Split-face Clinical Trial Research Articles

Effect of air pollution on carbonylated protein level in the stratum corneum and protective effect of pink pepper tree extracts and lipid mixtures on skin damage

Objective To evaluate the effect of air pollution on carbonylated protein level in the stratum corneum, and to assess the protective effect of pink pepper tree extracts and lipid mixtures on skin damage. Methods After the investigation of influencing factors in the preliminary experiment, fluorescence labelling assay was performed to detect the carbonylated protein level in the skin stratum corneum at different body sites of 34 healthy testees. Cigarette smoke was used to simulate pollutants, and the forearms of 15 healthy testees were exposed in the customized pollution simulation chamber with the flexor aspects facing upwards. After 0, 1, 2, 4, 5 hours of exposure, stratum corneum samples were collected by using D-squame tapes. In each of 14 selected healthy testees, 3 adjacent areas on the flexor aspect of unilateral forearm were divided into 3 groups: pink pepper tree group treated with 1% aqueous solution of pink pepper tree extracts, control group treated with deionized water, and blank group receiving no treatment. Then, the forearms of the 14 testees were exposed in the pollution simulation chamber for 5 hours, and stratum corneum samples were collected from the 3 areas before and after the exposure. Another 16 healthy testees were included, and 3 adjacent areas on the flexor aspect of their unilateral forearms were divided into 3 groups: lipid mixture group treated with 5% lipid mixture emulsion, control group treated with lipid mixture-free placebo emulsion, and blank group receiving no treatment. Then, the forearms of the 16 testees were exposed in the pollution simulation chamber for 5 hours, and stratum corneum samples were collected from the 3 areas before and after the exposure. Moreover, twenty healthy testees were enrolled into the double-blind split-face clinical trial. That is, one half of the face was randomly chosen to be treated with 1% emulsion of pink pepper tree extracts, and the other facial side was treated with placebo emulsion. Before and after 56-day treatment, stratum corneum samples were collected from the cheeks of testees by using D-squame tapes. Fluorescence labelling assay was conducted to detect the carbonylated protein level in the above stratum corneum samples. Results The analysis of 34 testees showed that carbonylated protein levels (average fluorescence intensity) significantly differed among different body sites (P < 0.001) , and the carbonylated protein levels were significantly higher in the cheeks (26.3 ± 7.1) and forehead (22.9 ± 7.9) than in the forearm (14.7 ± 4.9) and waist and back (12.6 ± 4.2) (P < 0.001) , and higher in the forearm than in the waist and back (P = 0.046) . In the short-term simulated accelerated exposure experiment, the carbonylated protein level increased along with the increase of the duration of exposure to pollution (R2 = 0.995 9) . After 5-hour exposure, the pink pepper tree group and lipid mixture group both showed significantly lower elevated levels of carbonylated protein in the stratum corneum (9.7 ± 5.2, 5.8 ± 4.9) compared with the corresponding blank groups (19.0 ± 10.0, 17.4 ± 8.8; P < 0.005) and control groups (18.5 ± 7.3, 15.9 ± 6.4; P < 0.005) . In the long-term human trial, the carbonylated protein levels significantly decreased in the facial side treated with 1% emulsion of pink pepper tree extracts for 8 weeks compared with the placebo-treated facial side. Conclusion Air pollution aggravates skin damage induced by protein carbonylation in the stratum corneum, and pink pepper tree extracts and lipid mixtures can effectively reduce the carbonylated protein level. Key words: Skin; Air pollution; Oxidative stress; Protein carbonylation; Pink pepper extract; Lipid mixture

A split-face design clinical trial to evaluate a novel facial cream in improving tolerance of retinoid therapy

A split-face design clinical trial to evaluate a novel facial cream in improving tolerance of retinoid therapy

Evaluation of Therapeutic Efficacy and Safety of Tranexamic Acid Local Infiltration in Combination with Topical 4% Hydroquinone Cream Compared to Topical 4% Hydroquinone Cream Alone in Patients with Melasma: A Split-Face Study.

