| Objective:To observe whether the efficacy of intense pulsed light and pulsed dye laser combined with Centella asiatica gel in the treatment of post acne erythema is better than that of single treatment;Comparison of the efficacy of two different combined treatment groups.Methods:One hundred patients diagnosed with post acne erythema in the outpatient clinic of our hospital from December 2021 to October 2022 were selected and randomly assigned to five groups(a,B,C,D,and E)as subjects.Group a treated with intense pulsed light,group B with pulsed dye laser,group C with intense pulsed light combined with external application of asiatic acid,group D with pulsed dye laser combined with external application of asiatic acid,and group E with external application of asiatic acid to repair the gel,the phototherapy was separated by 2 weeks for a total of 2 times,and the external gel was applied to the skin lesion1 time each morning and night.Clinical improvement of post acne erythema was finally assessed by a fixed dermatologist based on the post acne erythema lesion count,a four point erythema severity score,and a 5-point scale of improvement;Erythema index improvement was analyzed by a VISIA facial image analyzer;Safety was assessed by recording of adverse effects postoperatively;Patient self satisfaction and ratings were recorded at follow-up after treatment completion.Results:1.Patient general data:100 patients were enrolled,and 99 patients completed the experiments.Group A,total of 20 patients,17 males and 13 females,mean age 22.15 ± 2.96 years,disease duration 2(1.25,3.75)years.Group B,a total of 20 patients,5 males and 15 females,mean age 22.25 ± 3.19 years,disease duration 2.5(2,5)years.Group C,total 20 patients,4 males and 16 females,mean age 23.3 ± 4.26 years,disease duration 3.5(2,5.75)years.Group D,a total of 20 patients,5 males and 15 females,mean age 22.75 ± 4.79 years,disease duration 3(2,4)years.A total of 19 patients in Group E,5 males and 14 females,had a mean age of 21.05 ± 3.67 years and disease duration of 2(2,4)years.Before treatment,there were no significant differences among the five groups in patient sex,age,and disease duration(P > 0.05).2.Post-acne erythematous lesion count: the post-treatment erythematous lesion count of the five groups all decreased,and the average values before treatment were 69.12 ± 23.37 in group A,65.95±16.87 in group B,71.65±23.88 in group C,67.61±30.97 in group D,and67.47±19.72 in group E.The mean values 2 weeks after the end of the last treatment were48.15±17.50 in group A,43.40±13.64 in group B,31.80±14.78 in group C,27.35±11.21 in group D,and 59.11 ±19.99 in group E.The difference of skin counts before and after treatment was 20.95±9.29 in group A,22.55±11.09 in group B,39.85±21.63 in group C,40.25±26.77 in group D,and 8.37±5.79 in Group E,with statistically significant differences among the five groups(P < 0.05).3.Four point erythema severity score: all four point erythema severity scores decreased after treatment in the five groups,with mean values of 2.55±0.51 in group a before treatment,2.40±0.50 in group B,2.40±0.50 in group C,2.45±0.51 in group D,and 2.57±0.51 in Group E;2 weeks after the end of the last treatment,it was 1.75±0.44 in group A,1.70±0.47 in group B,1.30±0.47 in group C,1.25±0.44 in group D,and 2.26±0.45 in Group E;Quartile erythema severity score the difference before and after treatment was 0.8 ± 0.77 in group A,0.7±0.73 in group B,1.1±0.64 in group C,1.2±0.52 in group D,0.32±0.58 in Group E,and the difference among the five groups was statistically significant(P < 0.05).4.Degree of improvement 5 point scores: group a degree of improvement score 3(2.5,3),group B degree of improvement score 3(2,3),group C degree of improvement score 3.5(3,4),group D degree of improvement score 4(3,4),group E degree of improvement score mean1(1,2),the difference of 5 groups was statistically significant(P < 0.05).5.Erythema index: no significant difference existed among the five groups before treatment(P > 0.05).After treatment,the mean values were 218.45±45.00 in group A,221.35±37.20 in group B,184.85±70.27 in group C,175.15±58.86 in group D,266.63±47.06 in Group E,and the differences before and after EI treatment were 40.2±74.2 in group A,51.1±48.25 in group B,83.3±86.42 in group C,96.5±77.87 in group D,and 8±61.56 in Group E,with significant differences among the 5 groups(P < 0.05).6.Self satisfaction and ratings: group a score 3(2,3),satisfaction 55%,group B score 3(2,3),satisfaction 60%,group C score 4(3,4),satisfaction 100%,group D score 4(3.5,4),satisfaction 100%,group E score 2(1.5,2),satisfaction 0%,group 5 satisfaction scores were statistically significantly different(P < 0.05)7.Adverse reaction record: follow up four cases developed blisters,they were three cases after treatment in group A and one case in group C,all of them subsided within 72 h,the obvious erythema also gradually subsided within 72 h.Group B 2 patients developed hyperpigmentation without sun protection measures when working outdoors after treatment.No patient experienced skin infection,scar hyperplasia,pruritus,persistent erythematous discoloration during treatment.Conclusion:1.The modality of treatment of post-acne erythema with intense pulsed light,pulsed dye laser,intense pulsed light combined with Asiatic gel,pulsed dye laser combined with Asiatic gel,and topical Asiatic gel alone was effective.2.The efficacy of photoelectrical combined with asiatic acid in the treatment of post acne erythema was better than that of single photoelectrical or topical application;The efficacy of pulsed dye laser combined with asiatic acid was slightly better than that of intense pulsed light combined with asiatic acid.3.The combination of intense pulsed light,pulsed dye laser,and intense pulsed light combined with asiatic acid gel as well as pulsed dye laser combined with asiatic acid gel for the treatment of post-acne erythema has a low incidence rate,a short isoform period,is safe and effective,and the combination with topical asiatic acid accelerates the treatment speed and is suitable for wide application in clinical settings.4.Topical asiatic acid treatment of post-acne erythema has a slow onset and a long treatment course. |
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