A Prospective, Randomised, Controlled, Split-Face Clinical Trial to Assess the Safety and the Efficacy of Cold Atmospheric Plasma in the Treatment of Acne Vulgaris

Abstract

The increase in antibiotic resistance requires effective non-antibiotic therapies for acne. Cold atmospheric plasma (CAP) inactivates bacteria and improves wound healing, but its effect on acne has not been investigated. The objective of this controlled split-face study was to assess safety and efficacy of CAP in moderate acne. One side of the face received 8–10 treatments with cold helium plasma within 4–6 weeks; follow-up was two and four weeks thereafter. Acne lesions were counted, followed by global acne severity ratings. Of the 34 patients included, 29 completed the study. No serious adverse events occurred. The two facial sides did not significantly differ in the number of inflammatory and non-inflammatory lesions. An interaction effect of number and type of treatment was found for inflammatory lesions. Lesion reduction after 10 treatments was significantly higher on the treated than on the untreated side. Percentage of patients reporting improved aesthetics was higher for the treated than for the untreated side after treatment completion (79% vs. 45%) and at the two- (72% vs. 45%) and four-week follow-up (79% vs. 52%). In conclusion, CAP was safe with excellent tolerability, showed moderate reduction in acne lesions and led to higher patient-based ratings of aesthetics than non-treatment.

A Prospective Randomized Controlled Pilot Study to Assess the Response and Tolerability of Cold Atmospheric Plasma for Rosacea

“…Reduction of particularly inflammatory lesions after ten CAP treatments within 4 to 6 weeks was significantly higher on the CAP treated than on the untreated side. Also, percentage of patients reporting improved aesthetics was higher for the treated than for the untreated side after treatment completion and at the 2- and 4-week follow-up [43].…”

“…Atopic dermatitis, psoriasis, and herpes zoster, among others, are further skin diseases in which CAP has been successfully applied [23,[39][40][41][42]. Recently, Karrer et al [43] used a jet plasma device in a prospective, randomized, controlled, split-face trial to assess its safety and efficacy in the treatment of acne vulgaris. Reduction of particularly inflammatory lesions after ten CAP treatments within 4 to 6 weeks was significantly higher on the CAP treated than on the untreated side.…”

Cold atmospheric plasma therapy for Malassezia folliculitis: Laboratory investigations and a randomized clinical trial

“… 12 A controlled split‐face study on acne patients demonstrated improved aesthetics on the treated side, with 79% of patients reporting enhancement compared to 45% on the untreated side. 13 Notably, studies by Wiegand et al., and Tae‐Hyun Lee et al., indicated that plasma reduced the growth of M. pachydermatis in vitro. 14 , 15 In this study, we initially confirmed the inhibitory effect of CAP on Malassezia yeasts in vitro and subsequently designed a prospective study to provide insights into the efficacy and safety of CAP compared to itraconazole in patients with MF.…”

Plasma medicine: The era of artificial intelligence

“…[ 11 ] Another dermatological clinical application is the treatment of acne, with encouraging results in lowering the number of active lesions. [ 12 ] Furthermore, it has been used successfully to treat cervical and vaginal precancerous conditions, shrinking the lesion and preventing recurrence. [ 13 ]…”

“…[11] Another dermatological clinical application is the treatment of acne, with encouraging results in lowering the number of active lesions. [12] Furthermore, it has been used successfully to treat cervical and vaginal precancerous conditions, shrinking the lesion and preventing recurrence. [13] In light of all these clinically widespread and promising results, CAP could be assumed to be a straightforward technology to adapt to clinical use; however, recent studies have emphasized that the complex interactions between the plasma and the specific environment of interest (e.g., in vivo and in vitro microenvironments including cells, tissues, and microorganisms) make it difficult to control and predict the biological effects of CAP.…”