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Wednesday, September 21. 2011
Acne and Acne Scarring-review of the Literature.
Here are a series of articles on Acne and Acne scarring that I found particularly interesting.
We, at Foreveryoung, Inc., specialize on the treatment of Acne and Acne scarring:
Ablative skin resurfacing.
Source
Skin Laser & Surgery Specialists of New York & New Jersey, USA.
Abstract
Ablative skin resurfacing has remained the gold standard for treating photodamage and acne scars since the development of the first CO(2) lasers. CO(2) and Er:YAG lasers emit infrared light, which targets water resulting in tissue contraction and collagen formation. The first ablative laser systems created significant thermal damage resulting in unacceptably high rates of scarring and prolonged healing. Newer devices, such as high-energy pulsed lasers and fractional ablative lasers, are capable of achieving significant improvements with fewer side effects and shorter recovery times. While ablative resurfacing has become safer, careful patient selection is still important to avoid post-treatment scarring, dyspigmentation, and infections. Clinicians utilizing ablative devices need to be aware of possible side effects in order to maximize results and patient satisfaction. This chapter reviews the background of ablative lasers including the types of ablative lasers, mechanism of action, indications for ablative resurfacing, and possible side effects.
Dermatol Surg. 2011 Aug 11. doi: 10.1111/j.1524-4725.2011.02110.x. [Epub ahead of print]
Evaluation of the Effect of Fractional Laser with Radiofrequency and Fractionated Radiofrequency on the Improvement of Acne Scars.
Peterson JD, Palm MD, Kiripolsky MG, Guiha IC, Goldman MP.
Source
Dermatology Cosmetic Laser Associates of La Jolla, San Diego, California.
Abstract
BACKGROUND Options for acne scar reduction include peels, subcision, fillers, lasers, dermabrasion, and surgical excision, although not all are applicable in darker skin types. A novel device with a handpiece combining optical and radiofrequency (RF) energies along with a fractionated RF handpiece is available for nonablative resurfacing. OBJECTIVES Our primary objective was to evaluate the improvement in acne scars and skin texture. Secondary objectives were determination of patient satisfaction and comfort and evaluation of scar pigmentation improvement. Patients received five treatments at 30-day intervals. Post-treatment follow-up visits were performed 30 and 90 days after the last treatment. RESULTS A 72.3% decrease (p<.001) was observed on the acne scar scale from day 1 to 210. From day 30 to 210, investigator-rated changes in scarring, texture, and pigmentation improved 68.2% (p<.001), 66.7% (p<.001), and 13.3% (p=.05), respectively. Patient satisfaction scores showed no significant change over time, although patient-evaluated overall improved scores increased 60% over baseline (p=.02). CONCLUSION This technology may be a useful, nonablative resurfacing treatment for acne scarring. Scarring, texture, and pigmentation improved significantly according to investigator-rated assessment parameters. Although patient satisfaction scores did not improve, overall improvement scores did. The study was supported by Syneron.
© 2011 by the American Society for Dermatologic Surgery, Inc.
J Drugs Dermatol. 2011 Aug;10(8):907-12.
Evaluation of clinical improvement in acne scars and active acne in patients treated with the 1540-nm non-ablative fractional laser.
Isarría MJ, Cornejo P, Muñoz E, Royo de la Torre J, Moraga JM.
Source
Instituto Médico Láser, Servicio de Dermatología, Madrid (Spain). mjisarria@hotmail.com
Abstract
INTRODUCTION:
Acne is a characteristic condition of puberty; however, adults who continue to have acne outbreaks frequently attend dermatology clinics. Two conditions-active acne and residual scarring-often co-occur in these patients. The objective of the present study was to evaluate the improvement in scarring and active acne after treatment with a 1540-nm erbium: glass fractional laser.
MATERIAL AND METHODS:
The authors treated 20 patients with acne and scarring. Each patient received panfacial treatment in four sessions with a 1-month interval between sessions. Patients, the treating physician and a blinded observer evaluated the results in four areas: improvement in scars, improvement in pores, improvement in acne, and improvement in sebum secretion. Improvements were graded using the Global Aesthetic Improvement Scale. The evaluation was made 12 weeks after treatment finished.
