Treatment of Acne Vulgaris Using NAFL in Combination With Isotretinoin and Pricking Blood Therapy
Condition: Acne Vulgaris
MeSH terms: Acne Vulgaris
Study type: Interventional

Summary: 
      BACKGROUND Isotretinoin remains one of the first line medications for moderate-to-severe acne
      vulgaris (AV) but its side effect is a major concern for Asian patients.

      OBJECTIVE Investigators aimed to evaluate the efficacy and safety of the 1,565 nm
      non-ablative fractional laser (NAFL) in combination with isotretinoin and pricking blood
      therapy (PBT) for treatment of AV.

      METHODS A retrospective analysis of 60 patients with moderate-to-severe AV was performed.
      Four groups (n=15) were evaluated: 1,565nm NAFL alone, oral isotretinoin alone, double
      therapy (NAFL + isotretinoin) and triple therapy (NAFL + isotretinoin + PBT).
    

Detailed description: 
      BACKGROUND Isotretinoin remains one of the first line medications for moderate-to-severe acne
      vulgaris (AV) but its side effect is a major concern for Asian patients.

      OBJECTIVE Investigators aimed to evaluate the efficacy and safety of the 1,565 nm
      non-ablative fractional laser (NAFL) in combination with isotretinoin and pricking blood
      therapy (PBT) for treatment of AV.

      METHODS A retrospective analysis of 60 patients with moderate-to-severe AV was performed.
      Four groups (n=15) were evaluated: 1,565nm NAFL alone, oral isotretinoin alone, double
      therapy (1,565 nm non-ablative fractional laser + isotretinoin) and triple therapy (1,565 nm
      non-ablative fractional laser+ isotretinoin + PBT).
    

Intervention name(s): 1,565nm NAFL; Oral isotretinoin; Pricking blood therapy
Intervention type(s): Radiation; Drug; Other
Intervention description(s): 1,565nm M22-ResurFx NAFL can deliver additional benefits to existing acne scar and skin texture. Patients were first treated by the 1,565nm M22-ResurFx NAFL on inflammatory papules and boxcar atrophic scars using round or rectangle light spots with similar sizes of individual lesional papules or scars. The energy fluence was 60 mJ and spot density was 150 spots/cm2. A whole face pass treatment was followed using hexagon or rectangle light spots with fluences of 40-45 mJ, density of 200 spots/cm2 and no overlap on light spots. The end points of the treatment were appearance of localized erythema, edema and bruise on treated areas.; Oral isotretinoin has remained the most effective medication for moderate-to-severe AV.Subjects received oral isotretinoin (Xingyi Yan'an Pharmaceutical, Shanghai, China) (1mg/kg/d for the first 2-4 weeks and 0.5mg/kg/d for the next 12-14 weeks) for a total of 16 weeks. Serum triglycerides, cholesterol and levels of liver enzymes were monitored every month during oral isotretinoin medication.; Pricking blood therapy (PBT) is a modified acupuncture strategy that is adapted to treat inflammatory related diseases. It has been shown to be effective in treatment of many chronic and acute inflammatory conditions including vasomotor rhinitis, acute herpes zoster and acute gouty arthritis,suggesting a potential efficacy for AV as well. At the end point of each session of laser treatment, an acupuncture practitioner performed a PBT in the areas within 1.5 cm radius of the five facial acupoints (Yintang, Zhukong, Sun, Yingxiang, Cuanzhu) (Figure 1). These areas usually appeared intensive erythema. A facial sheet mask was used to clean the face after PBT, and the face was cooled by air cooler for 10 minutes.
Intervention MeSH terms: Isotretinoin
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Acne vulgaris; Acne scars; 1,565 nm non-ablative fractional laser; Isotretinoin; pricking blood therapy