Top

American Journal of Clinical Dermatology

Published in:

01-08-2004 | Current Opinion

Phototherapy in the Treatment of Acne Vulgaris

What is its Role?

Authors: Dr Aikaterini Charakida, Edward D. Seaton, Marietta Charakida, Paul Mouser, Antonias Avgerinos, Antony C. Chu

Published in: American Journal of Clinical Dermatology | Issue 4/2004

Abstract

Acne vulgaris is a common dermatosis affecting 80% of the population. To date, different treatments have been used to manage this condition. Antibacterials and retinoids are currently the mainstay of treatment for acne, but their success rate varies. Phototherapy is emerging as an alternative option to treat acne vulgaris.

Studies examining the role of different wavelengths and methods of light treatment have shown that phototherapy with visible light, specifically blue light, has a marked effect on inflammatory acne lesions and seems sufficient for the treatment of acne. In addition, the combination of blue-red light radiation seems to be superior to blue light alone, with minimal adverse effects. Photodynamic therapy has also been used, even in nodular and cystic acne, and had excellent therapeutic outcomes, although with significant adverse effects. Recently, low energy pulsed dye laser therapy has been used, and seems to be a promising alternative that would allow the simultaneous treatment of active acne and acne scarring.

Further studies are needed to clarify the role of phototherapy as a monotherapy or an adjuvant treatment in the current management of acne vulgaris.

Jowett S, Ryan T. Skin disease and handicap: an analysis of the impact of skin conditions. Soc Sci Med 1985; 20 (4): 425–9PubMedCrossRef

Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol 1998; 139 (5): 846–50PubMedCrossRef

Cotterill JA, Cunliffe WJ. Suicide in dermatological patients. Br J Dermatol 1997; 137 (2): 246–50PubMedCrossRef

Norris JF, Cunliffe WJ. A histological and immunocytochemical study of early acne lesions. Br J Dermatol 1988; 118 (5): 651–9PubMedCrossRef

Mouser PE, Baker BS, Seaton ED, et al. Propionibacterium acnes reactive T-cell lines established from early inflamed acne lesions [abstract]. J Invest Dermatol 2001; 117: 803

Leyden JJ, McGinley KJ, Mills OH, et al. Propionibacterium levels in patients with and without acne vulgaris. J Invest Dermatol 1975; 65 (4): 382–4PubMedCrossRef

Melo TB. Uptake of protoporphyrin and violet light photodestruction of Propionibacterium acnes. Z Naturforsch [C] 1987; 42 (1–2): 123–8

Lee WL, Shalita AR, Poh-Fitzpatrick MB. Comparative studies of porphyrin production in Propionibacterium acnes and Propionibacterium granulosum. J Bacteriol 1978; 133 (2): 811–5PubMed

Kjeldstad B, Johnsson A. An action spectrum for blue and near UV inactivation of Propionibacterium acnes; with emphasis on a possible porphyrin photosensitization. Photochem Photobiol 1986; 43 (1): 67–70PubMedCrossRef

10.

Byrne PA, Williams BD, Pritchard MH. Minocycline-related lupus. Br J Rheumatol 1994; 33 (7): 674–6PubMedCrossRef

11.

Gough A, Chapman S, Wagstaff K, et al. Minocycline induced autoimmune hepatitis and systemic lupus erythematosus-like syndrome. BMJ 1996; 312 (7024): 169–72PubMedCrossRef

12.

Ortonne JP. Oral isotretinoin treatment policy: do we all agree? Dermatol 1997; 195 Suppl. 1: 34–7CrossRef

13.

Stern RS. When a uniquely effective drug is teratogenic: the case of isotretinoin. N Engl J Med 1989; 320 (15): 1007–9PubMedCrossRef

14.

Griffin JP. A review of the literature on benign intracranial hypertension associated with medication. Adverse Drug React Toxicol Rev 1992; 11 (1): 41–57PubMed

15.

Eady EA, Jones CE, Tipper JL, et al. Antibiotic resistant propionibacteria in acne: need for policies to modify antibiotic usage. BMJ 1993; 306 (6877): 555–6PubMedCrossRef

16.

Eady EA. Bacterial resistance in acne. Dermatology 1998; 196 (1): 59–66PubMedCrossRef

17.

