Panchaprateep Ratchathorn, Munavalli Girish
Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
Lasers Surg Med. 2015 Feb;47(2):148-55. doi: 10.1002/lsm.22321. Epub 2015 Feb 2.
Persistent post-acne erythema is one of the most common aesthetic sequelae to arise after active acne resolves. The treatment remains challenging due to lack of effective laser modalities.
To evaluate the safety and efficacy of a low-fluence 585 nm Q-switched Nd:YAG laser for the treatment of post-acne erythema.
MATERIALS & METHODS: Twenty-five patients with post-acne erythema were treated with a low-fluence Q-switched Nd:YAG laser using the 585 nm Gold Toning™ handpiece (5 mm spot size, 5-10 ns, 0.30-0.55 J/cm(2) , 2-4 passes) for three sessions at 2-week intervals. Erythema lesion (macules) count, inflammatory acne (papules, pustules) count, erythema index, degree of post-acne erythema and overall improvement in post-acne erythema and acne scar were assessed at baseline, every 2 weeks and 6 weeks after the last treatment. Subjective degrees of satisfaction were also evaluated. Adverse events were recorded and pain was scored using a visual analog scale (VAS).
At 6 weeks after 3 sessions of laser treatment, all patients demonstrated clinical improvement. Erythema lesion counts decreased by 20.1% (versus baseline) after the first treatment (P = 0.004), by 32.7% after the second treatment, by 46.5% at 2 weeks after the third treatment and by 58.7% at the 6-week follow-up (all P < 0.001). Significant improvements were also noted in erythema indices (22.29 ± 2.4 to 17.51 ± 1.8) and mean post-acne erythema scores after the first treatment (both P < 0.001). The mean scores of independent physician assessments were 4.04 ± 0.9 in term of the improvement of post-acne erythema and 3.44 ± 0.9 in the improvement of scarring. In addition, we could observe a significant decrease in inflammatory acne lesion counts after two laser treatments with a decrease in mean lesion counts by 67% at the 6-week follow-up. Treatment was well-tolerated and adverse effects were limited to transient erythema and edema at treatment sites.
Low-fluence 585 nm Q-switched Nd:YAG laser treatment is safe and effective for the treatment of post-acne erythema with minimal discomfort and quantifiable improvement in the appearance of early acne scarring and inflammatory acne.
痤疮消退后，持久性红斑是最常见的美学后遗症之一。由于缺乏有效的激光治疗方式，其治疗仍然具有挑战性。
评估低能量585nm调Q Nd:YAG激光治疗痤疮后红斑的安全性和有效性。
25例痤疮后红斑患者接受低能量调Q Nd:YAG激光治疗，使用585nm金调肤™手持探头（光斑大小5mm，脉宽5 - 10ns，能量密度0.30 - 0.55J/cm²，照射2 - 4遍），每2周进行1次，共治疗3次。在基线、每次治疗后2周以及最后一次治疗后6周，评估红斑皮损（斑疹）数量、炎性痤疮（丘疹、脓疱）数量、红斑指数、痤疮后红斑程度以及痤疮后红斑和痤疮瘢痕的总体改善情况。同时评估患者主观满意度。记录不良事件，并使用视觉模拟评分法（VAS）对疼痛进行评分。
经过3次激光治疗后6周，所有患者均有临床改善。首次治疗后红斑皮损数量较基线下降20.1%（P = 0.004），第二次治疗后下降32.7%，第三次治疗后2周下降46.5%，6周随访时下降58.7%（所有P < 0.001）。首次治疗后红斑指数（从22.29 ± 2.4降至17.51 ± 1.8）和痤疮后红斑平均评分也有显著改善（均P < 0.001）。独立医生评估的平均评分显示，痤疮后红斑改善方面为4.04 ± 0.9，瘢痕改善方面为3.44 ± 0.9。此外，经过两次激光治疗后，炎性痤疮皮损数量显著减少，6周随访时平均皮损数量减少67%。治疗耐受性良好，不良反应仅限于治疗部位的短暂红斑和水肿。
低能量585nm调Q Nd:YAG激光治疗痤疮后红斑安全有效，不适程度最小，早期痤疮瘢痕外观和炎性痤疮有可量化的改善。