Introduction Melasma is an acquired pigmentary disorder characterized by hyperpigmented macules and/or patches affecting sun-exposed skin. Tranexamic acid (TA) can reduce melanin content of epidermis. Thus, we conducted this study to evaluate the efficacy and safety of tranexamic acid local infiltration in combination with topical 4% hydroquinone cream compared to topical 4% hydroquinone cream alone in patients with melasma. Material and Methods This study was a prospective assessor- and analyst-blind, randomized split-face clinical trial which was performed on patients with bilateral malar epidermal melasma. A total of 55 patients were enrolled, and each side of their face was randomly allocated to either TA+HQ or HQ alone treatment. The MASI score was applied as an objective measurement to compare two treatment groups. The patient's satisfaction of melasma treatment was evaluated using a four-scale grading, as well. Results The mean of MASI score in week 16 decreased in both groups significantly (p < 0.01). The therapeutic outcomes were significantly better in TA+HQ group than HQ group (p=0.001). Patients satisfaction with treatment was significantly higher in the TA + HQ group. The difference between the two groups regarding side effect occurrence was not statistically significant. Conclusion Addition of tranexamic acid injections to conventional hydroquinone therapy can increase the efficacy of topical treatment. This trial is registered with IRCT2015110324865N1.

A split-face design clinical trial to evaluate the efficacy of a masque when used post–full face nonablative fractionated laser treatment

A split-face design clinical trial to evaluate the efficacy of a masque when used post–full face nonablative fractionated laser treatment

A comparative study of two intense pulsed light devices for the treatment of facial photoaging

Objective To compare the efficacy and safety of two intense pulsed light (IPL) devices for the treatment of facial photoaging. Methods A randomized split-face clinical trial was conducted, and 30 female subjects with facial photoaging were enrolled and randomized to receive treatment with Lumenis One on one half of the face and BBL on the other facial side, once every 3-5 weeks for 5 sessions. Each subject was followed up before the first treatment (the first interview) , 4 weeks after the third treatment (the second interview) , 4 weeks after the fifth treatment (the third interview) and 8 weeks after the fifth treatment (the fourth interview) . During each follow-up period, global scores for photoaging (GSP) were used to evaluate the photoaging degree on the whole face, a 4-level grading method was applied to evaluate the improvement degree of 5 photoaging signs on each facial side, including wrinkles, skin texture, pigmented spots, telangiectasia and skin tightening, and the visual analogue scale (VAS) to assess pain induced by treatment. After the last treatment, self-assessment on the degree of satisfaction with therapeutic effects was conducted in subjects. Comparisons in the GSP and improvement scores between the two facial sides were conducted by repeated measures analysis of variance (ANOVA) . Results A total of 26 subjects completed all the treatments and follow-up. Evaluation of the whole face showed that the GSP significantly decreased from 3.19 ± 0.75 before the first treatment to 2.15 ± 0.83 at 4 weeks after the third treatment (P 0.01) . Evaluation of each facial side showed that improvement scores of skin texture, pigmented spots, telangiectasia and skin tightening on the two facial sides all increased at first and then decreased over the treatment time (Ftime= 18.75, 10.25, 12.83, 15.73, respectively, all P 0.05) , and improvement scores of 5 photoaging signs did not differ between the Lumenis One-treated side and BBL-treated side (all P > 0.05) . In addition, the VAS pain score was significantly lower in the BBL-treated side than that in the Lumenis One-treated side (4.62 ± 1.54 vs. 5.80 ± 1.74, t= 2.87, P < 0.05) . Most subjects were satisfied with the therapeutic effects (88.46%, 23/26) . Conclusion Both Lumenis One and BBL can be applied to treat facial photoaging safely and effectively, and improve signs of photoaging such as pigmented spots and skin texture, but the degree of pain on the BBL-treated side is milder than that on the Lumenis One-treated side. Key words: Skin aging; Phototherapy; Treatment outcome; Intense pulsed light

Clinical and Histologic Effects of Fractional Microneedling Radiofrequency Treatment on Rosacea.

Fractional microneedling radiofrequency (FMR) is an emerging treatment modality, but its effect on rosacea has not been studied yet. To investigate the potential impact of FMR treatment on clinical improvement and histologic changes in rosacea patients. A 12-week, prospective, randomized, split-face clinical trial was conducted. Two sessions of FMR were performed on one side of the cheeks with 4-week interval and the other side remained untreated. Erythema index from DermaSpectrometer and a* value from Spectrophotometer CM-2002 were measured at each visit for the objective measurement of erythema. Histologic analysis of skin samples was also carried out. Clinical evaluation and photometric measurement revealed the reduction of redness in the treated side compared with untreated side and baseline. Erythema index decreased 13.6% and a* value decreased 6.8% at Week 12 compared with baseline. Reduced expression of markers related to inflammation, innate immunity, and angiogenesis was observed in immunohistochemical staining of tissue obtained after FMR treatment. Fractional microneedling radiofrequency treatment showed modest clinical and histologic improvement of rosacea, and it might be used as an alternative or in combination with other treatment methods.

