March 1st, 2008
SAN ANTONIO, Feb. 3 /PRNewswire/ -- It is estimated that approximately
50 million people in the United States alone are affected by acne vulgaris,
and another 14 million Americans experience the redness, flushing and
pronounced blood vessels associated with rosacea. While there are no cures
for these persistent skin conditions, dermatologists are broadening their
treatment options to include laser, light and cosmetic therapies that are
proving effective in managing these conditions and improving patient
satisfaction.
Speaking today at the 66th Annual Meeting of the American Academy of
Dermatology, dermatologist Jenny J. Kim, MD, PhD, FAAD, assistant professor
of medicine and dermatology at the David Geffen School of Medicine,
University of California at Los Angeles (UCLA), in Los Angeles, Calif.,
discussed the latest approaches for treating acne, acne scarring and
rosacea with laser and light therapies -- by themselves, in combination
with each other or with cosmetic treatments, such as fillers.
"Therapies using lasers for acne and rosacea have really increased in
the last few years, with more clinical research being conducted that will
help shed light on the effectiveness of these new applications," said Dr.
Kim. "While not considered first-line therapies for either condition,
lasers and light sources are becoming more widely used by dermatologists
and offer patients an alternative to other treatments that might not be
alleviating their symptoms."
Acne
It is estimated that Americans spend more than $1.2 billion each year
on acne treatments, with medical treatments remaining the most commonly
used options to curb acne flares. However, a host of medical and social
concerns -- including the overuse of antibiotics, long-term antibiotic use,
and the potentially serious side effects and governmental restrictions on
the use of isotretinoin - have underscored the need for the use of new
therapeutic options for acne treatments.
With these concerns in mind, dermatologists have found laser and light
therapies to be viable alternatives in improving acne, and acne scars, with
limited side effects. Lasers and light sources are thought to work by
targeting the bacterium responsible for causing acne, Propionibacterium
acnes, which contains a light-absorbing molecule known as porphyrin. This
bacterium can absorb various lasers and light, which cause the bacterium to
burst and become destroyed -- leading to an improvement in the condition.
In addition, studies also show that lasers and light work by destroying
and shrinking the oil glands where the acne bacteria live. By altering the
structure of the skin where bacteria live, less oil is produced, leading to
an improvement in acne symptoms.
Some of the lasers and light therapies that have been used safely and
effectively for the treatment of acne include pulsed dye lasers, diode
lasers, intense pulsed light, blue light and red light. In addition, recent
studies have shown that photodynamic therapy (PDT) using a photosensitizer
(a chemical applied to the skin which makes the skin more reactive to
light), such as 5-aminolevulinic acid or indocyanine green, along with
lasers and light sources can enhance patient results.
"It has been shown that applying the photosensitizer aminolevulinic
acid topically during a PDT treatment can enhance laser absorption by the
skin and destroy the surrounding oil follicles, which inhibits oil
production and acne-causing bacteria," said Dr. Kim. "While no comparative
studies have been conducted on these different laser and light therapies,
dermatologists often select a therapy based on their personal preference
and experience, as well as the severity of the acne being treated."
Acne Scars
Prior to the recent introduction of lasers and light sources, invasive
treatments such as dermabrasion and CO2 laser resurfacing were the standard
treatment for acne scars. While these therapies provided patients with
minimal improvement, many experienced significant side effects, including
post-inflammatory darkening or lightening of the skin, redness and even
worsening of scars. Dr. Kim shared her experience with a new technique
known as fractional photothermolysis, in which various lasers are used to
produce small injuries to the skin that, in turn, repair the skin by
creating new collagen during the wound healing process. This treatment,
which is gentler than the invasive procedures, does not produce any visible
wounds, and the downtime required is minimal -- in most cases a few days
for the slight redness and flaking to subside.
While fractional photothermolysis is very effective in treating
superficial acne scars, long-lasting fillers, such as hyaluronic acid, can
be used in conjunction with this therapy for plumping up deeper, depressed
acne scars. Generally, hyaluronic acid fillers last between six to 12
months, depending on the area of injection. For example, areas around the
mouth or jaw where there is a lot of facial movement tend to break down the
fillers faster than areas with less movement, such as the forehead.
"These acne scar treatments produce good results and dermatologists can
use them in combination to target subtle differences, which is more
effective than one treatment alone," explained Dr. Kim. "We're also finding
that these acne scar therapies are safe when used on all skin types,
including ethnic skin patients -- a harder population to treat due to
resulting pigmentation problems that can occur."
Rosacea
Although dermatologists often consider medical or topical treatments
first to treat the symptoms of rosacea, some patients are becoming
increasingly concerned about taking these long-term medications and are
turning to laser and light therapies that generally do not cause any
systemic side effects.
One type of laser that has been used for many years to treat the
redness and visible blood vessels that occur from rosacea is the pulsed dye
laser (PDL). This laser's wavelength effectively targets the obvious blood
vessels, absorbing them through the light-attracting molecules that work to
destroy them. PDL also can reduce the flushing and redness that rosacea
patients experience, but Dr. Kim cautioned that this laser can cause some
temporary bruising in patients -- although some of the newer PDLs are
eliminating this side effect.
Another light therapy proven effective in treating rosacea is intense
pulsed light therapy (IPL). After filtering out the harmful, cancer-causing
UVA and UVB rays, IPL therapy delivers a multitude of light to the affected
areas where it absorbs the targeted blood vessels and redness. Dr. Kim
noted that IPL is preferred for larger areas of diffused redness, whereas
the PDL treatment works best for targeting the obvious blood vessels on the
face.
For a less common, but more problematic, symptom of rosacea known as
rhinophyma (a thickening of the skin on the nose and cheeks that can look
bumpy), the newer erbium lasers and fractional photothermolysis are being
used to smooth the nose without significant removal of the top layer of
skin, which is a common side effect of more aggressive treatments.
"Dermatologists are experts in skin and can help determine the most
effective treatment for their patients," added Dr. Kim. "We expect these
treatments to continue to improve as more basic and clinical research is
conducted."
For more information on acne and rosacea, go to
http://www.skincarephysicians.com, a Web site developed by dermatologists
that provides patients with up-to-date information on the treatment and
management of disorders of the skin, hair and nails.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations. With a membership of more
than 15,000 physicians worldwide, the Academy is committed to: advancing
the diagnosis and medical, surgical and cosmetic treatment of the skin,
hair and nails; advocating high standards in clinical practice, education,
and research in dermatology; and supporting and enhancing patient care for
a lifetime of healthier skin, hair and nails. For more information, contact
the Academy at 1-888-462-DERM (3376) or http://www.aad.org.
