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Published in: Dermatology and Therapy 5/2022

Open Access 01-05-2022 | Intense Pulsed Light | Original Research

Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients

Authors: Xianglei Wu, Xue Wang, Xiujuan Wu, Qingqing Cen, Wenjing Xi, Ying Shang, Zhen Zhang, Xiaoxi Lin

Published in: Dermatology and Therapy | Issue 5/2022

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Abstract

Introduction

Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH.

Methods

This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4–6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections.

Results

On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up.

Conclusion

IPL is an effective and safe treatment for acne-related PIE and PIH.
Literature
1.
go back to reference Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002;138(12):1584–90.CrossRef Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002;138(12):1584–90.CrossRef
2.
go back to reference Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Manolache L, Tzellos T, et al. Quality of life measurement in acne. Position paper of the European Academy of Dermatology and Venereology Task Forces on quality of life and patient oriented outcomes and acne, rosacea and hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2018;32(2):194–208.CrossRef Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Manolache L, Tzellos T, et al. Quality of life measurement in acne. Position paper of the European Academy of Dermatology and Venereology Task Forces on quality of life and patient oriented outcomes and acne, rosacea and hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2018;32(2):194–208.CrossRef
3.
go back to reference Hosthota A, Bondade S, Basavaraja V. Impact of acne vulgaris on quality of life and self-esteem. Cutis. 2016;98(2):121–4.PubMed Hosthota A, Bondade S, Basavaraja V. Impact of acne vulgaris on quality of life and self-esteem. Cutis. 2016;98(2):121–4.PubMed
4.
go back to reference Davern J, O’Donnell AT. Stigma predicts health-related quality of life impairment, psychological distress, and somatic symptoms in acne sufferers. PLoS ONE. 2018;13(9):e0205009.CrossRef Davern J, O’Donnell AT. Stigma predicts health-related quality of life impairment, psychological distress, and somatic symptoms in acne sufferers. PLoS ONE. 2018;13(9):e0205009.CrossRef
5.
go back to reference Yoon HJ, Lee DH, Kim SO, Park KC, Youn SW. Acne erythema improvement by long-pulsed 595-nm pulsed-dye laser treatment: a pilot study. J Dermatolog Treat. 2008;19(1):38–44.CrossRef Yoon HJ, Lee DH, Kim SO, Park KC, Youn SW. Acne erythema improvement by long-pulsed 595-nm pulsed-dye laser treatment: a pilot study. J Dermatolog Treat. 2008;19(1):38–44.CrossRef
6.
go back to reference Park KY, Ko EJ, Seo SJ, Hong CK. Comparison of fractional, nonablative, 1550-nm laser and 595-nm pulsed dye laser for the treatment of facial erythema resulting from acne: a split-face, evaluator-blinded, randomized pilot study. J Cosmet Laser Ther. 2014;16(3):120–3.CrossRef Park KY, Ko EJ, Seo SJ, Hong CK. Comparison of fractional, nonablative, 1550-nm laser and 595-nm pulsed dye laser for the treatment of facial erythema resulting from acne: a split-face, evaluator-blinded, randomized pilot study. J Cosmet Laser Ther. 2014;16(3):120–3.CrossRef
7.
go back to reference Abad-Casintahan F, Chow SK, Goh CL, Kubba R, Hayashi N, Noppakun N, et al. Frequency and characteristics of acne-related post-inflammatory hyperpigmentation. J Dermatol. 2016;43(7):826–8.CrossRef Abad-Casintahan F, Chow SK, Goh CL, Kubba R, Hayashi N, Noppakun N, et al. Frequency and characteristics of acne-related post-inflammatory hyperpigmentation. J Dermatol. 2016;43(7):826–8.CrossRef
8.