Cooper AJ. Systematic review of Propionibacterium acnes resistance to systemic antibiotics. Med J Aust 1998; 169 (5): 259–61PubMed

18.

Coates P, Vyakrnam S, Eady EA, et al. Prevalence of antibiotic-resistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study. Br J Dermatol 2002; 146 (5): 840–8PubMedCrossRef

19.

Cunliffe WJ. Acne. London: Dunitz, 1989CrossRef

20.

Cunliffe WJ, Goulden V. Phototherapy and acne vulgaris. Br J Dermatol 2000; 142 (5): 855–6PubMedCrossRef

21.

McGinley KJ, Webster GF, Leyden JJ. Facial follicular porphyrin fluorescence: correlation with age and density of Propionibacterium acnes. Br J Dermatol 1980; 102 (4): 437–41PubMedCrossRef

22.

Mills OH, Porte M, Kligman AM. Enhancement of comedogenic substances by UV radiation. Br J Dermatol 1978; 98 (2): 145–50PubMedCrossRef

23.

Sigurdsson V, Knulst AC, van Weelden H. Phototherapy of acne vulgaris with visible light. Dermatology 1997; 194 (3): 256–60PubMedCrossRef

24.

Suh DH, Kwon TE, Youn JI. Changes of comedonal cytokines and sebum secretion after UV irradiation in acne patients. Eur J Dermatol 2002; 12 (2): 139–44PubMed

25.

Mills OH, Kligman AM. UV phototherapy and photochemotherapy of acne vulgaris. Arch Dermatol 1978; 114 (2): 221–3PubMedCrossRef

26.

Lassus A, Salo O, Forstrom L, et al. Treatment of acne with selective UV-phototherapy (SUP): an open trial. Dermatol Monatsschr 1983; 169 (6): 376–9PubMed

27.

Meffert H, Kolzsch J, Laubstein B, et al. Phototherapy of acne vulgaris with the ‘TuR’ UV 10 body section irradiation unit. Dermatol Monatsschr 1986; 172 (1): 9–13PubMed

28.

Meffert H, Laubstein B, Kolzsch J, et al. Phototherapy of acne vulgaris with the UVA irradiation instrument TBG 400. Dermatol Monatsschr 1986; 172 (2): 105–6PubMed

29.

Van Weelden H, de Gruijl FR, van der Putte SC, et al. The carcinogenic risks of modern tanning equipment: is UV-A safer than UV-B? Arch Dermatol Res 1988; 280 (5): 300–7PubMedCrossRef

30.

Arakane K, Ryu A, Hayashi C, et al. Singlet oxygen (1 delta g) generation from coproporphyrin in Propionibacterium acnes on irradiation. Biochem Biophys Res Commun 1996; 223 (3): 578–82PubMedCrossRef

31.

Futsaether CM, Kjeldstad B, Johnsson A. Intracellular pH changes induced in Propionibacterium acnes by UVA radiation and blue light. J Photochem Photobiol B 1995; 31 (3): 125–31PubMedCrossRef

32.

Meffert H, Scherf HP, Sonnichsen N. Treatment of acne vulgaris with visible light. Dermatol Monatsschr 1987; 173 (11): 678–9PubMed

33.

Meffert H, Gaunitz K, Gutewort T, et al. Therapy of acne with visible light: decreased irradiation time by using a blue-light high-energy lamp. Dermatol Monatsschr 1990; 176 (10): 597–603PubMed

34.

Scherf HP, Meffert H, Biella U, et al. Aknetherapie mit sichtbarem Licht:Ein kontrollierter Vergleich gegenuber der Wirkung von Infrarotbestrahlungen. Dtsch Dermatol 1988; 36: 1281–7

35.

Kawada A, Aragane Y, Kameyama H, et al. Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation. J Dermatol Sci 2002; 30 (2): 129–35PubMedCrossRef

36.

Young S, Bolton P, Dyson M, et al. Macrophage responsiveness to light therapy. Lasers Surg Med 1989; 9 (5): 497–505PubMedCrossRef

37.

Mester E, Mester AF, Mester A. The biomedical effects of laser application. Lasers Surg Med 1985; 5 (1): 31–9PubMedCrossRef

38.

