Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients

Abstract

Introduction Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH. Methods This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4–6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections. Results On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement ( p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction ( p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up. Conclusion IPL is an effective and safe treatment for acne-related PIE and PIH.

Comparative Efficacy Between Intense Pulsed Light Narrow Spectrum and Broad Spectrum in the Treatment of Post-Acne Erythema (PAE)

“… 19 Our study also conducted a statistical analysis of the acne recurrence rate in each group. Eight (40%) out of 20 patients in the IPL 560/590 nm group and three (15%) in the blank control group had acne recurrence, while no acne recurrence was found in the IPL vascular group, consistent with the results of Wu et al, 11 who reported acne relapsing in seven patients (11.7%) treated with IPL 560–1200 nm and 590–1200 nm cut-off filters after 3–7 sessions at intervals of 4 weeks, Monib et al, 43 who showed three out of 15 patients treated with IPL 400 nm filter showed acne exacerbation after the first (−60%, −28.6%, −6.1%) and second (−35%, 47.6%, 36.4%) sessions, respectively, and Ross et al, 33 who used IPL (525–1200 nm) in the treatment of acne; after four sessions and 2 week intervals, the patient showed acne relapse (3–8 weeks) at follow-up. The energy of IPL broad-spectrum filters may affect larger and deeper tissues.…”

“… 10 These lesions may resolve slowly and spontaneously; however, in most patients, persistent post-acne erythema may last for years if no interventional management is conducted, which is cosmetically unacceptable and has great psychological, social, and financial implications for the patients. 11 Some patients tend to cover up PAE using cosmetic products such as foundations, concealers, or any other cream products, but the results are not very satisfactory, as some of these products may contain sensitive substances that can worsen the appearance of PAE and cause side-effects in some patients. Various therapies have been proposed to manage this cosmetic problem, but with resistance to oral and topical therapies, 10 , 12 and with no consistent results and minimal side-effects for laser and light-based devices.…”

Post‐inflammatory hyperpigmentation: A systematic review of treatment outcomes

“…After title/abstract screening of 2157 articles and full text review of 166 articles, ultimately 41 articles were included in this study representing 877 patients (Figure 1, Table S1). 10–50 Ten studies were level of evidence 1, 30 studies were level of evidence 2, and 1 study was level of evidence four. Study types included placebo‐controlled trials ( n = 2), non‐placebo‐controlled trials ( n = 8), cohort studies ( n = 30) and case series ( n = 1).…”

“…Poor to no response: fair, poor or no response/improvement based on criteria established for each included study in the review. For example, ‘11 [patients] (18.3%) remained unaltered’ in the study by Wu et al 12 Worsening: worsening of PIH based on criteria established for each included study.…”

The mechanism and application of computer‐assisted full facial skin imaging systems

“…Based on clinical images and data provided by computer‐assisted facial imaging systems, the severity and treatment efficacy of various facial skin diseases can be assessed. A combination of white light images with UV spot images or brown spot mode is commonly applied for severity evaluation and follow‐up of pigmented facial skin diseases 14 such as dull skin, 15 , 16 freckles, 17 melasma, 18 , 19 post‐inflammatory pigmentation, 20 , 21 and Riehl melanosis. 22 In the study of facial inflammatory dermatoses, white light mode and red area mode with or without UV light images are frequently combined to evaluate the condition, including acne, 23 , 24 rosacea, 4 , 6 , 25 , 26 , 27 rosacea‐like dermatitis induced by steroids, 28 and seborrhoeic dermatitis 29 in addition to facial vascular anomalies such as port wine stains.…”