Highlights from

AAD 2021

American Academy of Dermatology Virtual Meeting Experience 2021

Virtual 23-25 April 2021

Light-based therapies as secondary option for acne

Summary: Currently, no evidence is available stating that light-based treatments are better than conventional therapy such as antibiotics for the treatment of acne. Although it is not useful as primary treatment yet, light-based therapy may be useful as adjuvant therapy.

Acne is the most common condition in dermatology, affecting up to 50 million Americans annually. In 2013, more than 5.1 million people sought treatment for acne. Dr Kachiua Lee Main (Line Center for Laser Surgery, US) summarised the light-based options for treatment of mild-to-moderate acne vulgaris.1 Several light-based options have been on the market for a few decades and many new ones are on the horizon.

Results on light-based therapies are controversial: some studies have shown improvement in acne while others have shown no difference. The efficacy for laser treatment with 5-aminolevulinic acid (ALA) and methyl 5-aminolevulinate (MAL) has been demonstrated previously. ALA is used in the US and has blue light with a wavelength of 420 nm, whereas MAL is used in Europe and has a 630 nm wavelength.

What treatments are on the horizon for acne? Cryolipolysis is a method in which fat cells are frozen. Fat is sensitive to temperature, especially cold, changes. After cooling for 20 minutes, histological changes are already observed. In addition to breaking down fat cells, sebum production decreases after treatment. The technology is still under development and has not been commercialised yet. In addition to cryolipolysis, selective photothermolysis has been a topic of research. This therapy targets a specific area in the skin with minimal or no disruption of surrounding normal skin. It uses two wavelengths of 210 and 726 nm. The challenge lies in targeting chromophore as the absorption by lipids is only about 30% higher than that of water. It is encouraging that sebaceous glands have ranging depths from approximately 500 nm to 2 mm below the skin, which is surficial enough for lasers to target. As a third development, there is a device on the market that utilises gold nanoparticles. These nanoparticles are delivered into sebaceous glands and then targeted with a laser, resulting in a clear reduction of acne.

In conclusion, there has not been enough evidence yet to use light-based treatment of acne as primary therapy. In the meantime, while more research is being done, it can be helpful as an addition to traditional therapy.

  1. Lee K. Laser- and light-based treatments for acne. Session F002: Acne and rosacea - new developments. AAD VMX 2021, 23-25 April 2021.

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