A Randomized Split-Face Clinical Trial of Photodynamic Therapy with Methyl Aminolevulinate versus Ingenol Mebutate Gel for the Treatment of Multiple Actinic Keratoses of the Face and Scalp

Background: Photodynamic therapy with methyl aminolevulinate (MAL-PDT) and ingenol mebutate gel (IMB) are approved therapeutic options for multiple actinic keratoses (AKs). Objective: The aim of this intraindividual, split-face, randomized clinical trial was to compare treatment outcomes of MAL-PDT and IMB. Methods: Two symmetrical contralateral areas with a similar number of AKs were selected and randomly assigned to 3 days of an IMB treatment cycle or a single session of MAL-PDT. The next day, the local skin reaction (LSR) score was registered. The patients scored pain and time to healing of the treatment area. Results: After 90 days, the complete remission rate of lesions, the number of patients with complete remission of all lesions, cosmetic outcome, and patient preference were assessed. Conclusion: According to our results, IMB and MAL-PDT had a similar efficacy, but the cosmetic outcome was superior with MAL-PDT. Pain was higher with PDT, but LSR was more severe and time to healing was longer with IMB. Patients preferred MAL-PDT.

A randomized split-face clinical trial analyzing daylight photodynamic therapy with methyl aminolaevulinate vs ingenol mebutate gel for the treatment of multiple actinic keratoses of the face and the scalp

IntroductionDaylight photodynamic therapy with methyl aminolaevulinate (dlPDT) and ingenol mebutate gel (IMB) are approved therapeutic options for multiple actinic keratoses (AKs).The aim of this comparative, intra-patient, split-face, randomized clinical trial was to compare treatment outcomes of dlPDT and IMB. MethodsTwo symmetrical contralateral areas of 25cm2, harboring a similar (5–10) number of AKs, were selected and randomly assigned either to a 3days’ IMB treatment cycle or to a single session of dlPDT. The day after the local skin reaction (LSR) score was registered. Patients’ scored pain (assessed through VAS method) after the treatment, and time needed for wound closure, were subsequently registered. After 90days, the complete remission (CR) rate recorded for both single lesions and patients, the cosmetic outcome and the patients’ preference, were assessed. Results22 patients with a total of 311 AKs were enrolled. The mean pain VAS score was 3.55±1.82 with IMB and 2.05±0.72 with dlPDT (p<0.01). The mean LSR score was 9.91±4.24 and 4.59±4.03 (p<0.01), respectively. The mean days necessary for wound closure were 9.45±3.51 and 4.36±1.18days (p<0.01), respectively. After 3 months, 119 lesions with IMB and 120 lesions with dlPDT were healed and the CR rate with IMB (75.8%) was non-inferior to the CR rate with dlPDT (77.9%). The comparisons of CR rates of grade I and II AKs did not show any inferiority for one treatment compared to the other. Eight patients (36.4%) had all lesions cleared with IMB and 7 (31.8%) with dlPDT (p=NS). The cosmetic outcome was better with dlPDT and 17 patients evaluated dlPDT as their preferred treatment. ConclusionsA 3days’ treatment cycle with IMB and a single session of dlPDT had a similar efficacy for both grade I AKs and grade II AKs but dl PDT showed lower pain and inflammation scores, quicker wound closure, better cosmetic outcome and higher patients’ preference.

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.

Comparison of Clinical and Histological Effects between Lactobacillus-Fermented Chamaecyparis obtusa and Tea Tree Oil for the Treatment of Acne: An Eight-Week Double-Blind Randomized Controlled Split-Face Study

