Light and laser therapies for the treatment of sebaceous gland hyperplasia a review of the literature

Abstract

Sebaceous gland hyperplasia (SGH) is a benign cutaneous condition that presents primarily on the face and increases with UVB exposure and ageing. These lesions are a common cosmetic concern but are difficult to treat, as the entire sebaceous gland needs to be destroyed to prevent recurrence. Traditional methods of treatment include: cryosurgery, electrodessication, curettage, shave excision and topical trichloroacetic acid. These methods have an increased risk of skin discoloration and scarring to the area of treatment that may lead to inferior cosmetic outcomes. Alternatively, oral isotretinoin can treat SGH, but is a known teratogen in pregnancy and has high relapse rates with discontinuation. A systematic review of the literature was performed to look at photodynamic therapy (PDT) and laser treatment for SGH. According to the results of this study, PDT, lasers and combinations of the two treatments were found to offer alternatives to the more conventional techniques with better outcomes. In particular, the use of wavelength-specific laser for the sebaceous gland of 1720 nm were found to have better outcomes and provide minimal damage to surrounding tissues. Additionally, combination PDT with aminolevulinic acid and pre-treatment with carbon dioxide laser ablation or pulse-dyed laser offered higher cure rates over stand-alone laser or PDT treatments in a shorter number of sessions with similar transient side-effects. However, further large-scale prospective studies with adequate follow-up are required to confirm these findings and those for sebaceous gland-specific lasers.

Photodynamic Therapy and Skin Appendage Disorders: A Review

“…A very recent review reported that PDT, lasers, and combinations of the two treatments were found to offer alternatives to the more conventional techniques with better outcomes for SGH. In particular, the combination PDT with ALA and pretreatment with carbon dioxide laser ablation or pulsed-dye laser was shown to offer higher cure rates over stand-alone laser or PDT treatments in a shorter number of sessions with similar transient side effects [91] . The ALA-PDT and carbon dioxide laser association was also demonstrated by another study where CO 2 laser ablation was performed before ALA application to reduce lesion size and facilitate access of ALA and light, showing a higher marked improvement rate compared to PDT alone [92] .…”

Combination of CO2 laser therapy and curettage for sebaceous gland hyperplasia

“…Although photodynamic therapy is an effective treatment of choice with minimal complications for the removal of SH lesions, it requires multiple sessions and special equipment and is not available at most therapeutic centers (3,7). The advantages of the method for curing SH discussed herein are the few treatment sessions required and the accessibility of a CO2 laser device at most outpatient clinics.…”

Multiple Eruptive Sebaceous Hyperplasia Secondary to Cyclosporin in a Patient with Bone Marrow Transplantation

“…Nevertheless, patients had to be maintained on isotretinoin, as recurrence was common after the treatment had been stopped [3,7,9]. Other options include elctrodesiccation, shave excision, and photodynamic therapy [11]. …”