go back to reference Chen S, Wang Y, Ren J, Yue B, Lai G, Du J. Efficacy and safety of intense pulsed light in the treatment of inflammatory acne vulgaris with a novel filter. J Cosmet Laser Ther. 2019;21(6):323–7.CrossRef Chen S, Wang Y, Ren J, Yue B, Lai G, Du J. Efficacy and safety of intense pulsed light in the treatment of inflammatory acne vulgaris with a novel filter. J Cosmet Laser Ther. 2019;21(6):323–7.CrossRef
9.
go back to reference Deshpande AJ. Efficacy and safety evaluation of high-density intense pulsed light in the treatment of grades II and IV acne vulgaris as monotherapy in dark-skinned women of child bearing age. J Clin Aesthet Dermatol. 2018;11(4):43–8.PubMedPubMedCentral Deshpande AJ. Efficacy and safety evaluation of high-density intense pulsed light in the treatment of grades II and IV acne vulgaris as monotherapy in dark-skinned women of child bearing age. J Clin Aesthet Dermatol. 2018;11(4):43–8.PubMedPubMedCentral
10.
go back to reference Mokhtari F, Gholami M, Siadat AH, Jafari-Koshki T, Faghihi G, Nilforoushzadeh MA, et al. Efficacy of intense-pulsed light therapy with topical benzoyl peroxide 5% versus benzoyl peroxide 5% alone in mild-to-moderate acne vulgaris: a randomized controlled trial. J Res Pharm Pract. 2017;6(4):199–205.CrossRef Mokhtari F, Gholami M, Siadat AH, Jafari-Koshki T, Faghihi G, Nilforoushzadeh MA, et al. Efficacy of intense-pulsed light therapy with topical benzoyl peroxide 5% versus benzoyl peroxide 5% alone in mild-to-moderate acne vulgaris: a randomized controlled trial. J Res Pharm Pract. 2017;6(4):199–205.CrossRef
11.
go back to reference Fabi SG, Massaki A, Eimpunth S, Pogoda J, Goldman MP. Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage. J Am Acad Dermatol. 2013;69(6):965–71.CrossRef Fabi SG, Massaki A, Eimpunth S, Pogoda J, Goldman MP. Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage. J Am Acad Dermatol. 2013;69(6):965–71.CrossRef
12.
go back to reference Walker N, Lewis-Jones MS. Quality of life and acne in Scottish adolescent schoolchildren: use of the Children’s Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). J Eur Acad Dermatol Venereol. 2006;20(1):45–50.CrossRef Walker N, Lewis-Jones MS. Quality of life and acne in Scottish adolescent schoolchildren: use of the Children’s Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). J Eur Acad Dermatol Venereol. 2006;20(1):45–50.CrossRef
13.
go back to reference Karsai S, Schmitt L, Raulin C. The pulsed-dye laser as an adjuvant treatment modality in acne vulgaris: a randomized controlled single-blinded trial. Br J Dermatol. 2010;163(2):395–401.CrossRef Karsai S, Schmitt L, Raulin C. The pulsed-dye laser as an adjuvant treatment modality in acne vulgaris: a randomized controlled single-blinded trial. Br J Dermatol. 2010;163(2):395–401.CrossRef
14.
go back to reference Cuerda-Galindo E, Díaz-Gil G, Palomar-Gallego MA, Linares-GarcíaValdecasas R. Intense pulsed light induces synthesis of dermal extracellular proteins in vitro. Lasers Med Sci. 2015;30(7):1931–9.CrossRef Cuerda-Galindo E, Díaz-Gil G, Palomar-Gallego MA, Linares-GarcíaValdecasas R. Intense pulsed light induces synthesis of dermal extracellular proteins in vitro. Lasers Med Sci. 2015;30(7):1931–9.CrossRef
15.
go back to reference Faucz LL, Will SE, Rodrigues CJ, Hesse H, Moraes AC, Maria DA. Quantitative evaluation of collagen and elastic fibers after intense pulsed light treatment of mouse skin. Lasers Surg Med. 2018;50:644–50.CrossRef Faucz LL, Will SE, Rodrigues CJ, Hesse H, Moraes AC, Maria DA. Quantitative evaluation of collagen and elastic fibers after intense pulsed light treatment of mouse skin. Lasers Surg Med. 2018;50:644–50.CrossRef
16.
go back to reference Harper JC. An update on the pathogenesis and management of acne vulgaris. J Am Acad Dermatol. 2004;51(1 Suppl):S36–8.CrossRef Harper JC. An update on the pathogenesis and management of acne vulgaris. J Am Acad Dermatol. 2004;51(1 Suppl):S36–8.CrossRef