Background: Screening of natural compounds for the development of anti-acne therapeutic agents has been steadily required considering various side effects of acne medications. However, previous studies have mainly focused on experimental tests without clinical trials and histopathological analysis. Objectives: To compare the clinical efficacy, safety and histopathological changes between Lactobacillus-fermented Chamaecyparis obtusa (LFCO) and existing tea tree oil (TTO). Methods: A total of 34 patients were instructed to apply 5% LFCO to the involved areas of a randomly allocated side and 5% TTO extract to the other side for 8 weeks in a double-blind split-face clinical trial. Results: After 8 weeks, inflammatory acne lesions were reduced by 65.3% on the LFCO side and by 38.2% on the TTO side. LFCO was also superior to TTO in the onset time of efficacy (p < 0.05). The LFCO side further demonstrated improvement for non-inflammatory lesions (52.6%, p < 0.05), decreased size of sebaceous glands and sebum output reductions. Patients' subjective satisfaction was also higher without severe adverse reactions. Protein expressions of nuclear factor κB decreased earlier on the LFCO side, and those of interleukin-1a (IL-1a), IL-8, insulin-like growth factor 1 receptor and sterol regulatory element-binding protein 1 decreased subsequently. Ultra-performance liquid chromatography/high-resolution mass spectrometry further demonstrated that the contents of dihydroxybenzoic acid, taxifolin and quercetin were increased in LFCO after fermentation. Conclusions: LFCO treatment was rapid and effective for treating acne lesions compared to TTO. Histopathological findings correlated well with the clinical acne grade and treatment response. This novel natural compound appears to be effective and safe for acne treatment.

Clinical Evaluation of Glycolic Acid Chemical Peeling in Patients with Acne Vulgaris: A Randomized, Double-Blind, Placebo-Controlled, Split-Face Comparative Study

Glycolic acid (GA) peels are frequently performed as adjuvants to the treatment of facial acne. There have been few clinical trials reported of GA peels for acne in people with darker skin. To determine the safety and efficacy of GA peels in the treatment of moderate acne vulgaris in Asian skin. In this prospective, randomized, double-blind, placebo-controlled, split-face clinical trial, 26 patients with moderate acne were treated with 40% GA (pH 2.0) on half of the face and placebo on the other half. The procedure was performed five times at 2-week intervals. The GA sides had statistically significant reductions in acne lesions at each time point from baseline values. There were statistically significant differences between the GA and placebo sides. The GA sides had better responses for noninflammatory lesions than for inflammatory lesions. In bioengineering measurements, sebum levels were statistically significantly reduced after the initiation of therapy on both sides at weeks 8 and 10, but there were no statistically significant differences between the two sides. Forty percent GA peels significantly improved moderate acne in this study. It is effective and safe in Asians.

A split-face clinical trial to compare the safety and efficacy of two topical acne treatments in subjects with mild to moderate acne vulgaris

A split-face clinical trial to compare the safety and efficacy of two topical acne treatments in subjects with mild to moderate acne vulgaris

Efficacy of 2% metronidazole gel in moderate acne vulgaris

Background:Acne vulgaris is an inflammatory disease of the pilosebaceous units. Various systemic and topical options are available for its treatment.Aims:This study aimed to evaluate the efficacy of 2% metronidazole gel in acne vulgaris.Materials and Methods:Double-blind, randomized, placebo-controlled, split-face clinical trial. Seventy young adults with moderate acne vulgaris received 2% metronidazole gel on the right side of their face and placebo on the left side of their face twice daily for 8 weeks. The number of inflamed and noninflamed facial lesions and side effects of treatment were documented on weeks 1, 2, 4, and 8. The patients’ overall satisfaction was recorded at the end of the study. For statistical analysis we used the repeated-measures analysis, the chi-square test, Fisher's exact test, and the independent-samples t-test as appropriate.Results:Counts of inflamed and noninflamed facial lesions were comparable between the two sides at baseline. The number of the lesions was significantly lower on the metronidazole-treated side at all follow-up visits. Erythema and oily face decreased by 85.7% and 87.1%, respectively, on the metronidazole-treated side. Mild burning sensation and dryness on the metronidazole-treated side was reported by 3.4% and 22.9% of the patients, respectively. Eighty-eight percent of the patients were satisfied with the results of treatment on the metronidazole-treated side.Conclusions:Metronidazole gel (2%) is an effective, safe, and well-tolerated topical medication for moderate acne vulgaris.

Preparation and Evaluation of Topical Microemulsion System Containing Metronidazole for Remission in Rosacea

