The aim of the present study was to compare the clinical effectof microneedling and the most commonly used topical drug, tretinoin, in the treatment of comedonal acne.Methods: Patients with comedonal acne (n = 82) were randomized to receive topical tretinoin (n = 41) or 6 sessions of microneedling (n = 41) over a period of 3 months. Objective assessments suchas changes in acne severity score by global acne grading system (GAGS) and patients’ subjective satisfaction were investigated at the baseline, at the end of the treatment period, and at the3-month follow up.Results: GAGS was significantly reduced in both microneedling (7.8±3.8 to 3.5±2.6) and tretinoin (8±3.8 to 6.6±3.2) groups at the end of the treatment course compared with the baseline. Theoverall acne severity index reduction in microneedling group was significantly higher than that of the tretinoin group (P<0.001). Improvement in acne severity was also more permanent bymicroneedling. The severity of acne in tretinoin recipients was increased to 8.2±3.2 at the follow-up visit, while it remained nearly unchanged in the microneedling group. (3.3±2.4). Patients’subjective assessment concerning acne improvement was significantly more satisfactory in microneedling group (P<0.001). Conclusion: Compared with tretinoin, microneedling seems to be a more effective, permanent and satisfactory treatment in the treatment of comedonal acne.

A Review and Update of Treatment Options Using the Acne Scar Classification System

An unfortunate consequence of acne vulgaris is residual scarring that can negatively affect a patient's quality of life. Jacob and colleagues have previously described an acne scar classification system based on acne scar pathology that divided atrophic acne scars into icepick, rolling, and boxcar scars, and this review will evaluate new and developing treatment options for acne scarring. A Medline search was performed on the various treatments for acne scars, and particular attention was placed on articles that used the acne scar classification system of icepick, rolling, and boxcar scars. Therapies for acne scarring included surgical modalities, such as subcision, and punch excision and elevation, injectable fillers, chemical peels, dermabrasion, microneedling, and energy-based devices. In the past decade, there has been a trend toward using cosmetic fillers and energy-based devices to improve acne scarring. There were few high-quality evidence-based studies evaluating the management of acne scarring. Many disparate acne severity scores were used in these studies, and the acne scar type was frequently undefined, making comparison between them difficult. Nonetheless, research into interventions for acne scarring has increased substantially in the past decade and has given patients more therapeutic strategies.

Evaluation of Adolescents Diagnosed with Acne Vulgaris for Quality of Life and Psychosocial Challenges.

Background:Acne vulgaris is a common skin condition which affects most adolescents. It has a major impact on quality of life and psychosocial well-being.Aims:The aims of the study were to examine the psychosocial effects of acne on adolescents and changes in quality of life, and to reveal any difference in the possible effect between genders. In addition, an investigation of the association between acne severity and quality of life as well as psychosocial stress was conducted.Materials and Methods:The present study included 164 adolescents with a mean age of 12–18 years and was diagnosed with acne vulgaris without any previous treatment. The control group consisted of 188 healthy volunteers. Acne severity was evaluated by the global acne grading system. All patients filled in a Children's Dermatology Life Quality Index, Pediatric Quality of Life Questionnaire (PedsQL), and a Strength and Difficulties Questionnaire (SDQ).Results:The scores of SDQ and PedsQL were significantly lower in the case group. There was no significant correlation found between the genders in the control group for acne severity and scale scores. No significant correlation was found between acne severity and psychosocial challenges.Conclusions:The results of the present study show that acne has a significant effect on quality of life for adolescents, and this has an impact on their psychosocial life. Another important finding of the present study is that worsening in quality of life is not affected by some factors such as duration, severity of acne and age.

Oral Azithromycin Pulse Therapy and Daily Topical Adapalene in the Treatment of Acne Vulgaris: An Open Randomized Noncomparative Study

The safety and efficacy of oral azithromycin and topical adapalene are well documented. In this study, concomitant use of oral azithromycin pulse therapy and daily topical adapalene in the treatment of acne vulgaris is assessed. A total of 37 patients fulfilled the inclusion criteria were enrolled. Azithromycin, 500 mg orally once daily first 3 days of 10 days' cycle for 9 cycle &amp; topical Adapalene (0.5%) at night. Patients evaluated at 4 weeks' interval by using Michaelsson acne severity index. The overall assessment was made by percent reduction of acne lesions and severity score. At the end of 12 weeks' treatment 99.8% of comedones, 98.7% papular lesion, 94.3% pustular lesion and 88.8% infiltrated lesion were cleared. Only 2.9% cystic lesion responded to the regimens. Percent reduction of Michaelsson acne severity index was 87%, which was statistically highly significant. Overall assessment revealed acne lesion cleared in 22% cases, excellent improvement observed in 65% and 13% showed good response. Adverse effect was minimal. So, azithromycin pulse therapy and topical adapalene is indeed effective and safe in the treatment of acne vulgaris.Medicine Today 2016 Vol.28(2): 52-56