17.
go back to reference Lekwuttikarn R, Tempark T, Chatproedprai S, Wananukul S. Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood. Int J Dermatol. 2017;56(8):884–8.CrossRef Lekwuttikarn R, Tempark T, Chatproedprai S, Wananukul S. Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood. Int J Dermatol. 2017;56(8):884–8.CrossRef
18.
go back to reference Min S, Park SY, Yoon JY, Kwon HH, Suh DH. Fractional microneedling radiofrequency treatment for acne-related post-inflammatory erythema. Acta Derm Venereol. 2016;96(1):87–91.CrossRef Min S, Park SY, Yoon JY, Kwon HH, Suh DH. Fractional microneedling radiofrequency treatment for acne-related post-inflammatory erythema. Acta Derm Venereol. 2016;96(1):87–91.CrossRef
19.
go back to reference Lee SJ, Goo JW, Shin J, Chung WS, Kang JM, Kim YK, et al. Use of fractionated microneedle radiofrequency for the treatment of inflammatory acne vulgaris in 18 Korean patients. Dermatol Surg. 2012;38(3):400–5.CrossRef Lee SJ, Goo JW, Shin J, Chung WS, Kang JM, Kim YK, et al. Use of fractionated microneedle radiofrequency for the treatment of inflammatory acne vulgaris in 18 Korean patients. Dermatol Surg. 2012;38(3):400–5.CrossRef
20.
go back to reference Mathew ML, Karthik R, Mallikarjun M, Bhute S, Varghese A. Intense pulsed light therapy for acne-induced post-inflammatory erythema. Indian Dermatol Online J. 2018;9(3):159–64.CrossRef Mathew ML, Karthik R, Mallikarjun M, Bhute S, Varghese A. Intense pulsed light therapy for acne-induced post-inflammatory erythema. Indian Dermatol Online J. 2018;9(3):159–64.CrossRef
21.
go back to reference Isedeh P, Kohli I, Al-Jamal M, Agbai ON, Chaffins M, Devpura S, et al. An in vivo model for postinflammatory hyperpigmentation: an analysis of histological, spectroscopic, colorimetric and clinical traits. Br J Dermatol. 2016;174(4):862–8.CrossRef Isedeh P, Kohli I, Al-Jamal M, Agbai ON, Chaffins M, Devpura S, et al. An in vivo model for postinflammatory hyperpigmentation: an analysis of histological, spectroscopic, colorimetric and clinical traits. Br J Dermatol. 2016;174(4):862–8.CrossRef
22.
go back to reference Silpa-Archa N, Kohli I, Chaowattanapanit S, Lim HW, Hamzavi I. Postinflammatory hyperpigmentation: a comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. J Am Acad Dermatol. 2017;77(4):591–605.CrossRef Silpa-Archa N, Kohli I, Chaowattanapanit S, Lim HW, Hamzavi I. Postinflammatory hyperpigmentation: a comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. J Am Acad Dermatol. 2017;77(4):591–605.CrossRef
23.
go back to reference Elbuluk N, Grimes P, Chien A, Hamzavi I, Alexis A, Taylor S, et al. The pathogenesis and management of acne-induced post-inflammatory hyperpigmentation. Am J Clin Dermatol. 2021;22(6):829–36.CrossRef Elbuluk N, Grimes P, Chien A, Hamzavi I, Alexis A, Taylor S, et al. The pathogenesis and management of acne-induced post-inflammatory hyperpigmentation. Am J Clin Dermatol. 2021;22(6):829–36.CrossRef
24.
go back to reference Wang RF, Ko D, Friedman BJ, Lim HW, Mohammad TF. Disorders of Hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J Am Acad Dermatol. 2022;2(10):S0190-9622(22)00251-1. Wang RF, Ko D, Friedman BJ, Lim HW, Mohammad TF. Disorders of Hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J Am Acad Dermatol. 2022;2(10):S0190-9622(22)00251-1.
25.
go back to reference Alexis AF. Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI. Br J Dermatol. 2013;169(Suppl 3):91–7.CrossRef Alexis AF. Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI. Br J Dermatol. 2013;169(Suppl 3):91–7.CrossRef
26.
go back to reference Bae YC, Rettig S, Weiss E, Bernstein L, Geronemus R. Treatment of post-inflammatory hyperpigmentation in patients with darker skin types using a low energy 1927 nm non-ablative fractional laser: a retrospective photographic review analysis. Lasers Surg Med. 2020;52(1):7–12.CrossRef Bae YC, Rettig S, Weiss E, Bernstein L, Geronemus R. Treatment of post-inflammatory hyperpigmentation in patients with darker skin types using a low energy 1927 nm non-ablative fractional laser: a retrospective photographic review analysis. Lasers Surg Med. 2020;52(1):7–12.CrossRef
