Blue-Light Acne Therapy

April 1, 2003

San Francisco - More and more, researchers are finding how light and acne equate to a good match. Sun exposure is known to be beneficial for acne vulgaris in up to 70 percent of patients. And, not surprisingly, blue light has proven to be an effective phototherapy for the condition.

Now, a new study conducted by Akira Kawada, M.D., Ph.D., associate professor, department of dermatology at the Kinki University School of Medicine, Osaka, Japan, has shown that a novel blue light product (ClearLight Acne PhotoClearing system, Lumenis) can give physicians a highly effective tool for clearing moderate inflammatory acne without side effects, photosensitivity, or downtime.

"(This) light has higher intensity and more precise action spectrum for porphyrin," Dr. Kawada said. "It's better than previous products and may well be a new modality for the treatment of acne."

Halide Lamp Emits Blue Light

What makes it better and novel is a high-intensity, enhanced, narrowband 400-watt (405-420nm) metal halide lamp that delivers light to the acne-affected areas. Blue light is theorized to be an effective phototherapy because exposure to blue light induces photoexcitation of bacterial porphyrins, singlet oxygen production, and subsequent bacterial destruction.

Dr. Kawada's open study - one of six studies including more than 120 patients - integrated 27 female and three male patients with mild to moderate acne lesions of the face, back, and/or chest to try out the new blue-light therapy. Patients were required to have between 15 and 100 inflammatory lesions, and/or between 15 and 100 noninflammatory lesions, and no more than three nodules. In addition, patients were prohibited from using topical or oral drugs.

Acne patients were treated with the blue-light phototherapy twice a week for up to five weeks. Results showed a 64 percent reduction in acne lesions. Adverse reactions were insignificant, and the blue light source was well tolerated. Dryness of irradiated skin was seen in just two patients, and no patient quit treatment because of adverse effects. The best candidates for the blue light therapy were deemed to be those with mainly inflammatory acne lesions (papules and pustules) from which lesions P. acnes is cultured.

Patients have responded positively. "Most patients with good results were very satisfied because (now) they do not need other drug therapies," Dr. Kawada said.

Although the new blue-light therapy could replace other treatments, some patients might still prefer drugs. "Some patients like this method and respond well," Dr. Kawada said, "but it depends on the patient's condition."

This study showed that intensity and spectrum of light source are important considerations in choosing a light source for acne phototherapy, according to Dr. Kawada. "Prior to the treatment, dermatologists should confirm that patients have inflammatory acne lesions - both papules and pustules - and that P. acnes is cultured from skin lesions," he said.

The blue-light therapy method is simple, and most dermatologists and patients will have access to it. Still, insurance does not yet cover the therapy. Treatment costs depend on each individual dermatologist.

Other in vitro and in vivo studies have also demonstrated the effectiveness of this form of blue light phototherapy in destroying P. acnes, and additional multicenter studies are under way to support the efficacy of the blue-light phototherapy in treating acne. Still, further studies are needed to show its effectiveness and safety, according to Dr. Kawada. Eventually, he said, "This new treatment may become an adjunct to a panel of other acne treatments.

"I hope that more evidence from other hospitals will come in the near future," Dr. Kawada added. "After increasing the evidence of effectiveness and safety of this therapy, this application should be a new modality for acne."

-- Jane Schwanke. “New blue light edges out clindamycin.” Dermatology Times. 2004 March:25(3):40.

Blue light phototherapy in the treatment of acne

Background: Blue light irradiation is known to be effective against acne. However, the profile of a good candidate is still unclear.

Methods: Thirty-one Taiwanese with symmetrical facial acne were irradiated with blue light on one side of the face selected randomly twice weekly for 4 consecutive weeks. The other half of the face was left untreated as control. Parameters, including scar type, pore size, and facial follicular porphyrin fluorescence intensity, were documented. The severity of acne was assessed before the treatment, after two, four, and eight sessions of treatment, and 1 month after the treatment was completed.

Results: Compared with the non-irradiation side, eight sessions of blue light irradiation were effective in acne treatment (P<0.001). Gender (P=0.471), scar type (P-values of pitted, atrophic, and hypertrophic type were 0.688, 0.572, and 0.802, respectively), pore size (P=0.755), and pretreatment fluorescence intensity (P=0.656) could not be used as predictive factors of therapeutic effectiveness. Compared with pretreatment, nodulocystic lesions tended to worsen despite treatment. In addition, the therapeutic effectiveness was not related to the fluorescence intensity change (P=0.812).

Conclusions: Blue light irradiation is effective in acne treatment. Patients without nodulocystic lesions are better candidates for blue light irradiation.

-- Tien-Yi Tzung1, Kuan-Hsing Wu, Mei-Lun Huang. “Blue light phototherapy in the treatment of acne.” Photodermatology, Photoimmunology & Photomedicine. 2004 October; 20(5):266-9.

RESULTS: The data show more than an 80% response to 420nm acne phototherapy with a significant reduction of 59–67% of inflammatory acne lesions after only eight treatments of 8–15 minutes. The reduction in lesions was steady in the follow-ups at 2, 4 and 8 weeks after the end of therapy. Prolonged remission was evident in the 8 weeks after the end of therapy. No adverse

effects or patient discomfort were noted in any of the patients.

CONCLUSIONS: Acne phototherapy by high intensity, narrow band 405–420nm light is proven to be an attractive, fast, effective, non-invasive alternative to current topical and parenteral anti-acne remedies.

-- Elman M et al. “The effective treatment of acne vulgaris by a high-intensity, narrow band 405-420 nm light source.” Journal of Cosmetic and Laser Therapy. 2003 June;5(2):111-7

Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation.

Department of Dermatology, Kinki University School of Medicine, Ohno-Higashi 377-2, Osaka-Sayama city, Osaka 589-8511, Japan. kawada@med.kindai.ac.jp

The purpose of this study was to investigate the efficacy of phototherapy with a newly-developed high-intensity, enhanced, narrow-band, blue light source in patients with mild to moderate acne. An open study was performed in acne patients who were treated twice a week up to 5 weeks. Acne lesions were reduced by 64%. Two patients experienced dryness. No patient discontinued treatment due to adverse effects. In vitro investigation revealed that irradiation from this light source reduced the number of Propionibacterium acnes (P. acnes), but not Staphylococcus epidermidis that were isolated from the acne patients. Phototherapy using this blue light source was effective and well tolerated in acne patients and had an ability to decrease numbers of P. acnes in vitro, suggesting that this phototherapy may be a new modality for the treatment of acne. Copyright 2002 Elsevier Science Ireland Ltd.