ATLANTA — Patients with acne vulgaris may benefit from treatment with a device that combines pulsed light and radiofrequency energy, Dr. Neil Sadick reported at the joint annual meeting of the American Society for Dermatologic Surgery and the American College of Mohs Micrographic Surgery and Cutaneous Oncology.
In 32 patients with moderate acne who were treated twice a week for 4 weeks, the combined use of optical and conducted bipolar radiofrequency energy reduced the average lesion count by 47%.
Of patients surveyed, 59% rated overall improvement as good, 32% rated it as very good, and 4.5% rated it as excellent. Another 4.5% had mild or no improvement, said Dr. Sadick, clinical professor of dermatology at Cornell University, New York.
Biopsies were performed on four of the patients prior to treatment, 1 week after the initial treatment, and 1 month after the initial treatment. Compared with the baseline biopsy, the last biopsy showed a lower percentage of follicles with perifolliculitis (58% vs. 33%, respectively) and a reduction in the size of sebaceous glands (0.092 vs. 0.07, respectively). Heat shock protein 70 and procollagen-1 appeared unaffected by treatment.
The patients were treated using the Aurora AC device (Syneron Inc., Richmond Hill, Ont.). Those with Fitzpatrick skin types I-IV were treated with pulsed light of 8–10 J/cm
The combined use of optical energy and conducted bipolar radiofrequency current has a direct effect on Propionibacterium acnes by photochemical activation of porphyrins, and by selective hyperthermia of the sebaceous glands. The radiofrequency energy supplements the optical energy and raises the temperature of the sebaceous glands, severely damaging the bacteria, Dr. Sadick explained.
The technology is effective and safe for the typically young patients who present with acne vulgaris, but it is not a cure, he said. The effects are temporary and provide about a 3- to 4-month disease-free interval when the device is used as the sole acne treatment modality.
The mechanisms of action of this technology need to be further defined, and the optimal treatment settings and number need to be determined. Additional study of the use of this technology along with other treatment modalities is also warranted, Dr. Sadick concluded.
Dr. Sadick is a research consultant for Syneron Inc.
A patient is shown before undergoing treatment with the Aurora AC device.
Partial clearance is evident above after 1 month of twice weekly treatments. Photos courtesy Dr. Neil Sadick