Acne treatment efficacy of intense pulsed light photodynamic therapy with topical licochalcone A, l‐carnitine, and decanediol: A spilt‐face, double‐blind, randomized controlled trial

Abstract

Background: Depending on disease severity, standard acne treatments can vary from topical to systemic therapy. However, poor compliance caused by adverse events and antibiotic resistance is a major cause of treatment failure. Aims: To determine the effectiveness of photodynamic therapy (PDT) with intense pulsed light (IPL) in the treatment of acne when combined with a cream containing licochalcone A, L-carnitine and decanediol (so-called, 'active formulation') versus PDT alone. Patients/Methods: Twenty-nine volunteers, aged 21-39 years (26 women and 3 men, mean age 29.41 ± 5.24 years), with mild to severe facial acne, were enrolled. Each subject's face sides were randomized in a split-face manner to either receive PDT (IPL with a 400-720 nm cutoff filter, at 4 sessions with two-week intervals) combined with the active formulation cream twice daily for 10 weeks on one face side; or PDT and the vehicle cream on the other side, with the same treatment protocol. Reduction in acne quantity, melanin index and erythema index were assessed 2 weeks after the second treatment (day 28), 1 week after the fourth treatment (day 49), and 1 month after the fourth treatment (day 70). Results: Compared to baseline, patients in the active formulation group demonstrated a faster onset of reduction in the number of lesions at 2 weeks after the second treatment (p=0.010 for inflammatory acne and p=0.001 for non-inflammatory acne). A significantly greater reduction in lesion count was observed in the active formulation group compared with the vehicle group at all timepoints of evaluation for noninflammatory acne (day 28, day 49, and day 70; p=0.003, 0.005 and 0.002 respectively), and at 1 month after the fourth treatment for inflammatory acne (p=0.036). Compared to the vehicle group, the melanin index of the active formulation group decreased significantly at 1 month after the fourth treatment (p=0.015).

A Double-Blinded, Randomized, Vehicle-Controlled Study of the Efficacy of Moisturizer Containing Licochalcone A, Decanediol, L-Carnitine, and Salicylic Acid for Prevention of Acne Relapse in Asian Population

“…Dall'Oglio et al [ 15 ] suggested that the daily licochalcone A moisturizer with salicylic acid/L-carnitine as fluid or with hydroxy complex 10% as cream was used as an adjunctive treatment for mild acne. Recently, Wanitphakdeedecha et al [ 16 ] reported that a moisturizer containing the active ingredients of licochalcone A, L-carnitine, 1,2-decanediol, and salicylic acid, which are the same ingredients as those used in our study moisturizer, provided good synergistic effect when combined with photodynamic therapy to treat acne.…”

“…The ideal dermocosmetics for acne should be noncomedogenic, hypoallergenic, nonirritating, and compatible with acne treatment [ 12 ]. Moisturizer containing active ingredients, such as licochalcone, 1,2-decanediol, L-carnitine, and salicylic acid, for the treatment of acne was reported to have beneficial effects when combined with standard treatments [ 13 – 16 ]. Licochalcone A has a highly effective anti-inflammatory effect [ 17 ], decanediol has antibacterial efficacy against C. acnes [ 18 ], and L-carnitine can reduce sebum production [ 19 ].…”

Baicalin suppresses Propionibacterium acnes-induced skin inflammation by downregulating the NF-κB/MAPK signaling pathway and inhibiting activation of NLRP3 inflammasome

“…Presently, treatments for acne include topical therapies such as erythromycin, clindamycin, benzoyl peroxide, and retinoids, and systemic treatments such as oral antibiotics, oral retinoids, and hormonal therapy. However, these treatments often lead to irritant dermatitis ( 12 , 13 ), gastrointestinal disturbances ( 14 ), and bacterial resistance ( 15 ), among others. The primary disadvantage of the current therapies is antibiotic abuse, which can result in antibiotic resistance ( 16 ).…”

Efficacy and Safety of Intense Pulsed Light in Patients of Inflammatory Acne Vulgaris

“…3,4 Researchers have theorized that IPL therapy reduces Propionibacterium Acnes (P. acnes) in the skin and shrinks the size of the pilosebaceous unit and, subsequently, its function. 5,6 Previous literature has shown the efficacy of IPL for Acne vulgaris ranging from 34% to 88% in both inflammatory and non-inflammatory acne. [7][8][9] One study compared two different fluences, i.e., 35J/cm 2 and 20J/cm 2 , on the right and left side of the face, respectively.…”