The aim of this study was to prepare a topical water-in-oil type microemulsion containing metronidazole and to compare its effectiveness with a commercial gel product in the treatment of rosacea. A pseudo-ternary phase diagram (K(m)=2:1) was constructed using lecithin/butanol/isopropyl myristate/water. The microemulsion was chosen from the microemulsion region in the phase diagram. The formulation was a water-in-oil type microemulsion (droplet size: 11.6 nm, viscosity: 457.3 mPa·s, conductivity: 1.5 µs/cm, turbidity: 6.89 NTU) and the addition of the metronidazole did not alter the properties of the system. The release experiment showed that the release rate of metronidazole from the commercial gel product was higher than that of the microemulsion. Stability experiments showed that the metronidazole microemulsion remained stable for at least 6 months; none of the characteristic properties of the microemulsion had changed, the system retained its clarity and there was no sign that crystallization of metronidazole has occurred. Microemulsion was compared to a gel product in a randomized, double-blind, baseline-controlled, split-face clinical trial for the treatment of patients. After the 6-week treatment period there was a statistically significant difference in reduction of the main symptoms of rosacea. Of the patients treated with the microemulsion, 17% experienced complete relief from inflammatory lesions, and 50% from erythema. The microemulsion resulted in complete relief in 38% of the patients with telangiectasia while the commercial product did not provide any relief of telangiectasia symptoms. In conclusion, the microemulsion containing metronidazole was found to be more effective in reducing the symptoms of rosacea compared to the commercial gel product.

Intense Pulsed Light and Red Light Photo Rejuvenation for Skin Rejuvenation: A Split Face Clinical Trial

Introduction: Intense pulsed light (IPL) has long been used for skin rejuvenation. Photo rejuvenation with red light (with or without photo sensitizer) is a newer noninvasive way for this purpose; but, until now few comparative studies between these modalities have been performed. The aim of this study was to compare efficacy, adverse effects, and compliance of intense pulsed light rejuvenation and red light photo rejuvenation in a homogeneous group of women. Methods: In this clinical trial, ten female volunteers with Fitzpatrick skin types I, II, and III were enrolled. Patients underwent 6 sessions of IPL rejuvenation at 4-week intervals on one side, and 30 photo rejuvenation sessions (twice a week) with red light on the other side of their face. Improvement of the skin texture and reduction in the wrinkles were determined in two ways. Firstly, by comparing the photographs, and secondly, by measuring the skin elasticity with Reviscometer MPA 9 system, before and after the procedure. Results: Both treatments were associated with improvement in the skin texture and wrinkle depth, but red light was more effective on the nasolabial fold and IPL was more effective on the fine wrinkles. Conclusions: Red light photo rejuvenation without the use of photosensitizer can be a new, effective and safe procedure for rejuvenation.

Evaluation of Efficacy of Intense Pulsed Light (IPL) System in the Treatment of Facial Acne Vulgaris: Comparision of Different Pulse Durations; A Pilot Study

Background: Adequate control of acne is difficult, regardless of the various conventional modalities. Intense Pulsed Light (IPL) system is one of the emerging options that are become increasingly useful. Methods: To achieve the best IPL parameters we evaluated the efficacy and tolerability of IPL at 752-nm wavelength, 35 j/cm2 fluence, 55-ms pulse duration in comparison with 572-nm wavelength, 35 j/cm2 fluence, 101-ms pulse duration, in a 5 week, controlled, double-blind, split-face clinical trial. Final assessment was made by comparison of the changes in inflammatory and non-inflammatory acne lesions count and the Acne Global Severity Scale (AGSS) between two groups, based on standardized photography. Result: Fifteen female patients, with mean age of 23.53±2.47 years (range 20-28) completed the 5-week therapy period. For both therapies, significant reductions (approximately 30%) in the comedone and inflammatory lesions count were observed (p=0.0024). There was no significant difference in the efficacy of the two treatments in reducing the percentage of comedone and inflammatory lesions count from baseline to 5th week (p=0.76 and p=0.61, respectively). Based on acne global severity scale (AGSS), no significant difference in the severity of acne lesions of the two treatments was observed at 5th-week visit (p=0.26). Conclusion: Considering the lack of significant difference between the two tratments and since greater risks are associated with lower pulse duration, the use of longer pulse durations is recommended, especially in darker skin phenotype. Further studies with larger number of patients are required to fully comparison of efficacy of these parameters in IPL systems for acne vulgaris.

Pimecrolimus 1% cream for the treatment of steroid-induced rosacea: an 8-week split-face clinical trial

