Laser and other light therapies for the treatment of acne vulgaris: systematic review
Conflicts of interestF.L.H., J.C., A.M. and M.C. declare no competing interests. C.L. provides a private cosmetic dermatology service, which includes the use of laser therapies. A.L. has acted as an advisory consultant and researcher holding small grants for basic science and clinical research related to acne. She has been supported by a number of pharmaceutical companies linked to acne therapy over the years and has presented at pharmacy-supported symposia.
Summary
Background Acne is common and can lead to scarring of the skin, as well as to psychological distress and reduced self-esteem. Most topical or oral treatments for acne are inconvenient and have side-effects. Laser and other light therapies have been reported to be convenient, safe and effective in treating acne.
Objectives To carry out a systematic review of randomized controlled trials of light and laser therapies for acne vulgaris.
Methods We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycInfo, LILACS, ISI Science Citation Index and Dissertation Abstracts International for relevant published trials.
Results We identified 25 trials (694 patients), 13 of light therapy and 12 of light therapy plus light-activated topical cream (photodynamic therapy, PDT). Overall, the results from trials of light alone were disappointing, but the trials of blue light, blue–red light and infrared radiation were more successful, particularly those using multiple treatments. Red–blue light was more effective than topical 5% benzoyl peroxide cream in the short term. Most trials of PDT showed some benefit, which was greater with multiple treatments, and better for noninflammatory acne lesions. However, the improvements in inflammatory acne lesions were not better than with topical 1% adapalene gel, and the side-effects of therapy were unacceptable to many participants.
Conclusions Some forms of light therapy were of short-term benefit. Patients may find it easier to comply with these treatments, despite the initial discomfort, because of their short duration. However, very few trials compared light therapy with conventional acne treatments, were conducted in patients with severe acne or examined long-term benefits of treatment.
