What is the role of laser and light therapy in the treatment of acne vulgaris?

Updated: Mar 26, 2019
  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: William D James, MD  more...
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Answer

Of all forms of laser and light therapy, the most evidence is with photodynamic therapy (PDT) in treating acne. [33] PDT involves a photosensitizer applied to the skin, time allowed for it to be absorbed by the pilosebaceous units, and then application of a light source to activate the photosensitizer, generating reactive oxygen species to damage the glands and reduce Cutibacterium acnes (formerly Propionibacterium acnes). A 2016 Cochrane review was unable to draw firm conclusions regarding the benefit of light therapy in acne, owing to the variation in wavelength, dose, photosensitizer, comparator interventions, and treatment frequency that were studied. [68] However, despite the interstudy variation, many individual trials show PDT to be effective in reducing lesions in mild-to-severe acne, with 5-aminolevulinic acid and methyl aminolevulinate photosensitizers and red light source as promising treatment components. [69, 70]

There is also a growing body of evidence for laser treatment of acne, standalone or in the context of PDT. However, similar to light therapy, the power and quality of research is limited by small patient numbers, lack of a control population, and comparison to standard therapies. Nonetheless, preliminary studies have shown improvement in acne, and even potential long-lasting effects with the 1550-nm erbium-glass laser, 1064-nm Nd:YAG laser, and PDT with laser. [71]


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