Olumacostat glasaretil, a novel topical sebum inhibitor, in the treatment of acne vulgaris: A phase IIa, multicenter, randomized, vehicle-controlled study

Olumacostat glasaretil (OG) inhibits acetyl-coenzyme A carboxylase, the enzyme responsible for the first, rate-limiting step in de novo fatty acid synthesis. OG inhibited invitro human sebocyte lipid production and reduced invivo sebaceous gland size in hamster ears. Safety and efficacy of OG 7.5% gel were evaluated in patients with moderate to severe facial acne vulgaris. Patients were randomized (1:1) to twice-daily application of OG or vehicle for 12weeks. Efficacy was measured through changes in lesion counts and improvement in acne severity scores. A total of 108 patients received OG (n=53) or vehicle (n=55); these groups had mean baseline counts of 29.7 and 28.6 inflammatory and 40.9 and 38.8 noninflammatory lesions, respectively. At week 12, OG treatment showed greater reductions from baseline in inflammatory lesions (-63.9% vs -45.9%; P=.0006) and noninflammatory lesions (-48.1% vs -28.8%; P=.0025), and more patients with greater than or equal to 2-grade improvement in investigator global assessment score (24.5% vs 7.3%; P=.0070) than vehicle. Application-site adverse events (typically mild or moderate intensity) were more common with OG. Larger trials are needed to optimize OG dosing and confirm the current results. OG was well tolerated and showed evidence of efficacy, suggesting further development is warranted.

Intense Pulsed light Versus 1,064 Long-Pulsed Neodymium: Yttrium-Aluminum- Garnet Laser in the Treatment of Facial Acne Vulgaris.

Laser and light-based procedures provide a good and safe modality for treatment of active acne lesions when used properly. To compare the clinical efficacy of intense pulsed light (IPL) versus 1,064 long-pulsed Neodymium:Yttrium-Aluminum- Garnet (Nd: YAG) in treatment of facial acne vulgaris. Seventy four patients recruited between June 2013 and August 2014 was enrolled in this controlled, single-blind, split-face clinical trial. All participants received 3 sessions of IPL on the right side of the face and 1,064-nm Nd:YAG on the left side of the face at 4-weeks intervals. Final assessment was made by comparison of the changes in the count of inflammatory acne lesions (inflammatory papules, pustules, nodules and cyst) and non-inflammatory acne lesions (Comedones) and the acne severity score between both therapies, based on standardized photography. At the final visit, the inflammatory acne lesions were reduced on the IPL and 1,064-nm Nd:YAG treated sides by 67.1% and 70.2% respectively (p<0.05 for each), while non inflammatory acne lesions were reduced by 18.3% and 19.3% respectively (p>0.05 for each). For both therapies, there was significant difference in the improvement on inflammatory acne lesions in comparison to non-inflammatory lesions (p<0.05 for each). There was no significant difference in the efficacy of the two therapies in reducing the percentage of both types of acne lesions count from baseline to the end of the study (p>0.05 for each). Both IPL and 1,064-nm Nd:YAG laser are effective in treatment of inflammatory facial acne vulgaris. There is no significant difference between the effects of both therapies on facial acne lesions.

A new LED device used for photodynamic therapy in treatment of moderate to severe acne vulgaris

ObjectiveThis study investigated the efficacy and safety of a newly designed LED device used in photodiagnosis and photodynamic therapy of moderate to severe acne vulgaris in Chinese patients. MethodsForty-six patients with moderate to severe facial acne showing high degrees of fluorescence by ultraviolet light examination were illuminated during ALA-PDT with two wavelengths of light (543–548nm, and 630±6nm, respectively) after 2h of incubation with ALA. Each patient received treatment once every 30 days for two or three sessions. Two independent investigators assigned an acne severity score at baseline, one week after each treatment, as well as 4, 8, and 12 weeks after the completion of treatment. Adverse effects were recorded during and after each treatment. All patients rated their satisfaction with the results of treatment at a 12-week follow up visit. ResultsThe ALA-PDL treatment regimen showed an overall effectiveness rate of 89.13% (41/46 patients). Some degree of clinical efficacy was seen in 71.42%, 86.67%, and 95.83% of patients with grades IV, V, and VI acne, respectively, and the rate of clinical effectiveness increased with increasing acne severity. When compared with baseline scores, significant reductions in acne scores were obtained at 8, and 12 weeks after completion of treatment. Maximum efficacy was shown at the 12 week follow up. No severe adverse events were observed. ConclusionALA-PDT administered with the newly designed LED device was an effective treatment for moderate to severe acne vulgaris, and side effects were mild and reversible.