Laser therapy plus antioxidants improve post-acne dyschromia

Key takeaways:

• Acne vulgaris often results in erythema and hyperpigmentation.
• A combination of nonablative laser therapy and topical antioxidants showed improvement in mean post-inflammatory erythema and hyperpigmentation.

Nonablative laser therapy plus topical antioxidants significantly decreased post-inflammatory dyschromia associated with acne vulgaris, especially in patients with skin of color, according to a study.

“Acne vulgaris (AV) is the most common inflammatory dermatosis worldwide,” Jamie K. Hu, MD, of the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, and colleagues wrote. “While it presents in 95% to 100% of men and 83% to 85% of women during puberty, acne commonly extends into adulthood, and can result in disfiguring sequelae such as scarring, post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH).”  

Patients with facial IE and/or PIH from acne were enrolled in a single-center, prospective, controlled study in which they were randomized to receive treatment with nonablative laser therapy followed by topical Silymarin CF (SkinCeuticals), which contains 0.5% silymarin/0/5% salicylic acid/15% L-ascorbic acid/0/5% ferulic acid (SSAF), or vehicle (glycol serum).

Post-Acne Hyperpigmentation Index (PAHPI), Global Aesthetic Improvement Scale (GAIS) and Mexameter (Evalulab Inc.) erythema and melanin index values, along with blinded observation, were used to determine results. Collagen density was also evaluated using optical coherence tomography.

Of 25 patients (age range, 21-61 years), 20 were skin types III to VI. Also, 24 completed treatment and 20 completed Mexameter measurements.

Mean PAHPI scores decreased from 3.21 to 1.83 in all treatment groups, with those in the SSAF group having an average PAHPI decrease of 1.44, compared with a 1.28 decrease in the laser-only group.

In the SSAF group, GAIS scores improved by an average of 3.35, whereas the average improvement in the laser-only group was 3.1.

In patients with skin types III to VI, a 34% decrease in melanin pigmentation occurred after 12 weeks in the SSAF group. PIH and PIE were also both significantly improved in the SSAF group compared with the laser-only group.

“Although patients receiving the control solution also demonstrated improvement with laser monotherapy, the enhanced clinical response in patients receiving SSAF highlights the benefit of integrated treatment,” the authors wrote.

No adverse events or long-term complications were reported in either group, with average NRPS pain scores being 0.31 in patients who received at least two treatments. Most patients’ pain scores remained at 0 on the 10-point scale, with eight patients reporting pain scores between 0 and 3.