Steroid-induced rosacea is a relatively common dermatosis that is caused by the prolonged application of topical steroid to the face. The purpose of this investigator-blind, split-face study was to evaluate the efficacy and safety of pimecrolimus 1% cream for the treatment of steroid-induced rosacea. Patients were instructed to apply pimecrolimus 1% cream twice daily to the involved areas of a randomly allocated half side for the first 2 weeks, and to follow this by applying pimecrolimus 1% cream to both sides for a further 6 weeks. Fifteen of the 18 patients completed the 8-week study. After 1 week of application, a statistically significant improvement was observed for investigator's global assessments of erythema and papules on prior-treated sides (P-side). Later-treated sides (L-side) showed subsequent improvement after use of pimecrolimus on the L-side. Likewise, a statistically significant improvement was also observed for numbers of papules/pustules on P-sides after 1 week, and L-sides showed a significant improvement after application of pimecrolimus on the L-side. Comparative reflectance colorimetric assessments revealed that DeltaL*, Deltaa* and Deltab* tended to converge to zero during the first 4 weeks. A statistically significant improvement was observed for percentage area affected on P-sides after 1 week of application. The L-side showed a significant improvement after use of pimecrolimus cream on that side. The visual analogue scale of P-sides decreased more rapidly than those of L-sides. Cutaneous side-effects were mild and transient. This study suggests that pimecrolimus 1% cream is an effective and well-tolerated treatment for steroid-induced rosacea.

Single-Center, Prospective, Randomized, Phase 4 Clinical Trial to Determine the Effects of Single-Pass 560-nm Filter Intense Pulsed Light with or without an Additional Pass with a 755-nm Filter for the Reduction of Facial Rhytides

Objective: To investigate the clinical efficacy of the addition of a triple pulsed, 755-nm filtered flashlamp intense pulsed light to a single-pass 560-nm filter for the treatment of facial rhytids and other aspects of photodamage. Design: A single-center, prospective, randomized, phase 4 split-face clinical trial. Methods: Twenty female volunteers with Fitzpatrick skin type I–IV with a Rao-Goldman wrinkle score of 2 or higher received 2 split-face treatments 4 weeks apart, in which half of the face was treated with 1 pass of a double-pulsed 560-nm filter and the other half was treated with a double-pulsed 560-nm filter followed by a triple-pulsed 755-nm filtered nonablative intense pulsed light. Fluence varied from 15–19 J/cm2. Efficacy was evaluated by patient self-assessments and by blinded clinical and photographic evaluations 1 month after the final treatment. Adverse effects were assessed clinically. Results: All patients noted improvement in pigmentation on both sides of the face, and 60% of patients noted an improvement in skin texture on the side that received the 755-nm filter; however, there was no discernable difference in rhytid reduction between the 560 + 755 filtered side compared with the 560 filtered side alone. Discussion: Two split-face intense pulsed light treatments delivered 4 weeks apart with half of the face receiving double-pulsed 560 filter treatment and the other half receiving a double-pulsed 560 filter + triple-pulsed 755 filter treatment showed no improvement in rhytid reduction. There was a subjective improvement in texture and pore size noted by patients on the side treated with the 560 + 755-nm filtered intense pulsed light treatment.

A randomized, controlled, split-face clinical trial of 1320-nm Nd:YAG laser therapy in the treatment of acne vulgaris

There is a need for additional effective treatments for acne vulgaris. Laser therapy has been explored as a therapeutic option for acne, but rigorously designed studies in this area have been limited. We sought to examine the efficacy of an infrared laser in the treatment of acne. We conducted a randomized, controlled, single-blind, split-face clinical trial of 46 patients with facial acne. Patients received a series of 3 nonablative laser treatments using a novel neodymium:yttrium-aluminum-garnet (Nd:YAG) laser to half of the face. Serial blinded lesion counts and global acne severity rating of standardized bilateral patient photographs were performed. Sebum production was measured, and patient self-assessment surveys were administered. A transient but statistically significant improvement in lesion counts of open comedones was demonstrated in treated skin as compared with untreated skin. There were no significant differences between treated and control sides of the face in terms of changes in mean papule or pustule counts. Grading of serial photographs revealed no significant differences between treated and untreated skin. Patient surveys indicated that the majority of patients found the treatments to be at least mildly effective for both acne and oiliness. The current study only addresses the efficacy of a single laser system employing a specific treatment regimen. Infrared laser therapy may improve comedonal acne. Additional work is needed to better define the degree and duration of the effect. Patients appear to positively view such therapy for both acne and oily skin.

Laser Treatment of Acne: Still Waiting

Results of several uncontrolled trials suggest that various lasers and light sources improve acne. Unfortunately, the placebo effect is strong in acne treatment, making controlled studies essential. In this randomized, controlled, split-face clinical trial, 46 patients underwent three treatments, 3 weeks apart, to half the face with a near-infrared laser (CoolTouch II; 1320-nm wavelength). The entire face was pretreated with lidocaine 4% topical anesthetic cream. Participants stopped all acne therapy for 1 month before treatment. Patients were examined at 7 and 14 …