Combined 400-600nm and 800-1200nm Intense Pulsed Phototherapy of Facial Acne Vulgaris

Background and Objective: Laser and light-based therapies are relatively new treatment options for acne vulgaris patients. Intense pulsed light (IPL) is believed to exploit the photosensitivity of P. acnes residing in the pilosebaceous units at lower wavelengths and induce anti-inflammatory effects by influencing cytokine release at higher wavelengths. Our study aimed to assess the clinical safety and efficacy of a novel dual-band "notch" acne filter (400-600nm and 800-1200nm) in improving inflammatory and non-inflammatory lesions in patients presenting with mild-to-moderate acne. Materials and Methods: The study was designed as a single-site, prospective study of 10 patients with Fitzpatrick skin types II-V presenting with mild to moderate inflammatory facial acne vulgaris. A total of five whole-face light treatments were conducted at 1-2-week intervals with an IPL system (Lumenis M22 System, Lumenis Ltd.) equipped with a dual-band "notch" acne filter (400-600nm and 800-1200nm). Follow-up visits were performed at 1 and 4 weeks following the last treatment session. Acne mean change from baseline was assessed using the 4-point Investigator Global Assessment (IGA) scale. Comprehensive facial photographs were taken, and lesions were counted at screening, treatment 4, and both 1- and 4-week follow-up visits. The investigator and the patients assessed overall improvements in appearance, using the 5-point Likert scale. Subjects also completed the Cardiff Acne Disability Index (CADI) questionnaire and rated their satisfaction from treatment. Subject-reported pain, using the visual analog scale (VAS), and downtime were also recorded. Results: Treatment impact on overall lesion clearance was most substantial at 4 weeks follow-up, at which 50% of patients showed at least a 50% reduction from baseline of lesion counts (P<0.0001). IGA scores improved throughout the course of the study, and significant improvements in the overall skin condition was noted, with mean 1.63-point and 1.50-point increases from baseline in the acne improvement ratings, at 1- and 4-weeks follow-up, respectively (P=0.0074, 0.0063). Patient-assessed CADI improved throughout the treatment and follow-up visits, peaking at a 3.22-point and 4.9-point average reductions from baseline at 1-week follow-up (P=0.0001) and 1-month follow-up (P<0.0001), respectively. The majority of the patients (80%) rated their acne lesions as improved, much improved, or very much improved at 4-weeks follow-up (P=0.0004). Significant enhancements were also noted for skin texture. Eighty percent of the patients reported overall satisfaction with treatment outcomes, while 60% rated their satisfaction as "good" or "very good" at 4-weeks follow-up (P<0.0001). Treatments were well tolerated, with mean per-session VAS scores being ≤3.77, while the mean downtime was negligible (a few hours). Conclusion: The use of an IPL device equipped with a proprietary "notch" acne filter elicited a significant effect on acne vulgaris. No severe pain, erythema, edema, folliculitis, crusting or exfoliation was noted, emphasizing the safety of our technique. J Drugs Dermatol. 2019;18(11):1116-1122.

Sequential facial skin rejuvenation with intense pulsed light and non-ablative fractionated laser resurfacing in fitzpatrick skin type II-IV patients: A prospective multicenter analysis.

BACKGROUND: While skin aging is triggered by multiple factors and typically presents with multiple manifestations, conventional treatment regimens deploy a single treatment modality. Typical approaches exploit ablative techniques, which involve considerable patient discomfort and downtime and can induce adverse events. Non-ablative fractionated laser (NAFL) resurfacing promotes neocollagenesis, with significantly fewer complications and discomfort. At the same time, intense pulsed light (IPL) therapies have a marked impact on skin tone, with an effect on collagen deposition. This study evaluated the combined effect of same-day, sequential IPL-NAFL treatment on photoaging of the face. DESIGN: In this prospective study, 30 patients presenting Fitzpatrick skin types II-IV, elastosis scores 3-6 and mild to moderate pigmentation, underwent three sessions, of full-face IPL therapy, followed immediately by NAFL treatment, conducted at 4-6 weeks intervals. Wrinkle/elastosis and skin qualities were scored at 1, 3, and 6 months after the last treatment session. Immediate responses were evaluated up to 30 min following treatment and adverse events were monitored throughout the study period. RESULTS: Wrinkle/elastosis scores gradually improved over the treatment period, with 59% of patients presenting a ≥1-point improvement in FES scores by the 1-month follow-up session, which persisted also at the 6 months follow-up visit. Good to excellent pigmentation responses were recorded for ≥63% and improvements in texture, brightness, and tightness were recorded for ≥80% of patients throughout the follow-up period. Over 90% of the treated patients exhibited improved or much improved overall appearance. Patient scorings and satisfaction level reflected physician assessments. Treatments were well tolerated and the social downtime observed was of 1.5 ± 0.25 days. CONCLUSION: The same-day combined IPL-NAFL regimen proved safe and elicited a significant skin rejuvenating effect, in a similar manner to that shown in other same-day combined therapies, without prolonging downtime of each individual modality. Lasers Surg. Med. 51:141-149, 2019. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Awareness of the risks of tanning lamps does not influence behavior among college students.

HYPOTHESIS: Awareness of the risks of artificial tanning influences tanning behavior among college students. OBJECTIVE: To correlate the prevalence of tanning lamp use, the perceived benefits and risks associated with UV exposure, and knowledge about skin cancer among university students. DESIGN: A survey was designed and administered to college students seeking "walk-in" care at a university student health center from September 7, 1999, through September 30, 1999. SETTING: A large midwestern public university student health center. PARTICIPANTS: Undergraduate and graduate students attending the student health center for any medical condition. INTERVENTION: None. MAIN OUTCOME MEASURE: Completion of the survey. RESULTS: Of the surveyed students, 47% had used a tanning lamp during the preceding 12 months. Female students were more common users than male students. Of the students surveyed, 39% reported never having used tanning lamps. More than 90% of users of tanning lamps were aware that premature aging and skin cancer were possible complications of tanning lamp use. CONCLUSIONS: Despite adequate knowledge of the adverse effects of UV exposure, university students freely and frequently use tanning lamps, primarily for desired cosmetic appearance. To alter this risky behavior will require a fundamental change in the societal belief that tans are attractive and healthy.