Study: Laser Therapy Ineffective for Acne

Pulsed dye model doesn't result in any improvement

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HealthDay Reporter

TUESDAY, June 15, 2004 (HealthDayNews) -- Lasers are used to reduce scarring from severe acne and, increasingly, to treat active acne. A small, new study has found, however, that the therapy with one type of laser does not improve the acne itself.

"The study is not an indictment of laser surgery in general, and it may even be that this particular type of laser ultimately proves to work for acne, but it certainly suggests that additional studies are needed," said Dr. Jeffrey S. Orringer, lead author of the study. He is director of the Cosmetic Dermatology and Laser Center at the University of Michigan Medical School.

The study, which looked at the effectiveness of a pulsed dye laser, appears in the June 16 issue of the Journal of the American Medical Association.

Lasers are used for various other health conditions, but because so many people suffer from acne, adding that problem to the list can make a device much more valuable. Most other therapies for acne involve medications, such as antibiotics or the drug Accutane, both of which carry risks.

"Laser treatments are localized, very safe, have no systemic side effects, and have been shown to be effective," said Dr. David Avram, a cosmetic dermatologist in New York City. "That's the beauty of these forms of treatment."

"The idea of applying laser or light treatment for acne really just began about two years ago, and I would say that it just gained usage among the general population in the last year or so," said Dr. Arielle Kauvar, a spokeswoman for the American Academy of Dermatology and clinical associate professor of dermatology at New York University School of Medicine. Among teens, laser treatment tends to be used for those who are resistant to other treatments while, in adults, it's more likely to be used as a first-line treatment.

Lasers can be used in one of two ways: To get rid of the bacteria causing the acne or to damage the oil-producing glands. The latter method tends to be more effective.

"These are techniques that are only being used by people who specialize in laser. It's really a new area, and there's a lot of investigation going on," Kauvar said. "Because acne is such a global problem, obviously we are looking for things that work better than what we already have."

The study enrolled 40 people aged 13 or older with facial acne who received two pulsed dye laser treatments to half of the face for 12 weeks. The other half of the face received no treatment at all.

"Everybody had the opposite side of their face serving as an internal control," Orringer said. "That's sort of the ultimate control, because it's the patient's own skin."

A separate group of experts who did not know which side of the face had received laser therapy counted the remaining lesions. Yet another group of experts, a panel of dermatologists, then looked at photographs of the participants to determine if acne had been reduced.

In the end, 26 people completed the study, many withdrawing because they were not seeing sufficient results. As it turned out, the experts involved in the study did not see sufficient results in the remaining participants, either.

The laser used in this study has been approved and is marketed to treat fine lines and wrinkles. However, it targets the skin more superficially than other lasers, which treat acne by delivering energy to the oil-producing glands, Avram said.

Right now, there is more evidence for lasers to be used to treat acne scarring, although they have shown promise for active acne.

"There certainly is hope [that lasers can treat active acne]," Orringer said. "We just have to find out which types of systems seem to do the job more effectively... The world of light-based acne treatment is in its relative infancy. It's going to continue to evolve over the next few years, but it has to be driven by good science, not claims."

More information

The American Academy of Dermatology has more information on acne.

SOURCES: Jeffrey S. Orringer, M.D., clinical assistant professor in dermatology and director, Cosmetic Dermatology and Laser Center, University of Michigan Medical School, Ann Arbor; David Avram, M.D., cosmetic dermatologist, New York City; Arielle Kauvar, M.D., spokeswoman, American Academy of Dermatology, and clinical associate professor of dermatology, New York University School of Medicine, New York City; June 16, 2004, Journal of the American Medical Association

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