27.
go back to reference Siadat AH, Iraji F, Bahrami R, Nilfroushzadeh MA, Asilian A, Shariat S, et al. The comparison between modified Kligman formulation versus Kligman formulation and intense pulsed light in the treatment of the post-burn hyperpigmentation. Adv Biomed Res. 2016;5:125.CrossRef Siadat AH, Iraji F, Bahrami R, Nilfroushzadeh MA, Asilian A, Shariat S, et al. The comparison between modified Kligman formulation versus Kligman formulation and intense pulsed light in the treatment of the post-burn hyperpigmentation. Adv Biomed Res. 2016;5:125.CrossRef
28.
go back to reference Li N, Han J, Hu D, Cheng J, Wang H, Wang Y, et al. Intense pulsed light is effective in treating postburn hyperpigmentation and telangiectasia in Chinese patients. J Cosmet Laser Ther. 2018;20(7–8):436–41.CrossRef Li N, Han J, Hu D, Cheng J, Wang H, Wang Y, et al. Intense pulsed light is effective in treating postburn hyperpigmentation and telangiectasia in Chinese patients. J Cosmet Laser Ther. 2018;20(7–8):436–41.CrossRef
29.
go back to reference Negishi K, Wakamatsu S, Kushikata N, Tezuka Y, Kotani Y, Shiba K. Full-face photorejuvenation of photodamaged skin by intense pulsed light with integrated contact cooling: initial experiences in Asian patients. Lasers Surg Med. 2002;30(4):298–305.CrossRef Negishi K, Wakamatsu S, Kushikata N, Tezuka Y, Kotani Y, Shiba K. Full-face photorejuvenation of photodamaged skin by intense pulsed light with integrated contact cooling: initial experiences in Asian patients. Lasers Surg Med. 2002;30(4):298–305.CrossRef
30.
go back to reference Kawada A, Shiraishi H, Asai M, Kameyama H, Sangen Y, Aragane Y, et al. Clinical improvement of solar lentigines and ephelides with an intense pulsed light source. Dermatol Surg. 2002;28(6):504–8.PubMed Kawada A, Shiraishi H, Asai M, Kameyama H, Sangen Y, Aragane Y, et al. Clinical improvement of solar lentigines and ephelides with an intense pulsed light source. Dermatol Surg. 2002;28(6):504–8.PubMed
31.
go back to reference Hamilton FL, Car J, Lyons C, Car M, Layton A, Majeed A. Laser and other light therapies for the treatment of acne vulgaris: systematic review. Br J Dermatol. 2009;160(6):1273–85.CrossRef Hamilton FL, Car J, Lyons C, Car M, Layton A, Majeed A. Laser and other light therapies for the treatment of acne vulgaris: systematic review. Br J Dermatol. 2009;160(6):1273–85.CrossRef
32.
go back to reference Bakus AD, Yaghmai D, Massa MC, Garden BC, Garden JM. Sustained benefit after treatment of acne vulgaris using only a novel combination of long-pulsed and Q-switched 1064-nm Nd: YAG lasers. Dermatol Surg. 2018;44(11):1402–10.CrossRef Bakus AD, Yaghmai D, Massa MC, Garden BC, Garden JM. Sustained benefit after treatment of acne vulgaris using only a novel combination of long-pulsed and Q-switched 1064-nm Nd: YAG lasers. Dermatol Surg. 2018;44(11):1402–10.CrossRef
33.
go back to reference Shahidullah M, Tham SN, Goh CL. Isotretinoin therapy in acne vulgaris: a 10-year retrospective study in Singapore. Int J Dermatol. 1994;33(1):60–3.CrossRef Shahidullah M, Tham SN, Goh CL. Isotretinoin therapy in acne vulgaris: a 10-year retrospective study in Singapore. Int J Dermatol. 1994;33(1):60–3.CrossRef
Metadata
Title
Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients
Authors
Xianglei Wu
Xue Wang
Xiujuan Wu
Qingqing Cen
Wenjing Xi
Ying Shang
Zhen Zhang
Xiaoxi Lin
Publication date
01-05-2022
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 5/2022
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-022-00719-9

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