Laser Safely Zaps Acne

Latest Non-Drug Treatment Offers Hope -- and Gets FDA Approval

From the WebMD Archives

Oct. 23, 2003 -- A laser that has been used for several years to treat wrinkles, scars, and other lesions appears to be safe and effective against the most common skin problem of all -- acne.

Acne affects about 85% of Americans at some point in their lives. But British researchers report in this week's issue of The Lancet that after just one 15-minute treatment, overall acne severity was reduced by half in 31 patients three months after treatment -- with no adverse effects. Meanwhile, another 10 patients who received a sham laser treatment got little, if any, improvement.

"The critical thing is that one treatment lasts up to three months," study researcher Tony Chu, FRCP, of London's Imperial College, tells WebMD. "Our results suggest that this laser treatment could be developed as a new therapeutic approach that would allow simultaneous treatment for both active acne and associated scarring."

In fact, Chu says that's how the N-Lite laser was shown to be effective in clearing acne -- while being used to treat permanent pockmark scars that can result when pimples are prematurely popped.

"It appears that the laser energy induces the production of chemicals that reduce inflammation in the skin and prevent spots from developing," he tells WebMD. "We are currently doing research to find out exactly how this works."

But the president of the company that markets the laser in the U.S. -- which was developed in Wales -- says because N-Lite penetrates more deeply than other light therapies, it appears to have a two-pronged benefit against acne.

"Not only does it destroy the bacteria that causes acne, but it also stimulates collagen development," says Robert Trow, PhD, of USA Photonics in Nanuet, N.Y.

Its fast-pulsed laser heats small blood vessels, allows them to open and release healing "mediators" that removes redness and builds collagen. This also prevents future skin eruptions, he says. Laser Benefits

This collagen-building effect makes its useful in removing wrinkles and scars -- its primary applications in this country since 2000, when it was first approved for use. However, N-Lite has also been used to treat psoriasis, rosacea, eczema, and warts and is currently employed in some 200 dermatology practices in the U.S., says Trow.

In June, the FDA approved using the N-Lite laser to also treat inflammatory acne vulagris, the most common type. That approval was based on Chu's study, published this week but presented earlier this year before the Royal Society of Medicine in England and at the annual meeting of the American Academy of Dermatology.

It's the latest in a recent series of nonpharmacological treatments being investigated, in part because of growing concern that the bacteria that cause acne may become resistant to antibiotics often used to treat severe cases.

For several years, so-called "blue lights" have been used to kill the bacteria, but with limited success because they don't penetrate skin as deeply as N-Lite -- producing shorter-lived results. And a more powerful laser has also been used on acne, but only on back skin because it can cause irritation, says Chu. Because N-Lite has a different wavelength that doesn't damage skin, it can be used on facial skin and is relatively painless.

Still, one expert not connected with Chu's study -- which was not sponsored by the Wales-based manufacturer of N-Lite -- tells WebMD that it's still too early to determine if this laser will be the "go-to" treatment against acne.

"FDA approval for acne is not the same for lasers as for drugs," says Guy F. Webster, MD, PhD, vice chairman of dermatology at Jefferson Medical College in Philadelphia, who wrote an editorial in The Lancet that accompanies Chu's study. "Drugs have to be shown to work with big studies. Lasers seem to only need to show safety and some response."

Webster notes that the results seen in Chu's study, the first to evaluate N-Lite's potential against acne, was similar to that of benzoyl peroxide, a popular over-the-counter acne medication -- that is, "not insubstantial, but also not enough to satisfy many patients."

Meanwhile, a single N-Lite treatment costs about $600 in the U.S., says Trow. "That's on par with something like Accutane (a prescription medication for severe acne)," he says. "The only problem is that N-Lite isn't covered by insurance. Anything that's new always costs a little more."

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SOURCES: Seaton, E, The Lancet, Oct. 25, 2003; vol 362: pp 1347-1352. Webster, G, The Lancet, Oct. 25, 2003; vol 362: p 1342. Tony Chu, FRCP, consulting dermatologist, Imperial College, London. Robert Trow, PhD, president, USA Photonics, Nanuet, N.Y. Guy F. Webster, MD, PhD, professor and vice chairman, department of dermatology, Jefferson Medical College, Philadelphia.
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