Kjeldstad B. Photoinactivation of Propionibacterium acnes by near-UV light. Z Naturforsch [C] 1984; 39 (3–4): 300–2

39.

Yu W, Naim JO, Lanzafame RJ. Effects of photostimulation on wound healing in diabetic mice. Lasers Surg Med 1997; 20 (1): 56–63PubMedCrossRef

40.

Abergel RP, Lyons RF, Castel JC, et al. Biostimulation of wound healing by lasers: experimental approaches in animal models and in fibroblast cultures. J Dermatol Surg Oncol 1987; 13 (2): 127–33PubMed

41.

Breitbart H, Levinshal T, Cohen N, et al. Changes in calcium transport in mammalian sperm mitochondria and plasma membranes irradiated at 633 nm (He-Ne laser). J Photochem Photobiol B 2003; 34: 117–21CrossRef

42.

Karu TI. Photobiological fundamentals of low-power laser therapy. J Quantum Electron 1987; 10 (10): 1703–17CrossRef

43.

Papageorgiou P, Katsambas A, Chu A. Phototherapy with blue (415 nm) and red (660 nm) light in the treatment of acne vulgaris. Br J Dermatol 2000; 142 (5): 973–8PubMedCrossRef

44.

Divaris DX, Kennedy JC, Pottier RH. Phototoxic damage to sebaceous glands and hair follicles of mice after systemic administration of 5-aminolevulinic acid correlates with localized protoporphyrin IX fluorescence. Am J Pathol 1990; 136 (4): 891–7PubMed

45.

Hongcharu W, Taylor CR, Chang Y, et al. Topical ALA-photodynamic therapy for the treatment of acne vulgaris. J Invest Dermatol 2000; 115 (2): 183–92PubMedCrossRef

46.

Itoh Y, Ninomiya Y, Tajima S, et al. Photodynamic therapy for acne vulgaris with topical 5-aminolevulinic acid. Arch Dermatol 2000; 136 (9): 1093–5PubMedCrossRef

47.

Itoh Y, Ninomiya Y, Tajima S, et al. Photodynamic therapy of acne vulgaris with topical delta-aminolaevulinic acid and incoherent light in Japanese patients. Br J Dermatol 2001; 144 (3): 575–9PubMedCrossRef

48.

Ibbotson SH. Topical 5-aminolaevulinic acid photodynamic therapy for the treatment of skin conditions other than non-melanoma skin cancer. Br J Dermatol 2002; 146 (2): 178PubMedCrossRef

49.

Morton CA, Brown SB, Collins S, et al. Guidelines for topical photodynamic therapy: report of a workshop of the British Photodermatology Group. Br J Dermatol 2002; 146 (4): 552–67PubMedCrossRef

50.

Lloyd JR, Mirkov M. Selective photothermolysis of the sebaceous glands for acne treatment. Lasers Surg Med 2002; 31 (2): 115–20PubMedCrossRef

51.

Tan OT, Sherwood K, Gilchrest BA. Treatment of children with port-wine stains using the flashlamp-pulsed tunable dye laser. N Engl J Med 1989; 320 (7): 416–21PubMedCrossRef

52.

Seaton ED, Charakida A, Mouser A, et al. Pulsed-dye laser treatment for inflammatory acne vulgaris: randomised controlled trial. Lancet 2003 Oct 25; 362 (9323): 1347–52PubMedCrossRef

Title: Phototherapy in the Treatment of Acne Vulgaris
What is its Role?
Authors: Dr Aikaterini Charakida
Edward D. Seaton
Marietta Charakida
Paul Mouser
Antonias Avgerinos
Antony C. Chu
Publication date: 01-08-2004
Publisher: Springer International Publishing
Published in: American Journal of Clinical Dermatology / Issue 4/2004
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI: https://doi.org/10.2165/00128071-200405040-00001

At a glance: The STEP trials

Springer Medicine

Phototherapy in the Treatment of Acne Vulgaris

What is its Role?

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2004

Stratum Corneum pH in Atopic Dermatitis

Topical Calcineurin Inhibitors in the Treatment of Atopic Dermatitis

Methicillin-Resistant Staphylococcus Aureus

Benzoyl Peroxide-Based Combination Therapies for Acne Vulgaris

Optimal Management of Fungal Infections of the Skin, Hair, and Nails