RESULTS:
Patients presented an improvement in both acne and scars. In 80 percent of cases, patients felt that the appearance of the scars had improved, and the improvement was classified as very much improved in 40 percent. In 85 percent of cases, patients felt that active acne had improved, and the improvement was classified as very much improved in 45 percent. Pore size was evaluated as improved by 75 percent of patients. Sebum secretion improved in 80 percent of cases.
CONCLUSION:
A 1540-nm non-ablative fractional laser provides effective treatment of acne scars. Patient satisfaction is high and active acne lesions improve significantly. Treatment of this mixed condition (scarring and active acne) with a single device is reliable, with a favorable safety profile and a high degree of patient acceptance.
Acne vulgaris in children and adolescents.
Source
Department of Dermatology Biederstein, Technical University, München, Germany - nina.schnopp@lrz.tu-muenchen.de.
Abstract
Acne vulgaris is a very common inflammatory skin disease originating from the pilosebaceous unit. Peak incidence is at puberty, but acne can affect all age groups. Prepubertal acne is rare, but important to recognize as diagnostic and therapeutic procedures differ from pubertal acne. Acne neonatorum is a mild, self-limiting disease, whereas acne infantum commonly presents with moderate to severe lesions and high risk of scarring thus requiring early intervention. Mid-childhood or prepubertal acne raises the suspicion of hyperandrogenemia, further investigations are indicated to rule out underlying disease. The same applies to any patient with very severe acne, acne not responding to therapy or unusual clinical presentation. Etiopathogenesis of acne is not yet fully understood. Familiy history is the most important risk factor to develop severe acne and scarring. The relevance of life style factors such as smoking or diet is controversial. Lately high carbohydrate diet and dairy products have been implicated as aggravating factors. Mild acne normally responds to topical monotherapy, in moderate disease combination of two synergistically acting substances (e.g. benzoyl peroxid plus antibiotic, benzoyl peroxid plus retinoid, retinoid plus antibiotic, benzoyl peroxid plus azelaic acid) will improve clinical response. Retinoids and/or benzoylperoxid have been shown to be effective in maintenance therapy. In patients with severe disease or high risk of scarring systemic therapy with antibiotics, oral contraceptives with antiandrogenic properties and in particularly isotretinoin as most effective acne treatment should be considered early to avoid physical and emotional scars.
Curr Probl Dermatol. 2011;42:40-7. Epub 2011 Aug 16.
Dermatol Surg. 2011 Jul;37(7):945-61. doi: 10.1111/j.1524-4725.2011.02036.x. Epub 2011 Jun 17.
Treatment of acne scarring using a dual-spot-size ablative fractionated carbon dioxide laser: review of the literature.
Source
Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. etierney29@gmail.com
Abstract
BACKGROUND:
Fractional photothermolysis has been reported in the literature to improve pigmentary and textural changes associated with acne scarring.
OBJECTIVE:
To review the literature for the treatment of acne scarring using nonablative fractional laser (NAFL) and ablative fractional laser (AFL) resurfacing.
METHODS:
Review of the Medline literature evaluating NAFL and AFL for acne scarring.
RESULTS:
NAFL and AFL are safe and effective treatments for acne scarring. It is likely that the controlled, limited dermal heating of fractional resurfacing initiates a cascade of events in which normalization of the collagenesis-collagenolysis cycle occurs. We present the results of a patient treated using a novel dual-spot-size AFL device. Three months after the final treatment, the patient reported 75% improvement in acne scarring and 63% overall improvement in photoaging.
CONCLUSIONS:
Fractionated resurfacing for the treatment of acne scarring is associated with lesser risks of side effects of prolonged erythema and risks of delayed-onset dyspigmentation and scarring which complicate traditional ablative laser resurfacing approaches. We present herein preliminary data suggesting that a dual-spot-size AFL device presents novel advantages of improving texture and pigmentation in acne scarring and photoaging.
© 2011 by the American Society for Dermatologic Surgery, Inc
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