Combined use of energy‐based interventions with low‐dose isotretinoin for the treatment of inflammatory acne: An retrospective cohort analysis

Abstract

Background The combined use of oral isotretinoin with energy‐based interventions including fractional microneedle radiofrequency, pulsed dye laser, and ablative fractional laser is an effective way to treat moderate‐to‐severe inflammatory acne lesions. However, studies regarding its efficacy and safety are limited. Aims This study aimed to assess the efficacy and safety of a treatment using low‐dose isotretinoin with energy‐based interventions for inflammatory acne. Patients and Methods This retrospective cohort study included 126 patients who were diagnosed with inflammatory acne and were treated with systemic isotretinoin for at least 3 months. Patients were divided into EBD (energy‐based intervention) (n = 82) and non‐EBD groups (n = 44). Clinical outcomes of both groups were assessed using medical records and digital photographs. Results After treatment, the modified Global Acne Grading Score of the EBD and non‐EBD groups decreased by 35.1 ± 17.2 and 25.6 ± 10.1, respectively. The improvement in acne severity was significantly greater in the EBD group than in the non‐EBD group. Cumulated isotretinoin dose and frequency of drug‐related side effects were significantly higher in the non‐EBD group than in the EBD group. Conclusion Combined treatment with low‐dose isotretinoin and energy‐based intervention is well tolerated and associated with positive responses in patients with inflammatory acne.

Combination of Fractional Microneedling Radiofrequency and Ablative Fractional Laser versus Ablative Fractional Laser Alone for Acne and Acne Scars

“… 2 10 12 13 Meanwhile, several studies have reported improvements in inflammatory acne assessed by acne severity scoring or lesion counts with FMR treatment. 8 11 In our study, the FMR+AFL treatment demonstrated superior efficacy compared to AFL monotherapy in patients with both inflammatory acne and post-acne scars. The gap in improvement rate for inflammatory acne and acne scars between the two methods was more prominent in the follow-up period ( Figs.…”

“…We have previously reported the real-world practice of the combined use of low-dose isotretinoin and different modes of energy-based interventions. 11 As the FMR+AFL treatment showed inhibitory effect on sebum secretion, reduced acne lesions, and improved scar texture, it can be considered a promising treatment option for personalized medicine, with or without pharmacological interventions.…”

“… 7 8 9 Previous studies have shown that FMR can be combined with other laser modalities, such as AFL and pulsed dye lasers, to treat inflammatory acne and acne scars with favorable efficacy and safety profiles. 10 11 12 13 …”

Targeting Inflammation in Acne: Current Treatments and Future Prospects

“…Combining FRFM with isotretinoin is particularly effective in treating inflammatory acne and reducing scarring [ 83 ]. In fact, combinations of isotretinoin with other energy-based devices including PDL and ablative fractional lasers are effective treatments for active inflammatory acne as well [ 84 ]. Lastly, microneedling devices may be implemented in the transdermal delivery of topical retinoids and salicylic acid and for improving scarring [ 85 ].…”

Exploring Acne Treatments: From Pathophysiological Mechanisms to Emerging Therapies

“…Non-ablative fractionated radiofrequency microneedling (FRFM) and combinations with isotretinoin have been effective in treating active acne and reducing scarring, with the adjunctive use of microneedling facilitating the enhanced delivery of topical treatments (retinoids and salicylic acid) and scar improvement [272][273][274][275]. Using isotretinoin in conjunction with other energy-based devices such as PDL and ablative fractional lasers has also been proven effective in managing active inflammatory acne [276].…”