Evaluation Of Combined Intense Pulsed Light And Nonablative Fractional Photothermolysis Treatment For Moderatesevere Acne And Acne Scars In Asians

Background and Objective:In the past,drug therapy is the preferred treatment for acne. Along with the development of photoelectric equipment, concerns about the side effects of medication, intense pulsed light（IPL） and other physical therapy is gradually replacing drugs with the control of acne. Ablative lasers, such as carbon dioxide（CO₂） and erbium : yttrium-aluminum-garnet（Er : YAG）, offered significant improvements to treatment scars, but also were associated with prolonged postoperative recovery and many side effects. Nonablative fractional photothermolysis which was a emerging technology had been used to treat various scars. To assess the efficacy and safety of the intense pulsed light and nonablative fractional photothermolys is followed by nonablative fractional photothermolysis in Asians with moderate-severe acne and acne scars. Methods:Nineteen patients（Fitzpatrick skin types III and IV）)with moderate-severe acne and acne scars received up to six treatments of combined a intense pulsed light equipped with a MaxG hand piece and 1540-nm Erbium glass fiber laser（Lux 1540 TM, Palomar Medical Technologies,Burlington,MA,USA）equipped with a 10-mm handpiece（100 microbeams/cm2, microbeam diameter 150 μ m）. According to the degree of skin lesion and Fitzpatrick skin type to choose a proper parameter with six sessions at three to six weeks intervals. During the treatment combined with drug therapy, prevention ultraviolet ray,needle-ching and skin cleaning with a follow-up period of six months. Clinical assessment was performed by two independent physicians by comparing the standard digital pictures taken before each treatment and four weeks after the last treatment. Patients’ satisfaction after the finial treatment was assessed by questionnaire. Results:After the first treatment of IPL,16/19（84.2%）patients showed moderate or marked improvement in acne inflammation. Four weeks after the final session,15/19（78.9%）patients showed moderate or marked improvement in moderate-severe acne scars. After the finial treatment 17/19（89.4%）patients satisfied with the treatment in self-evaluation of patient satisfaction. At the end of the treatment all the patients may be mild skin redness immediately. No blister, crusting,pigmentaion, depigmentation and infection were observed after treatment during the six months follow-up. Only one female patient appeared temporary hyperpigmentation and after five months recovered natural. Conclusion:In accordance to previous studies, use of IPL with nonablative fractional photothermolysis followed by nonablative fractional photothermolysis was shown to be effective and safe for moderate-severe cystic acne and acne scars with modest improvement and low PIH rate comparable to other resurfacing techniques in the Asian case series, which don’t affect patient’s life or work and don’t require any downtime. Most patients also showed improvements in skin texture and pore size with high degree of satisfaction with the procedure.